Glossary

Actinic keratosis - a precancerous condition of thick, scaly patches of skin.

Age spots - Also called liver spots, lentigo simplex and senile lentigines, these flat, gray, brown or black spots affect more than 90 percent of fair-skinned people after age 50. They range from freckle-size to a few inches across. They're most common on your face and the backs of your hands - areas most exposed to the sun. They may darken with sun exposure. True age spots never become cancerous and don't need treatment. However, they can look like cancerous growths. For cosmetic reasons they can be lightened with skin-bleaching products or removed. You can help prevent new spots by avoiding the sun and using sunscreen.

Alpha hydroxy acids - used in over-the-counter cleansers, lotions and other products, cause mild shedding of surface skin, a process called exfoliation; higher concentrations of these acids are often used in salon "mini-peels" or in chemical peels.

Antioxidant vitamins - laboratory studies suggest that topical forms of vitamin C may reduce signs of aging and increase production of collagen in skin.

Artecoll - a tissue agent comprised of three ingredients. One of the ingredients, PMMA, is a material used to bind bones and artificial hips. For cosmetic purposes, the PMMA is prepared in smooth microscopic beads specifically sized to go through a fine needle. The two other ingredients include collagen, as a delivery system, as well as a trace dose of anesthetic to minimize discomfort. Artecoll is injected into the target area where the beads provide a lift and support structure beneath the skin. While the injected collagen eventually dissipates, the procedure stimulates production of the patient's own collagen so that it can grow around the beads and serve as a permanent filler.

Atrophy - usually refers to thinning of the epidermis leaving an easily wrinkled and/or shiny surface. Atrophy may also apply to dermal and/or subcutaneous tissue, with or without changes in the epidermis.

Augmentation - Patients seek to augment one or more of the facial regions to give a more youthful and defined appearance to the face. The nasolabial creases and lips usually are augmented with small, soft synthetic implants that are placed deeply in the skin and underlying subcutaneous tissue. Examples are Articoll and Soft Form.

Blepharoplasty - a plastic surgery procedure of the eyelids which removes bags under the eyes and the extra skin of the eyelids. The procedure can be done with a scalpel or with a CO2 laser.

Botox - a purified and weakened form of the same toxin that can cause botulism. Injected under the skin. the toxin can temporarily weaken or paralyze small facial muscles. decreasing frown furrows and laugh and squint lines. The procedure must be repeated every 3 to 6 months. Side effects are rare. In another promising new technique, small, synthetic fibers are injected into your skin to stimulate the growth of collagen at the site. As yet, neither of these injection techniques has received FDA approval for cosmetic use.

Chemical peel - In this procedure, the doctor applies an acid that is stronger than is available in topical creams. The acid (trichloroacetic acid is generally preferred) burns the outer layer of the skin, which peels off, causing new, smoother skin to regenerate. The skin has a scab for about 10 days and is pink for about 3 months. The patient may be left with small scars, and the skin will be permanently lighter and more susceptible to sunburn. Chemical peels can cause blotchy skin in people with darker skin.

Collagen - A fibrous insoluble protein found in the connective tissue, including skin, bone, ligaments, and cartilage that keeps your skin taut. Collagen represents about 30% of the total body protein.

Collagen injections - Collagen from cattle can be injected into deeper wrinkles on the face. The injected collagen smoothes out wrinkles and fills in furrows, such as those around the nose and mouth and between the eyebrows. The collagen degrades over several months but may trigger the body to produce new collagen. The procedure may need to be repeated every few months.

Collagen regeneration - the process whereby the human body produces more collagen and replaces old, worn down collagen secondary to sun damage and aging. Heating of the dermis results in the body regenerating its own collagen.

Cosmetic unit - an area of the body often treated separately from others. Examples of cosmetic units: the skin around the eyes, the skin around the mouth, the cheeks.

Dermabrasion - Fine wrinkles, age spots and scars can be "sanded down" with a small, rotating wheel. Scabbing and swelling generally last a couple of weeks. Complete healing takes longer.

Dermis - The dermis, which lies under the epidermis, makes up about 90 percent of the thickness of your skin. It contains a dense meshwork of collagen and elastin fibers, two types of protein. This meshwork supports lymph and blood vessels, nerves, muscle cells, sweat and sebaceous glands and hair follicles. Collagen and elastin fibers give your skin its strength and elasticity. Sebaceous glands produce an oily substance called sebum. which keeps your skin smooth and moist.

• Papillary dermis - small elevations of the layer of the skin that lie immediately under the epidermis that indent the inner surface of the epidermis; it is 113 microns thick.
• Reticular dermis - layer of connective tissue forming the deeper portion of the dermis; lies beneath the papillary dermis

Epidermis - The skin's outer layer, the epidermis, is a robust and resilient structure and is as thin as a pencil line. It provides a protective layer of skin cells, which are continually shed. The very outer surface is made up of dead skin cells and functions as a physical barrier to protect the deeper dermis, retaining the skin's hydration. Squamous cells lie just below the outer surface. Basal cells, which produce new skin cells, are at the bottom of the epidermis. The epidermis also contains cells (melanocytes) responsible for producing the pigment melanin. The amount of melanin in the skin determines the skin color.

Erosion - a loss of epidermis above the basal layer leaving a denuded surface.

Erythema - Diffuse redness over the skin caused by capillary congestion, usually due to dilatation of the superficial capillaries as a result of some nervous mechanism within the body, inflammation, or some external influence such as heat, exposure to sunlight, or cold.

Fitzpatrick Skin Types - Description of the various types of skin amongst humans as it relates to pigmentation.

• Type I Very white or freckled, always burns
• Type II White, usually burns, tans less than average (with difficulty)
• Type III White to olive, sometimes mild burn, tans about average
• Type IV Brown, rarely burns, above average - black
• Type V Dark, very rarely burns, risk of pigmentation is common
• Type VI Black, never burns, risk of pigmentation very common

Hyperpigmentation - localized increase in skin pigment

Keloid scar - see Scars.

Keratinoeytes - The basic cell type of the epidermis; containing keratin, a fibrous protein, they are produced by basal cells in the inner layer of the epidermis.

Laser skin resurfacing - a controlled vaporizing of the outer layer of skin (epidermis). Layers of skin underneath shrink to tighten skin and eliminate wrinkles. The underlying skin (dermis) eventually heals more tightly and smoothly.

Melanin - The pigment of the skin. The amount of this substance accounts for variations in skin color in different people and different races.

Microdermabrasion - Aluminum oxide crystals are projected onto the skin in a uniform manner to exfoliate layers of the epidermis. These crystals, along with dead skin cells, are vacuumed into a closed filter container and discarded. A control gauge allows for increased vacuum for a more aggressive peel and decreased vacuum for a more gentle peel. Microdermabrasion leaves skin smooth and clean with mild erythema. Blackheads are loosened, whiteheads become unsurfaced, hyperpigmentation lightens and acne scars, enlarged pores and epidermal wrinkles become less prominent. Blood, containing oxygen and nutrients, is drawn to the surface to feed and repair cells. Microdermabrasion is performed in a doctor's office by a doctor, esthetician or nurse or in spa by an Non-ablative skin rejuvenation - non-invasive treatment to reduce the signs of aging; does not require the removal of surface tissue to accomplish collagen regeneration, wrinkle reduction and a more youthful appearance.

Non-ablative skin resurfacing - Techincally this term does not exist as there is no resurfacing or removal of the skin's surface in CoolTouch Thermescent Skin Technique.

Non-invasive - devices or procedures which do not require entering the body or puncturing the skin.

Photoaging - Skin damage caused by the sun.

Pigmentation - Coloration due to deposition of pigments.

• Hyperpigmentation - Increased amount of coloration from pigments Ex: Cafe au lait spots, freckles. Permanent hyperpigmentation can occur as a complication post-sclerotherapy.
• Hypopigmentation - Decreased amount of coloration from pigments Ex: vitiligo.

Rosacea - Common skin condition that causes redness and swelling on the face. Often referred to as "adult acne," rosacea may begin as a tendency to flush or blush easily, and progress to persistent redness in the center of the face that may gradually involve the cheeks, forehead, chin and nose. It also may involve the ears, chest and back. As the disease progresses, small blood vessels and tiny pimples, some of which contain pus, begin to appear on and around the reddened area; however, unlike acne, there are no blackheads. In more advanced cases of rosacea, a condition called rhinophyme may develop. The oil glands enlarge causing a bulbous, enlarged red nose and puffy cheeks. Thick bumps can develop on the lower half of the nose and nearby cheeks.

Scar - A hard plaque of dense fibrotic tissue covered by a thin epidermis. A mark of injury from any sort of process (physical or pathologic). The injured tissue has been replaced by connective tissue. Scars may result from wounds that have healed, lesions of diseases, or surgical operations. When first developed, a scar is red or purple, later whitish and glistening.

• Atrophic scar - Scar that is depressed below the skin
• Hypertrophic scar - Scar that is raised above the skin
• Keloid scar - This fibroid growth of epidermal tissue results from the healing process of surgical incision or traumatic skin injury. There is a greater tendency towards keloids in blacks and fair skinned Caucasians. The etiology is unknown.
• Acne scar - depressed scar that results when acne is picked. Types of acne scars include ice pick, rolling and boxcar. Ice pick scars are deep, well defined and narrow Rolling scars are subtle with an undulating appearance Boxcar scars can be superficial (shallow) or deep Shallow boxcar scars respond best to lasers

Soft Form - synthetic tissue augmentation implant placed in the face used to smooth out wrinkles and furrows.

Solar elastosis - Excessive exposure to sunlight over many years damages collagen and elastin fibers that support skin. This can lead to loose, sagging, tough skin that can look 15 to 20 years older than normal. Solar elastosis is most common in light-skinned people who are often exposed to intense sunlight.

Subcutaneous tissue - Under the epidermis and dermis lies subcutaneous tissue composed primarily of fat. This skin layer insulates and protects your inner organs and helps give your skin its resilience.

Thermescent Skin Technique - A non-invasive treatment that heats the subsurface tissue while preserving the epidermis using 1320 nm laser energy and cryogen cooling spray. There is selective injury only to the upper dermal tissue, which initiates a healing response by the body to stimulate fibroblasts to produce collagen.

T-Max - A measurement of the peak or maximum surface skin temperature obtained following the delivery the laser pulse in Thermescent Skin Treatment.

Wrinkle class - a way of classifying wrinkles by the following description: Glo au Wrinkle Scale

• I No Wrinkles
• II Mild Wrinkling
• III Moderate Wrinkling
• IV Severe Wrinkling