Noemi "Noi" Kaiser
Rock & Roll Tattoo
2457 E Commercial Blvd
Fort Lauderdale, 33308 Florida
Call: 1-954-397-4882



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Archive for the ‘Skin Art’

SECOND SKIN: The Erotic Art of Lingerie: Patrice Farameh …08.01.18

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Events | THE SKIN ART07.22.18

Events | THE SKIN ART Dr. Nidhi S. Tandon was awarded the Health Icon Award 2018 in the field of Dermatology in U.P. by Times of India & Navbharat Times. She was facilitated by Honorable Deputy Chief Minister Dr. Dinesh Sharma. An event organised by FICCI FLO ( Lucknow Kanpur )and Chaired by Dr. Nidhi S. Tandon on Motherhood. The guest of honor was Padmabhushan Smt. Sharmila Tagore Ji Free Consultation & Treatments at IWAAF 2018 Organised by UP Tourism & FICCI FLO Ladies Organisation Dr. Nidhi S.Tandon being facilitated by Chief Minister of U.P Shri Yogi Adityanath Ji. Wonderful session at the skin art clinic on hair care by leading trichologist and hair transplant surgeon dr manjot MarwahThe main aim of the session was to educate about hair products and hair treatments .She covered topics like Shampoos conditioners , hair treatments for damaged hair and the best ways to get healthy hair. Thank You Dr manjot Marwah for sharing all information with our guests. FICCI FLO LkoDated : 10th May 17FICCI FLO Lko- Kanpur Chapter Organised a session on Skin Art & Anti ageing on 10th May 2017. Dr.Nidhi S.Tandon was the speaker at the event and she enlightened the guests with her knowledge on Skin Care & Anti ageing Treatments. Medical Director & Consultant Dermatologist of The Skin Art Clinic Dr. Nidhi S.Tandon exchanging knowledge about skin care & healthy skin with the students of Bhavya Kapurs Makeup Academy.Dated : 9th May 17

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Skin Art By Randy in Gastonia, NC 28054 | Citysearch07.07.18

Randy is the BEST tattoo artist around!! Randy gave me my 1st tattoo and I was VERY pleased. He is an amazing artist! After seeing the awesome detail in my tat…. even my DAD wouldn’t consider going anywhere else!! I highly recommend Skin Art by Randy in Gastonia to ANYONE. Regardless of the type you want. He can do detailed “pictures” and captures the faces outstandingly. He can do more “cartooned” tattoos too!! He is good at what he does and he takes pride in every peice of work he does….

I’ll put it this way… if Randy were to retire, I’d never get another tat!! He’s the only person that I’ll go to! Not to mention how incredibly CLEAN and STERILE his business is! I was VERY VERY happy with the one I have now and plan to get at least 2 more…… but ONLY BY RANDY!!!

THANKS RANDY!!!!!!!!

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Skin Art Gallery – 31 Photos & 33 Reviews – Tattoo – 4297 …05.18.18

33

My boyfriend got his ears pierced and I got a tattoo here. The piercers were efficient, friendly, and clean! Leidi was one of them and I didn’t catch the other girl’s name. I got my tattoo done by Jude and they were excellent accommodating me. They drew up a version of an image I brought in and their style fit me perfectly. I am so happy with how it turned out! The Saniderm they had is also awesome and I wish I had it for my other tattoos I have had done in be past. I would definitely recommend coming here for piercings or tattoos!!

Worked with John on my latest tattoo. Very professional and works to make your idea a reality. I had him do a Steampunk Owl, he had a good design idea for it and made it look great.

Kristie did my tattoo and I absolutely love it. She put her own spin on it and of course being a cat lady too she enjoyed doing the artwork. I plan on going back for more!

Got tattooed by Shayla. So hot, her art is awesome too! Pretty stoked to get back into her bed and get poked!

Very unwelcoming. Came into get a little tattoo and he brushed me off because it wouldn’t make him enough money I guess. Went somewhere else for that because he seemed like a real jerk. But got a dermal piercing removed before asking about the tattoo. The piercer was amazing! I was nervous because they were in my cheeks , but it was soPainless

This is a review for Ryan he’s the guy that’s going to poke you with a needle. Very professional. He’s going to ease you into your piercing session. Place is clean! They have a lot of street cred…why I chose to go here…I’m just here to solidify that!Also great selection of metal 😉

Went in to get my nipples done and was SUPER nervous. Leydi made me feel super comfortable and did an amazing job. It was super clean. Will definitely be recommending this place to friends!

Greatness…Wifey and I got fresh ink by Dan…I saw his work online and reached out to Dan, I sent him a few pics for reference & he killed it!!!We are both very pleased with his work, he exceeded our expectations…looking forward to collaborating with him on future pieces…The shop is clean and staff very professional…Highly recommend…

I have actually been to Skin Art a few times over the past decade. Each iteration I received incredibly friendly service, but my experience today takes the cake. I cannot speak highly enough of Ryan’s (body mod/piercing artist) expertise, professionalism, skill, patience, and artistry. He was confident, knowledgable, and answered all of my questions succinctly and thoroughly all while being incredibly friendly and not the least bit impatient about my pre-piercing nerves.The rest of the staff, while I had very limited dealings with them, were very friendly, and the shop was clean. The atmosphere of the shop is, generally speaking, very comfortable and professional.

I got my daith pierced by Ryan 2 days ago (this was my first inner ear piercing). He was professional and walked me through the process and piercing was over before I knew it. The shop was clean and I was greeted as soon as entered. Good place I will go back for my cartilage.

Was guided to this store by its sister shop, legacy arts tattoo’s. I was getting my first tattoo as well as my gf and her sister. The new tattoo artist, Christie, was extremely patient and helped us walk through the process of getting our tattoo’s. She could not have done the tattoos’ any better, we were extremely happy with it. It was a great experience and will be coming back for more tattoo work.

I stopped in a few times, randomly, to swap out my belly piercing. The guys here are great and always willing to help.

I mainly get work done by the owner Richard Garcia, but every single artist at this shop is a special kind of talented! I am very blessed to have found a shop that is overall amazing! Come here you won’t regret it!!

I was looking for the best place to get my nose pierced and I decided upon this place. I am so glad that I did!! Ryan was the best in explaining the process. This was my second time I got my nose pierced. The first time I had it done the piercer was the worst in giving me after care instructions. Ryan was quick and it was a lot less painful than the last time that I got it done. He was very thorough and provided detailed aftercare instructions. Very Professional. I HIGHLY recommend Skin Art Gallery for piercings.

I went here to get pierced tonight and after a previous bad experience at another parlor, I was a little worried. But the piercer was fantastic and while getting a snug, I didn’t feel any pain, just a pinch and it was all over. I’m already set to get my industrial redone here.

I have wanted to get my daith pierced I called and asked if their piercer was in and spoke to Ryan that said come on in. I showed up and only had a 10 minute wait Ryan was great he did a fantastic job talked me through the whole thing which I appreciate. He pulled the instruments out of the sterilizer in front of me. I would recommend you see Ryan if you want a good painless piercing.

Let me begin by saying that I had neither a tat nor a piercing done here. I did however go in, in search of a new stud for my nostril piercing. While Skin Art had some gorgeous clickers that may have worked, they couldn’t sell any because they said the jewelry belonged to their piercer who was on vacation. Doesn’t seem like anyway to run a business but at least they were polite and referred me to their sister location, Legacy Tattoo in Carrollton. Please read my review for that experience.

Big Mike did a great job on my latest tattoo. Staff was friendly and the place is clean. What more can you ask for in a tattoo shop?Went there on a Saturday night thinking I would just get a price quote, which was very reasonable considering it took two hours of ink time for my job. I noticed a lot of walk-ins, but everyone was greeted nicely and those who wanted to get work done were seen within an hour at most.

Joe Tricomi did a great refresh to my old tattoo. He is the man. He takes his time and really takes pride in his work.

Everyone here is kind. They treat you with respect and help you develop your idea for a tattoo.

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Canmore, Alberta Art of Skin Care Treatment Laser And …03.27.18

Alopecia Treatments

Alopecia refers to medically related hair loss. Alopecia, in most cases, does not pose significant health risks by itself (the exception being the increased risk of skin cancer on the scalp in patients who have lost their scalp hair an important blocker of damaging UV light), but many people seek treatment for their alopecia, because of the social stigma associated with irregular or premature hair loss.

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If you have noticed expression lines or wrinkles on your face, and you are unhappy with them, at Art of SKIN, we have safe and effective solutions for wrinkle reduction.

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There are a variety of different types of cysts that can develop on the skin. They can occur anywhere on the body but commonly occur on the scalp, face, neck, trunk (chest and back), axillae (underarms) and groin. They can occur on the extremities but they are less common. Cysts are noncancerous growths and have a sac-like structure that can be filled with fluid, pus, or other materials.

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As we age, and particularly if we enjoy a lot of outdoor activities, we may see the development of individual age spots or sunspots (medically known as solar lentigines), liver spots (a misnomer, as they are not related to the liver at all), and other signs of chronic sun damage on our skin.

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Patients with multiple moles, moles that are changing in any way, or with a family history of skin cancer of any kind should have their moles routinely examined by a dermatologist. Failure to have melanoma diagnosed in its early stages and treated accordingly can result in significant morbidity for the patient, and even death.

More Info

Rejuvenation of the skin with laser and intense pulsed light (IPL) can effectively treat many or all of these imperfections all at once. Advanced photo-rejuvenation allows for noticeable improvement in the appearance of your skin with little or no discomfort or downtime.

More Info

A scar is a mark left on the skin by the healing of injured or damaged tissue. Scars can be disfiguring, can cause unnecessary unhappiness, and contribute to low self-esteem and self-confidence. In some cases, they can be painful reminders, either psychologically or physiologically, of medical conditions, previous trauma or accidents.

More Info

Rejuvenation of the skin with laser and intense pulsed light (IPL) can effectively treat many or all of these imperfections all at once. Advanced photo-rejuvenation allows for noticeable improvement in the appearance of your skin with little or no discomfort or downtime.

More Info

Acne is a common and often chronic skin disorder that affects teenagers and adults, males and females alike. Unfortunately, acne is often underrecognized and undertreated in our society.

More Info

If you have noticed expression lines or wrinkles on your face, and you are unhappy with them, at Art of SKIN Dermatology, Laser and Cosmetic Surgery, Laser and Cosmetic Surgery, we have safe and effective solutions for wrinkle reduction.

More Info

At Art of SKIN Dermatology and DermaSpa, we offer a variety of chemical peels for a wide range of skin concerns, including, pigmentation reduction, improving the tone and texture of the skin or brightening skin before a big event. Chemical peels are also used to treat active acne. These reasons for the use of chemical peels are in addition to their use for precancerous lesions or acne scarring (to see how chemical peels are used to treat acne scarring, click here).

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Fat Reduction and Body Sculpting refers to a variety of non-surgical and surgical treatments useful for reducing or removing excessive fat from localized areas of the body.

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Significant developments in modern laser technology over the last 2 decades have provided todays cosmetic dermatologists with an incredible arsenal of extremely advanced laser devices and the opportunity to provide our patients with a multitude of safe and effective skin treatment options that have never previously been possible.

More Info

Rejuvenation of the skin with laser and intense pulsed light (IPL) can effectively treat many or all of these imperfections all at once. Advanced photo-rejuvenation allows for noticeable improvement in the appearance of your skin with little or no discomfort or downtime.

More Info

Dermal or subdermal (subcutaneous) filler injection is a safe, common and well-established method used to quickly restore or add volume and fullness to the skin, particularly to the face. Treatment with volumetric fillers is used to subtly or significantly improve the appearance of a tired or aged face by reducing the appearance of folds, lines and wrinkles.

More Info

Wrinkles are a by-product of the aging process. With age, skin cells divide slower, and the inner layer of the skin, called the dermis, begins to thin. The network of elastin and collagen fibers, which support the outer layer, loosens and unravels, which results in depressions on the surface.

More Info

If you have noticed expression lines or wrinkles on your face, and you are unhappy with them, at Art of SKIN, we have safe and effective solutions for wrinkle reduction.

More Info

At Art of SKIN Dermatology and DermaSpa, we offer a variety of chemical peels for a wide range of skin concerns, including, pigmentation reduction, improving the tone and texture of the skin or brightening skin before a big event. Chemical peels are also used to treat active acne. These reasons for the use of chemical peels are in addition to their use for precancerous lesions or acne scarring (to see how chemical peels are used to treat acne scarring, click here).

More Info

Fat Reduction and Body Sculpting refers to a variety of non-surgical and surgical treatments useful for reducing or removing excessive fat from localized areas of the body.

More Info

Significant developments in modern laser technology over the last 2 decades have provided todays cosmetic dermatologists with an incredible arsenal of extremely advanced laser devices and the opportunity to provide our patients with a multitude of safe and effective skin treatment options that have never previously been possible.

More Info

Microneedling (more formally known has Collagen Percutaneous Induction Needling or CPIN) is a method of inducing a controlled injury into the skins dermal and epidermal layers that induces the synthesis of important skin growth factors, and the production of new collagen and elastin.

More Info

Rejuvenation of the skin with laser and intense pulsed light (IPL) can effectively treat many or all of these imperfections all at once. Advanced photo-rejuvenation allows for noticeable improvement in the appearance of your skin with little or no discomfort or downtime.

More Info

Seborrheic keratoses are common, noncancerous skin growths seen in older adults, particularly in people of fair skin. They appear as brown, black or light tan growths anywhere on the body, can be slightly elevated, and are usually painless.

More Info

Wrinkles are a by-product of the aging process. With age, skin cells divide slower, and the inner layer of the skin, called the dermis, begins to thin. The network of elastin and collagen fibers, which support the outer layer, loosens and unravels, which results in depressions on the surface.

More Info

One unfortunate consequence of acne is the potential development of scarring. Some skin scars more easily than others, and some types of acne are more likely to scar than others.

More Info

At Art of SKIN Dermatology and DermaSpa, we offer a variety of chemical peels for a wide range of skin concerns, including, pigmentation reduction, improving the tone and texture of the skin or brightening skin before a big event. Chemical peels are also used to treat active acne. These reasons for the use of chemical peels are in addition to their use for precancerous lesions or acne scarring (to see how chemical peels are used to treat acne scarring, click here).

More Info

Significant developments in modern laser technology over the last 2 decades have provided todays cosmetic dermatologists with an incredible arsenal of extremely advanced laser devices and the opportunity to provide our patients with a multitude of safe and effective skin treatment options that have never previously been possible.

More Info

Liposuction or Body Sculpture as Dr. Lubitz likes to as referred to it as, is a surgical technique that improves the bodys contour by removing excess fat from deposits located between the skin and the muscle.

More Info

Microneedling (more formally known has Collagen Percutaneous Induction Needling or CPIN) is a method of inducing a controlled injury into the skins dermal and epidermal layers that induces the synthesis of important skin growth factors, and the production of new collagen and elastin.

More Info

Rejuvenation of the skin with laser and intense pulsed light (IPL) can effectively treat many or all of these imperfections all at once. Advanced photo-rejuvenation allows for noticeable improvement in the appearance of your skin with little or no discomfort or downtime.

More Info

A scar is a mark left on the skin by the healing of injured or damaged tissue. Scars can be disfiguring, can cause unnecessary unhappiness, and contribute to low self-esteem and self-confidence. In some cases, they can be painful reminders, either psychologically or physiologically, of medical conditions, previous trauma or accidents.

More Info

Dermal or subdermal (subcutaneous) filler injection is a safe, common and well-established method used to quickly restore or add volume and fullness to the skin, particularly to the face. Treatment with volumetric fillers is used to subtly or significantly improve the appearance of a tired or aged face by reducing the appearance of folds, lines and wrinkles.

More Info

Acne is a common and often chronic skin disorder that affects teenagers and adults, males and females alike. Unfortunately, acne is often underrecognized and undertreated in our society.

More Info

One unfortunate consequence of acne is the potential development of scarring. Some skin scars more easily than others, and some types of acne are more likely to scar than others.For this reason, acne should be assessed and treated as soon as possible, while it is still in its early stages, and in most cases by a dermatologist.

More Info

There are a variety of different types of cysts that can develop on the skin. They can occur anywhere on the body but commonly occur on the scalp, face, neck, trunk (chest and back), axillae (underarms) and groin. They can occur on the extremities but they are less common.

More Info

Excessive hair growth occurs for many reasons, such as, hypertrichosis (excessive hair growth for an individuals age, gender or race, or medical reasons, such as hormonal imbalances associated with hirsutism (male patterns of hair growth on a woman).

More Info

Liposuction or Body Sculpture as Dr. Lubitz likes to as referred to it as, is a surgical technique that improves the bodys contour by removing excess fat from deposits located between the skin and the muscle.

More Info

Patients with multiple moles, moles that are changing in any way, or with a family history of skin cancer of any kind should have their moles routinely examined by a dermatologist. Failure to have melanoma diagnosed in its early stages and treated accordingly can result in significant morbidity for the patient, and even death.

More Info

Seborrheic keratoses are common, noncancerous skin growths seen in older adults, particularly in people of fair skin. They appear as brown, black or light tan growths anywhere on the body, can be slightly elevated, and are usually painless.

More Info

Stretch marks, or striae, are very common. While the skin is a remarkable organ that is designed to stretch, if growth or weight gain occurs too rapidly, the skin will intrinsically weaken, a partial tear of sorts, and heal, leaving behind the scars we call stretch marks.

More Info

One unfortunate consequence of acne is the potential development of scarring. Some skin scars more easily than others, and some types of acne are more likely to scar than others.For this reason, acne should be assessed and treated as soon as possible, while it is still in its early stages, and in most cases by a dermatologist.

More Info

At Art of SKIN Dermatology and DermaSpa, we offer a variety of chemical peels for a wide range of skin concerns, including, pigmentation reduction, improving the tone and texture of the skin or brightening skin before a big event. Chemical peels are also used to treat active acne. These reasons for the use of chemical peels are in addition to their use for precancerous lesions or acne scarring (to see how chemical peels are used to treat acne scarring, click here).

More Info

Excessive hair growth occurs for many reasons, such as, hypertrichosis (excessive hair growth for an individuals age, gender or race, or medical reasons, such as hormonal imbalances associated with hirsutism (male patterns of hair growth on a woman).

More Info

As we age, and particularly if we enjoy a lot of outdoor activities, we may see the development of individual age spots or sunspots (medically known assolar lentigines), liver spots (a misnomer, as they are not related to the liver at all), and other signs of chronic sun damage on our skin.

More Info

Liposuction or Body Sculpture as Dr. Lubitz likes to as referred to it as, is a surgical technique that improves the bodys contour by removing excess fat from deposits located between the skin and the muscle.

More Info

Melasma is a common pigmentation condition that is caused by an over production of tyrosinase which over-stimulates the melanocytes of the skin. Once melanocytes are over stimulated, they start producing more pigmentation.

More Info

Rejuvenation of the skin with laser and intense pulsed light (IPL) can effectively treat many or all of these imperfections all at once. Advanced photo-rejuvenation allows for noticeable improvement in the appearance of your skin with little or no discomfort or downtime.

More Info

Stretch marks, or striae, are very common. While the skin is a remarkable organ that is designed to stretch, if growth or weight gain occurs too rapidly, the skin will intrinsically weaken, a partial tear of sorts, and heal, leaving behind the scars we call stretch marks.

More Info

At Art of SKIN Dermatology and DermaSpa, we offer a variety of chemical peels for a wide range of skin concerns, including, pigmentation reduction, improving the tone and texture of the skin or brightening skin before a big event. Chemical peels are also used to treat active acne. These reasons for the use of chemical peels are in addition to their use for precancerous lesions or acne scarring (to see how chemical peels are used to treat acne scarring, click here).

More Info

As opposed to simply addressing specific fine lines, wrinkles or facial skin folds, the fat transfer procedure addresses the whole face, producing dramatic yet naturallooking results.

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Canmore, Alberta Art of Skin Care Treatment Laser And …

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ZO Skin Centre – Beverly Hills, CA03.27.18

ZO Skin Centre – Beverly Hills, CA

Whether you’re looking for a revitalizing facial treatment, a therapeutic peel, a Botox treatment or any other anti-aging skin care, our four southern California locations will cater to your every need. We’re also your source for the full line of ZO products, formulated specifically to support and enhance your personal skin health procedures.

While you’re shopping for the perfect look on Rodeo Drive, stop by ZO Skin Centre in Beverly Hills to make sure your skin is as stunning as your outfit. Our full-service cosmetic dermatology practice offers dermatological consultations and medical grade ZO facial treatments, or pick up your favorite ZO skin care products.

Beverly Hills Hours

Monday through Friday 9am 5pm

Saturday 9am 1pm

Our Staff can speak four languages including English, Spanish, Arabic, and Russian.

Enjoy the sunny days of Southern California, but make sure your skin stays healthy with visits to ZO Skin Centre in Laguna Beach and Newport Beach. Learn about the ZO Skin Health Circle to treat, maintain, and protect your complexion.

Laguna Beach Hours

Tuesday through Friday 9am 5pm

Saturday 9am 4pm

Newport Beach Hours

Monday through Friday 10am 8pm

Saturday 10am 7pm and Sunday 11am – 6pm

Our Laguna Beach Staff can speak two languages including English and Spanish.

Our Newport Beach Staff can speak two languages including English and Farsi.

Keep your skin radiant and youthful at ZO Skin Centre full-service cosmetic dermatology practices in Pasadena. The experienced team of ZO skin care professionals will create a customized plan to get your best results.

Pasadena Hours

Tuesday through Saturday 9am 6pm

Our Pasadena Staff can speak six languages including English, Spanish, Tagalog, Cantonese, Mandarin, and Amharic.

2018 ZO Skin Centre | Powered By: DoctorLogic

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Skin care: 5 tips for healthy skin – Mayo Clinic03.23.18

3. Treat your skin gently

Daily cleansing and shaving can take a toll on your skin. To keep it gentle:

A healthy diet can help you look and feel your best. Eat plenty of fruits, vegetables, whole grains and lean proteins. The association between diet and acne isn’t clear but some research suggests that a diet rich in fish oil or fish oil supplements and low in unhealthy fats and processed or refined carbohydrates might promote younger looking skin. Drinking plenty of water helps keep your skin hydrated.

Uncontrolled stress can make your skin more sensitive and trigger acne breakouts and other skin problems. To encourage healthy skin and a healthy state of mind take steps to manage your stress. Get enough sleep, set reasonable limits, scale back your to-do list and make time to do the things you enjoy. The results might be more dramatic than you expect.

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Skin care: 5 tips for healthy skin – Mayo Clinic

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Bionyx Skin Care03.21.18

I have suffered from HUGE pores and acne issues all my life. This was before I realized that my biggest issue was that my skin was very dry, which always put my oil glands into overdrive. A friend recommended Bionyx products, and I am very happy with the results. Pricy products, but no regrets! I use the day moisturizer every morning right after a shower, and within one week, my pores look smaller. The moisturizer also brings about a nice glow and makes those super huge pores less noticeable.

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I was using a drug store serum for the past few years, but it didnt seem to offer anything special. Finally decided to try switching to a luxury product, and came across Bionyx. I am so happy to have chosen this brand, because in a week, my skin looks so much better. The wrinkles seem diminished and the face has a beautiful glow that just makes my day every morning. Make sure that you order your product quickly. Im sure this will sell out fast.

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I usually get my peels done at a spa, but this has turned out to be so much cheaper and better. Yes, the product is quite expensive, but it lasts you for a really long time. So I am sure it is cheaper in the long run. One of my biggest complaints with at-home serums was that they always led to burning and redness. However, this particular facial peel is extremely gentle on the skin. It actually exfoliates more skin than a spa session and leaves my face feeling refreshed and glowing. No redness or irritation. LOVE THIS PRODUCT.

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I have almost always had puffy eyes and I have tried so many products, to no avail. Nothing ever seemed to help. I must admit that I was a bit sceptical when I first came across Bionyx, it just sounded too good to be true. But, this stuff actually works! I bought the cream a week ago, and use it every morning. Just dab it a little around the eyes, and the skin looks healthier already. The puffiness as well as the fine lines around my eyes seem lesser. YAY.

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Bionyx Skin Care

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Body painting – Wikipedia03.19.18

Body painting, or sometimes bodypainting, is a form of body art. Unlike tattoo and other forms of body art, body painting is temporary, painted onto the human skin, and can last several hours or many weeks (in the case of mehndi or “henna tattoos”) about two weeks. Body painting that is limited to the face is known as face painting. Body painting is also referred to as (a form of) “temporary tattoo”; large scale or full-body painting is more commonly referred to as body painting, while smaller or more detailed work can sometimes be referred to as temporary tattoos.

Body painting with clay and other natural pigments existed in most, if not all, tribalist cultures. Often worn during ceremonies, it still survives in this ancient form among the indigenous people of Australia, New Zealand, the Pacific islands and parts of Africa. A semi-permanent form of body painting known as Mehndi, using dyes made of henna leaves (hence also known rather erroneously as “henna tattoo”), is practiced in India, especially on brides. Since the late 1990s, Mehndi has become popular amongst young women in the Western world.

Many indigenous peoples of Central and South America paint Jagua Tattoos, or designs with Genipa americana juice on their bodies. Indigenous peoples of South America traditionally use annatto, huito, or wet charcoal to decorate their faces and bodies. Huito is semi-permanent, and it generally takes weeks for this black dye to fade.[1]

Body painting is not always large pieces on fully nude bodies, but can involve smaller pieces on displayed areas of otherwise clothed bodies. There has been a revival of body painting in Western society since the 1960s, in part prompted by the liberalization of social mores regarding nudity and often comes in sensationalist or exhibitionist forms.[2] Even today there is a constant debate about the legitimacy of body painting as an art form. The current modern revival could be said to date back to the 1933 World’s Fair in Chicago when Max Factor, Sr. and his model Sally Rand were arrested for causing a public disturbance when he body-painted her with his new make-up formulated for Hollywood films.[3] Body art today evolves to the works more directed towards personal mythologies, as Jana Sterbak, Rebecca Horn, Youri Messen-Jaschin, Jacob Alexander Figueroa or Javier Perez.

Body painting is sometimes used as a method of gaining attention in political protests, for instance those by PETA against Burberry.

Body painting led to a minor alternative art movement in the 1950s and 1960s, which involved covering a model in paint and then having the model touch or roll on a canvas or other medium to transfer the paint. French artist Yves Klein is perhaps the most famous for this, with his series of paintings “Anthropometries”. The effect produced by this technique creates an image-transfer from the model’s body to the medium. This includes all the curves of the model’s body (typically female) being reflected in the outline of the image. This technique was not necessarily monotone; multiple colors on different body parts sometimes produced interesting effects.

Joanne Gair is a body paint artist whose work appeared for the tenth consecutive year in the 2008 Sports Illustrated Swimsuit Issue. She burst into prominence with an August 1992 Vanity Fair Demi’s Birthday Suit cover of Demi Moore.[4][5] Her Disappearing Model was part of an episode of Ripley’s Believe It or Not!.[6]

Body painting festivals happen annually across the world, bringing together professional body painters and keen amateurs. Body painting can also be seen at some football matches, at rave parties, and at certain festivals. The World Bodypainting Festival is a week-long festival which originated in 1998 and which has been held in Klagenfurt, Austria since 2017. Participants attend from over fifty countries and the event has more than 20,000 visitors.

Body painting festivals that take place in North America include the North American Body Painting Championship, Face and Body Art International Convention in Orlando, Florida, Bodygras Body Painting Competition in Nanaimo, BC and the Face Painting and Body Art Convention in Las Vegas, Nevada.

Australia also has a number of body painting festivals, most notably the annual Australian Body Art Festival in Eumundi, Queensland[7] and the Australian Body Art Awards.[8]

In Italy, the Rabarama Skin Art Festival (held every year during the Summer and Autumn, with a tour in the major Italian cities), is a different event focused on the artistic side of body painting, highlighting the emotional impact of the painted body in a live performance[9] more than the decorative and technical aspects of it. This particular form of creative art is known as “Skin Art”.[10]

The 1960s supermodel Veruschka is a much appreciated muse for bodypaint artists. Images of her in the book Transfigurations by photographer Holger Trulzsch have frequently been emulated. Other well-known works include Serge Diakonoff’s books A Fleur de Peau and Diakonoff and Joanne Gair’s Paint a licious. More recently Dutch art photographer Karl Hammer has taken center stage with his combinations of body painting and narrative art (fantastic realism)

Following the already established trend in Western-Europe, body painting has become more widely accepted in the United States since the early 1990s. In 2006 the first gallery dedicated exclusively to fine art body painting was opened in New Orleans by World Bodypainting Festival Champion and Judge, Craig Tracy. The Painted Alive Gallery is on Royal Street in the French Quarter. In 2009, a popular late night talk show Last Call with Carson Daly on NBC network, featured a New York-based artist Danny Setiawan who creates reproductions of masterpieces by famous artists such as Salvador Dal, Vincent van Gogh, and Gustav Klimt on human bodies aiming to make fine art appealing for his contemporaries who normally would not consider themselves as art enthusiasts.

Since 2005 the Australian visual artist Emma Hack has been creating photographs of painted naked human bodies that visually merge with a patterned background wall inspired by the wallpaper designs of Florence Broadhurst. Hack is best known for the Gotye music video for the song Somebody That I Used to Know, which uses stop-motion animation body painting and has received over 800 million views on YouTube.[11] Hack now creates her own canvas backgrounds and her work is often featured with live birds, representing nature. Hack’s artworks are exhibited worldwide.

Los Angeles artist, Paul Roustan, is known for his work in body painting and photography which spans both the fine art and commercial worlds. His body painting has garnered numerous awards, including winner of the North American Body Paint Championships.[13]

Many artists work professionally as body painters for television commercials, such as the Natrel Plus campaign featuring models camouflaged as trees. Stills advertising also used body painting with hundreds of body painting looks on the pages of the world’s magazines every year. Body painters also work frequently in the film arena especially in science fiction with an increasing number of elaborate alien creations being body painted.

Syl Verberk (nicknamed ‘syllie faces’) is a commercial body paint artist who, as a two-time European champion and winner of various prizes, is frequently consulted by major companies and theme parks for their advertisements and designs. Other celebrated commercial artists are Guido Daniele, Jean-Paul Bourdier and the Australian company “Human Statue Bodyart”.

The Sports Illustrated Swimsuit Issue, published annually, has frequently featured a section of models that were body painted, attired in renditions of swimsuits or sports jerseys. Also Playboy magazine has frequently made use of body painted models. In the 2005 Playmates at Play at the Playboy Mansion calendar, all Playmates appeared in the calendar wearing bikinis, but Playmates Karen McDougal and Hiromi Oshima actually appeared in painted-on bikinis for their respective months.

The success of body painting has led to many notable international competitions and a specific trade magazine (Illusion Magazine [14]) for this industry, showcasing work around the world.

Face painting is the artistic application of cosmetic “paint” to a person’s face. There are special water-based cosmetic “paints” made for face painting; people should ask before having face paints applied what products are being used. Acrylic and tempera craft paints are not meant for use on skin and are not acceptable, nor are watercolor pencils or markers. Products not intended for use on skin can cause a variety of issues ranging from discomfort to severe allergic reactions.[15] Just because the product is marked “non-toxic” does not mean it is meant to be used on the skin.

From ancient times, it has been used for hunting, religious reasons, and military reasons (such as camouflage and to indicate membership in a military unit). Recent archaeological research shows that Neanderthals had the capability and tools for face painting; although they are no longer considered a direct ancestor of homo sapiens, they lived alongside them in some areas and it is a reasonable assumption that humanity has painted faces and bodies since the very beginning.

In some forms of folk dance, such as Border Morris, the faces of the dancers are painted with a black pigment in a tradition that goes back to the Middle Ages. In the 18th century cosmetic face painting became popular with men and women of the aristocracy and the nouveau riche,[16] but it died out in Western culture after the fall of the French aristocracy. During the 19th century blackface theatrical makeup gained popularity when it was used by non-black performers to represent black people, typically in a minstrel show.[17] Its use ended in the United States with the Civil Rights Movement of the 1960s[18] at about the same time that face painting re-entered the popular culture as part of the hippie movement of the late 1960s, when it was common for young women to decorate their cheeks with flowers or peace symbols at anti-war demonstrations.

Actors and clowns around the world have painted their facesand sometimes bodiesfor centuries, and continue to do so today. More subdued form of face paints for everyday occasions evolved into the cosmetics we know today.

For several decades it has been a common entertainment at county fairs, large open-air markets (especially in Europe and the Americas), and other locations that attract children and adolescents. Face painting is very popular among children at theme parks, parties and festivals throughout the Western world. Though the majority of face painting is geared towards children, many teenagers and adults enjoy being painted for special events, such as sports events (to give support to their team or country) or charity fund raisers. Face painting is also a part of cosplay practice, and is enjoyed yearly by people who dress up as zombies to dance with the annual worldwide “Thrill the World” event on the Saturday before Halloween.

It is common to find if someone is dressed in an animal costume, a black nose will be added alone to give the impression of an animal face and not just body. Sometimes, a full face is added or sometimes none at all.

Most theme parks have booths scattered around where a person can have a design painted on their face. A similar activity is the application of “instant tattoos”, which are paint or ink-based designs that are put on as one unit and removed by means of water, alcohol, soap, or another mild solvent. More elaborate temporary tattoos may be made using stencils and airbrush equipment.

It is common in armies all over the world for soldiers in combat to paint their faces and other exposed body parts (hands, for example) in natural colors such as green, tan, and loam for camouflage purposes. In various South American armies, it is a tradition to use face paint on parade in respect to the indigenous tribes.[19]

As well as paint, temporary tattoos can be used to decorate the body. “Glitter tattoos” are made by applying a clear, cosmetic-grade glue (either freehand or through a stencil) on the skin and then coating it with cosmetic-grade glitter. They can last up to a week depending on the model’s body chemistry.

Foil metallic temporary tattoos are a variation of decal-style temporary tattoos, printed using foil stamping technique instead of ink. On the front side, the foil design is printed as a mirror image in order to be viewed in the right direction once it is applied to the skin. Each metallic tattoo is protected by a transparent protective film.

Modern water-based face and body paints are made according to stringent guidelines, meaning these are non-toxic, usually non-allergenic, and can easily be washed away. Temporary staining may develop after use, but it will fade after normal washing. These are either applied with hands, paint brush, and synthetic sponges or natural sea sponge, or alternatively with an airbrush.

Contrary to the popular myth perpetuated by the James Bond film Goldfinger, a person is not asphyxiated if their whole body is painted.[20]

Liquid latex may also be used as body paint. Aside the risk of contact allergy, wearing latex for a prolonged period may cause heat stroke by inhibiting perspiration and care should be taken to avoid the painful removal of hair when the latex is pulled off.

The same precautions that apply to cosmetics should be observed. If the skin shows any sign of allergy from a paint, its use should immediately be ceased. Moreover, it should not be applied to damaged, inflamed or sensitive skin. If possible, a test for allergic reaction should be performed before use. Special care should be paid to the list of ingredients, as certain dyes are not approved by the US FDA for use around the eye areagenerally those associated with certain reddish colorants, as CI 15850 or CI 15985or on lips, generally blue, purple or some greens containing CI 77007.[21][22] More stringent regulations are in place in California regarding the amount of permissible lead on cosmetic additives, as part of Proposition 65.[23] In the European Union, all colorants listed under a CI number are allowed for use on all areas. Any paints or products which have not been formulated for use on the body should never be used for body or face painting, as these can result in serious allergic reactions.

As for Mehndi, natural brown henna dyes are safe to use when mixed with ingredients such as lemon juice. However, a commonly marketed product called “black henna”, is not safe to use because the product has been made by mixing natural henna with synthetic black dyes containing PPD, which can cause serious skin allergies, and should be avoided due to the substantial risk of serious injury.[24] Another option is Jagua, a dark indigo plant-based dye that is safe to use on the skin and is approved for cosmetic use in the EU.

Hands and faces can be marbled temporarily for events such as festivals, using a painting process similar to traditional paper marbling, in which paint is floated on water and transferred to a person’s skin. Unlike the traditional oil-based technique for paper, neon or ultraviolet reactive colours are typically used, and the paint is water-based and non-toxic.[25][26]

“Hand art” is the application of make-up or paint to a hand to make it appear like an animal or other object. Some hand artists, like Guido Daniele, produce images that are trompe l’oeil representations of wild animals painted on people’s hands.

Hand artists work closely with hand models. Hand models can be booked through specialist acting and modeling agencies usually advertising under “body part model” or “hands and feet models”.

Body painting features in various media. The popular TV variety show, Rowan & Martin’s Laugh-In, featured bodies painted with comedic phrases and jokes during transitions. The Pillow Book, a 1996 film by Peter Greenaway, is centred on body painting. The 1990 American film Where the Heart Is featured several examples of models who were painted to blend into elaborate backdrops as trompe-l’il. Skin Wars is a body painting reality competition hosted by Rebecca Romijn that premiered on Game Show Network on August 6, 2014.

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Body painting – Wikipedia

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Skin and Medical Topics – The Skin Center10.25.17

Mohs Surgery

What is Mohs micrographic Surgery (MMS)? Where can I have Mohs Surgery? How long does the surgery take? What kind of physician can perform Mohs Surgery? Where can I find a doctor board certified in Mohs? Is Mohs only for skin cancer? Can I remove my moles using Mohs? Am I a good candidate for Mohs Surgery? What if I have artificial joints or other health issues? What areas are treatable by Mohs Surgery? What are possible complications of Mohs? Is there scarring from surgery? What are alternatives for Mohs Surgery? What about plastic surgery? What about insurance coverage and costs? How do I prepare for my surgery? Can I smoke and drink alcohol before surgery? How is recovery? Can I return to work or school? Is there pain after surgery? What is the chance that my cancer will recur? Can I go out in the sun after surgery? How are skin cancers treated? Why is it called Mohs?

What is Mohs micrographic Surgery (MMS)?Mohs micrographic surgery is a minor surgical procedure and special method of removing skin cancers using local anesthesia (numbing). The majority of cases are performed right in the physicians office. Mohs is a very precise, highly detailed technique whereby small layers of skin are removed and immediately examined under the microscope to make sure the skin cancer is completely removed.

The procedure uses frozen sections of skin which are then stained with special dyes. The dyed frozen pieces of skin are further examined under the microscope and a tumor map is drawn by the Mohs surgeon. The freezing process allows an immediate examination of the entire tumor margin and tissue histology (microscopic examination of cells).

If more cancer cells or roots are seen under the microscope, then another skin layer is removed and again examined. Each time that a skin level is removed, it is called a level. If no more cancer roots are seen, then it is called clear (no more tumor) and no additional levels are needed.

By removing only tissue where cancer is known to be present, the technique combines a very high cure rate with good preservation of normal skin. Once the cancer has been fully removed, the Mohs surgeon looks at the wound to determine the way to get the best wound repair and cosmetic result for you.

Mohs is special because the entire edge and under-surface of each skin cancer layer is carefully examined under the microscope for the presence of very small cancer cells. With regular or traditional surgery only about 1 to 3% of the tumor margins are actually examined thereby increasing the chances that a small tumor root would be missed and left behind. Mohs allows for examination of 100% of the tumor margins thereby reducing the chance that tumor cells will be left behind.

Mohs is usually scheduled only on certain days in the doctors office because of the required equipment, tissue stains (dye), Mohs technologists, and microscopes. Most of these procedures are generally performed with the patient waiting in the office for the tissue to be read or interpreted by the Mohs surgeon.

Where can I have Mohs Surgery?Mohs micrographic surgery is usually performed in an outpatient setting like a doctors office and under local anesthetic (lidocaine). Sometimes the procedure may be performed in an outpatient surgical center with the assistance of an anesthesiologist. Rarely, it is performed in an inpatient hospital setting.

How long does the surgery take?You are generally in the medical office for several hours( average 2-7 hours) on the day of your Mohs procedure. Depending on how large or difficult your skin cancer is, different numbers of levels may be required to achieve clearance. Mohs requires your patience and your doctors careful effort and skill. It is not always possible to predict ahead of time how many hours your specific procedure will take. Most patients leave their days schedule open to allow for adequate time to complete their Mohs.

What kind of physician can perform Mohs Surgery?Most Mohs surgeons are specially trained dermatologists. There are also some plastic surgery, or Ear , Nose and Throat ( ENT) surgeons who are trained and may also perform Mohs.

Where can I find a doctor board certified in Mohs?There is no current Board Certification for Mohs Surgery. There are two nationally recognized and respected national Mohs specialty groups called the American College of Mohs Surgery and the American Society for Mohs Surgery (ASMS).Both of these medical groups have specialty training and certification exams for their members. Members of The American College of Mohs Surgery usually have completed an additional 1 to 2 years of Mohs training. Members of the American Society for Mohs Surgery are also trained and required to actively participate in an annual quality control Mohs slide peer review.

Is Mohs only for skin cancer?Yes, Mohs is a widely used method of surgically removing the most common types of skin cancers including basal cell carcinoma and squamous cell carcinoma. It is currently not used to remove non-cancerous growths.Less frequently, Mohs may also be used for other malignant tumors. In special cases, Mohs may be used to surgically treat malignant melanoma, lentigo maligna, dermatofirosarcoma protuberans, merkel cell tumor, microcystic adnexal carcinoma, malignant trichoepithelioma, angiosarcoma, atypical fibroxanthoma and other cancerous tumors. However, most Mohs surgeons treat primarily basal and squamous cell cancers by this technique.

Can I remove my moles using Mohs?

No, Mohs is usually not for mole removal. It is primarily designed for removing skin cancers. Moles are usually removed by standard or traditional surgery.

Am I a good candidate for Mohs Surgery?You may not be a good candidate for Mohs if you are unable to tolerate local anesthesia, have extreme anxiety, have a surgical phobia, or are in very poor health.Your decision on the best treatment choice may depend on different factors such as the location and type of skin cancer, your past treatments, your overall health, and level of comfort. Your physician can help you sort through the different treatments and assist in your shared decision making process. However, the right decision for you is always yours and your doctors to make.

What if I have artificial joints or other health issues?Your Mohs surgeon needs to know of any other medical conditions that may affect your surgery or wound healing. You would want to make sure to tell your surgeon beforehand if you have any artificial parts (implants) like knees or hips , a pacemaker or defibrillator, or need to take antibiotics before dental procedures because of a heart condition or murmur.Your Mohs surgeon needs to know if you have had a history of Staph or other skin infections in the recent past. You may be asked to wash with a special antibiotic soap or wash like Hibiclens ( Chlorhexidine) the night or morning before surgery to help reduce the number of bacteria on your skin.

Patients need to also advise their surgeon of any drug allergies such as to anesthetics like lidocaine, xylocaine, epinephrine, or novacaine. Additionally, the surgeon may need to know of any bleeding or bruising tendencies, Hepatitis, HIV/ AIDS, or pregnancy.

What areas are treatable by Mohs Surgery?Mohs is used primarily for the treatment of head and neck basal and squamous cell skin cancers. It is particularly useful for skin cancers in difficult areas such as nose, lips, ears, and genitals.

It is also used on hands and feet where there is not a lot of extra tissue for bigger surgical removals. Mohs is very effective for the treatment of recurrent tumors (tumors that were previously removed and have re-grown at the same site). However, depending on the specific patient and tumor type, any area of the body may be treated by Mohs surgery.

What are possible complications of Mohs?As with any surgery or procedure , Mohs is associated with some possible risks and complications. While it is overall a very safe and effective minor surgical treatment, there are some possible uncommon complications. Since a scar usually forms anytime you cut the skin, most patients understand and expect some type of a scar after skin cancer removal.

Possible risks and complications of Mohs include (but are not limited to) bleeding, bruising, wound infection, pain, unsightly scar, keloid ( raised, thick scar), cosmetic disfigurement, skin discoloration, nerve damage, allergic reactions, pain, reaction to local anesthesia, widened or sunken in( depressed) scar, wound opening ( dehiscence) and spitting or retained stitches, cancer recurrence, need for further surgery or treatment including radiation or plastic surgery, and rarely death.

Minor, serious, or life threatening reactions can occur with the use of anesthetics or with medications given before, after or during surgery. Nerves controlling muscle movement, sensation, or other functions may be damaged. This nerve damage may be permanent.Overall, most patients tolerate the minor surgery very well without any complications.

What is reconstruction?Reconstruction is repairing or fixing the wound.

Repairing or closing the wound may involve having your surgeon stitch the wound closed side by side. Sometime an area may heal better by letting the wound heal in by itself naturally without stitches. Additional reconstruction options include using a skin graft, moving a flap of skin, and plastic surgery closure.

Shared decision making is very important in this part and you are involved in how you prefer to repair the wound. Your Mohs surgeon may make some recommendations on how to close your wound.

The main goal with Mohs surgery is to remove the skin cancer first. Once the cancer is cleared out, then your Mohs surgeon will look at how to best fix the area. The goal of Mohs is to clear skin cancer, achieve the smallest scar, and preserve normal tissue.

Is there scarring from Mohs surgery?Yes, all human beings heal by permanent scar formation. In general, when you cut the skin, there will be some type of scar. Some people heal better than others. Some scars are more noticeable depending on the location and skin type.

There are many options for treatment of surgical scars including lasers, scar creams and gels, cortisone injections, and many other choices depending on the scar. You may want to discuss ways to help minimize scarring with your doctor at your stitch removal appointment.

What are alternatives for Mohs Surgery?It is important to understand that there are alternative treatments and options to Mohs. Additional treatment choices include (but are not limited to) local radiation, prescription topical creams, plastic surgery, curettage and desiccation (scrape and burn), regular surgery, chemotherapy creams or injections, cryosurgery ( deep freezing), photodynamic therapy ( uses a type of light and a light activated chemical called a photosensitizer).

What about insurance coverage and costs?Mohs surgery is generally considered a medical service and is not considered cosmetic. Currently, most insurance plans cover the procedure under their provided benefits. However, with the many changes in insurance plans, it is always advisable to contact your insurance carrier prior to scheduling surgery and confirm your eligibility and benefits.

Mohs, like any surgical procedure, will result in additional procedure charges above the routine office visit fees. These surgical fees may range from one to two thousand dollars depending on the area, number of Mohs levels, and the type of closure or repair required. The more number of levels required, the higher the cost. Surgical centers and hospitals usually have a much greater costs associated with a facility fee in addition to the surgery fee.

Insurance benefits vary and reimbursement depends on what benefits you have contracted for with your company. Currently, Medicare generally covers 80% of Mohs cancer surgery. If you have a secondary insurance plan, that may help take care of the remainder 20% not covered by Medicare.

Commercial or non-Medicare insurances currently generally cover a large percentage of your surgery unless you have to meet an out of pocket deductible first. You may want to get to know and understand your insurance benefits before having surgery. In many cases, you may also ask the billing office at the medical center or hospital for an approximate estimate of your charges before scheduling the procedure.

What about plastic surgery?You may decide to have regular surgery with a plastic surgeon instead of having Mohs.

Alternatively, you may also choose a hybrid option where your Mohs surgeon removes the tumor and clears it for you and then you have the plastic surgeon fix up the wound and stitch it up for you.

If you prefer to have your plastic surgeon repair the wound, you will want to let your plastic surgeon and dermatologist know ahead of time and plan that into your Mohs schedule.

Heavy alcohol use is not advised at least one week before surgery. Heavy alcohol use can cause more bleeding and thin your blood. An occasional glass of wine or small cocktail may not cause severe bleeding. Your physician will want to know of any factors that may affect your surgery or wound healing.

How is recovery?Recovery is usually very easy and uneventful. Overall, resting as much as possible the first few days after surgery is generally helpful.

Stitches (sutures) are usually removed at the surgeons office anywhere from 4-14 days from the date of surgery. Your physician will let you know what date to return for stitch removal .

Can I return to work or school?Most patients are able to return to work or school the same day or next day after Mohs. Avoiding heavy lifting, straining, or strenuous exercise for 7-21 days may be required depending on the area of surgery. Your physician will need to let you know what activity precautions are required based on the area and size of your procedure.

Is there pain after surgery?Most patient report no or minimal discomfort after surgery and require no pain medication.

If there is pain, many patients find that they prefer to take something for pain at the first hint of discomfort instead of waiting until the pain builds up to an unbearable level. If you have mild or moderate pain, your doctor may advise you to take Tylenol (Acetaminophen) or another pain reliever over the counter. Aspirin or Aspirin containing pain relievers may cause increased bleeding. Rarely, prescription pain medications may be required for severe pain.

Your physician will let you know what pain medications are recommended for your specific condition.

How do I take care of my surgical area after Mohs?It is generally required to check with your surgeon for their specific wound care instructions just after surgery.Often, you will be asked to go home and take it east for the rest of the day couch potato day. A few patients like to return to work and resume their work day after surgery.

It may be advisable to avoid heavy lifting and exercise especially the first 24-48 hours after surgery. Your physician will usually give you more detailed instructions depending on the area and size of the surgery.

You will have usually have a bulky pressure dressing on the surgery area for 1 day. You may be asked to keep the area dry until 24 hours. Swimming pools, oceans, and jaccuzis are usually off limits while the stitches are in. These may increase your chance of infection. Many physicians allow you to shower the next day after surgery. Wound care may require cleaning the wound with soap or hydrogen peroxide 2-3 times a day and applying an over the counter antibiotic ointment to the area.

Mild swelling is not uncommon the 1st day or two after surgery and can be lessened by use of an ice bag, ice cubes or chips in a small Ziplock baggie, or frozen peas in their bag. Leaving the dressing in place, ice use every 5-15 minutes every hour for the first 8-24 hours after surgery. Swelling is more common around for surgeries around the eyes or lips. Sleeping propped up on a few pillows or in a reclining chair may help decrease swelling after surgery of the head and face area.The surgical area may ooze a little blood or clear liquid especially in the first few hours after surgery; activity may aggravate this. Hot drinks or bending over at the waist can also initiate or worsen bleeding of face wounds. If bleeding occurs, firm pressure applied directly to for ten to fifteen minutes to the site may be helpful. Most bleeding will stop if you apply enough pressure. Your surgeon should be notified of non-stopping bleeding. Rarely, a visit to the hospital emergency room may be necessary for severe bleeding.Your surgeon will need to know if pain is increasing after 1-2 days after your surgery or you are having fever or other concerning symptoms. In such cases, you may need to be seen at the surgeons office. The surgical area may need to be promptly checked for bleeding or infection.

Limiting hot foods, hot drinks, and heavy chewing for 48 hours may help decrease the chances of postoperative bleeding for wounds around the mouth or cheek areas.

Your physician will let you know their recommended wound care.

What about makeup?Most patients are advised to try to avoid applying makeup or powder directly on a fresh wound unless the surface is fully healed. Skin colored tape strips called steristrips are available to minimize and help cover-up a visible wound.It is important to follow your own physicians instructions for wound care.

What is the chance that my cancer will recur?There is a very low chance that your skin cancer will recur after Mohs surgery. Mohs cure rates have been reported as high as 96-99%.It is important to understand that no cancer treatment or surgery has a 100% cure rate. A skin cancer may recur or a new cancer may arise in the same or adjacent area even after Mohs or other surgery. Some skin cancers are more aggressive than others and need additional treatment and closer follow up.Skin cancers frequently need additional follow up and possible further treatment. Although Mohs surgery tends to have the highest cure rate compared to other treatments, Mohs may not be necessarily curative in advanced skin cancer ( rare cases) and may need one or more procedures such as radiation or further surgery to fully treat the lesion.Good follow up appointments with your physician are very important, especially in the first few years after Mohs. Many patients are seen every 4-6 months after their diagnosis of a skin cancer. Self skin examinations monthly are good practice for patients with a history of skin cancer. Any changing or new growth should be promptly checked by your physician. More regular follow up appointments may be needed for those with more aggressive tumors or tumors in high risk areas.Your physician will recommend the proper follow up for your specific condition.

How many levels of Mohs will I need?On average, most patients may only need 1 or 2 levels before clearing the tumor roots. Depending on the skin cancer type and location, a patient may need anywhere from 1 to 10 or more levels of Mohs to clear a tumor.There is no way to predict ahead of time how many levels your cancer will require for cure. The number of Mohs levels needed to completely remove the skin cancer depends on how big your cancer is and where the roots are. Mohs surgeons alway strive to remove your cancer in as few levels as possible.There is also very little way to predict beforehand how large a skin cancer is because often there are invisible portions roots which can be seen only with the help of a microscope. Sometimes, more than one surgical procedure may be required to remove very large or invasive tumors, cancers in small areas or difficult areas, or to obtain the best medical and cosmetic result.

Can I go out in the sun after surgery?

There are no specific strict sun restrictions after Mohs surgery. You may go out in the sun with sunscreen and protective hats and clothing. Overall, the sun is not your friend and should be avoided in excess. Excess sun exposure has been linked to possible skin cancer.Use of sunscreen or other cover up on the scar is very helpful for at least 6 months after surgery to help minimize scarring. It is important to follow your own physicians instructions for wound care and sun protection.

How are skin cancers treated?There are many good and effective ways to treat skin cancers. Options include local radiation (X-ray) treatments, curettage and desiccation C&D ( scrape and burn), cryosurgery ( specialized deep freezing), photodynamic therapy using Levulan and laser and or blue light, regular surgical excision, plastic surgery treatment, interferon injections, laser removal and surgery, Mohs surgery, and several prescription creams including Aldara ( imiquimod) and Efudex ( flurouracil).

Why is it called Mohs?Mohs is named after its inventor Dr. Frederic Mohs who first described the technique in 1941.

Photodynamic Therapy

What is Photodynamic Therapy?Photodynamic Therapy (PDT) is a special medical treatment that uses a photosensitizing drug and a light source to activate the applied drug. The result is an activated oxygen molecule that can destroy specific cells, including pre-cancerous or certain types of cancer cells. The procedure is generally minor and performed in a physicians office or outpatient setting.

PDT essentially has three steps. First, a light sensitizing liquid, cream, or intravenous drug (photosensitizer) is applied or administered. Second, there is an incubation period of minutes to days. Finally, the target tissue is then exposed to a specific wavelength of light which then helps activate the photosensitizing medication.

Steps: 1. Application of photosensitizer drug 2. Incubation period 3. Light activation

Although first discovered around 1913, PDT in the modern sense is a fairly new, evolving science whereby varying incubation times of a light sensitizing drug are used in combination with varying types of available light sources depending on the target tissue. The basic premise of PDT is selective tissue destruction. Although the photosensitizer may be absorbed all over by many cells, atypical or cancerous cells preferentially take up more of the drug and also may retain the drug for longer duration than normal tissues.

At present, the primary limitation of available PDT techniques is the depth of penetration of the light and ability to target cells within at most 1/3 of an inch ( approximately 1cm) of the light source. Therefore tumors or atypical growths must be fairly close to the skin or treatment surface for PDT to work.

What is Photodynamic Therapy used for?PDT is currently used in multiple medical fields including oncology (cancer), dermatology (skin), and cosmetic surgery.

In oncology, it is FDA approved for non-small cell lung cancer, esophageal cancer, and pre-cancerous changes of Barretts esophagus. Its use is also being further investigated through clinical trials in general oncology for conditions including cancers of the cervix (mouth of uterus), prostate gland, brain, and peritoneal cavity (the abdominal space that contains the stomach, liver, and internal organs).

In dermatology, PDT using Levulan Kerastick (20% delta-aminolevulinic acid HCl) became FDA approved in 2001 for the treatment of pre-skin cancers called actinic keratosis (AK). The initial approval was specifically for normal (non-hyperkeratotic) actinic keratosis of the face and scalp with a specified 14 to 18 hour drug incubation time, and 1,000 seconds (16 minutes and 40 seconds) of activation by a proprietary blue light source.

Since 2001, PDT has also received many other non-FDA approved ( also called off-label ) uses including acne, rosacea, skin cancer, sun damage, cosmetic skin improvement, oily skin, enlarged sebaceous glands, wrinkles, rejuvenation (anti-aging), warts, hidradenitis suppurativa, psoriasis, and many other skin conditions.

What photosensitizer drugs are available?At least 3 currently FDA approved photosensitizers are available including Photofrin (porfimer sodium), Levulan ( 5-aminolevulinic acid or ALA ), Metvix (methyl aminolevulinate (MAOP)) . More drugs are undergoing trials and may become available in the near future. Photofrin is used intravenously ( IV)for internal cancers while Levulan and Metvix are applied topically for skin therapy.

What light sources are available?PDT can essentially use many types of light sources. These include laser, intense pulsed light, light-emitting diodes (LEDs) , blue light, red light, many other visible lights, including natural sunlight. Photosensitizer drugs may become activated by one or several types of applied light depending on the ideal wavelength for the particular drug used and target tissue.

How is the light applied?The light source needs to be directly applied to the target tissue for a specific amount of time. For surface skin treatments, the light is easily directly applied to the area of the skin where the photosensitizer drug has been applied ( such as face, scalp, arms, etc.).For internal cancers, delivering the light to the desired area is more challenging. The light may be delivered through small fiber optic cables into the body cavity or area being treated. Sometimes endoscopes ( a thin lighted elongated tube which is inserted into a body space) are used to deliver the light into the lungs, stomach, or bladder.

How does PDT work?PDT works by direct injury to the target cells and tissues. While all of the exact mechanisms are not fully known yet, the basic pathway seems to involve an activated oxygen molecule that has the ability to injure or destroy nearby or specific cells.Aminolevulinic acid is then incorporated into the bodys natural heme ( blood) biosynthesis pathway and activated to form protoporphyrin IX, a potent photosensitier. Protoporphyrin IX then becomes excited to an activated singlet state. This active singlet state is then directly toxic to cells.Other potential pathways include directly killing abnormal or cancerous cells, damaging the blood vessels and blood supply to the tissue, causing inflammation and irritation, and possibly also activating the persons own immune system to attack the abnormal or cancerous cells.

Does PDT make me permanently more sensitive to light?No, PDT causes a temporary sensitivity to light, including natural sunlight and some indoor lights. The light sensitivity resolves with time depending on both the photosensitizer drug and dosage used.

How long do I have to stay out of the sun and light?Light avoidance is generally required after PDT. The duration depends on the drug and dosage used. Intravenously given Porfimer may make the body including the skin and eyes sensitive to light for about 6 weeks after treatment. Proper protection including long sleeves and sunglasses may be required.Topically applied aminolevulinic acid (Levulan) or methyl aminolevulinate (Metvix) may cause skin sensitivity only on the treatment areas for approximately 24-72 hours. These do not usually cause sensitivity on other body parts other than where the drug was directly applied. Your physician will need to discuss with you the required sun and light avoidance period required after your particular treatment.

How is PDT used to treat the skin?

PDT using Levulan ( 5-aminolevulinic acid or ALA ) and a proprietary Blue light is currently FDA approved for the treatment of skin pre-cancers called actinic keratosis ( rough scaly spots generally on sun exposed skin in more fair skin individuals).PDT is also known as ALA/PDT treatment or Super Blue Light. It has been referred to as a super photo facial when the photosensitizer is used with a machine called intense pulsed light or IPL. These treatments may help remove sun damaged pre-cancerous zones and spots. Sun damage, fine lines, and blotchy pigmentation may also be improved because of the positive effect of PDT. IN some patients, PDT also has been shown to help decrease the appearance of pores and reduce oil glands, effectively treating some subtypes of patients with stubborn acne, rosacea, and help improve the appearance of some small superficial acne scars.Although PDTs use in skin was first investigated in 1990s for actinic keratosis, it was not as popular or widely used because of the required long incubation times (usually 18-24 hours) and limited indications. Since approximately 2001, PDT has become more widespread in use primarily because of advances including shorter incubation times (30-60 minutes) and more applications including acne and cosmetic skin rejuvenation.

What is a photosensitizer drug?Photo sensitizers are chemical compounds that become activated only when exposed to light.

What is Aminolevulinic acid or Levulan?5-aminolevulinic acid also called Levulan or ALA for short is a naturally occurring protein in the body. It is found in small quantities as part of the normal heme ( blood) synthesis pathway. In larger quantities, it is a substance known to increase sensitivity to certain wavelengths of light.

How does PDT work?By preferentially attacking the active or abnormal cells, PDT combines a very high success rate with good preservation of normal skin without significant risks for scarring. Once the areas have healed following PDT, the areas are re- examined to see if additional treatments or possible biopsies are needed.

PDT is special because it is a targeted treatment to preferentially target more rapidly dividing cells and atypical skin growths. With regular or traditional cryosurgery ( freezing with liquid nitrogen) or burning, only the visible pre skin cancers are treated thereby leaving ones that arent as apparent ( sub clinical or hidden) lesions undetected. Photodynamic Therapy allows for field or blanket treatment of an entire area of sun damage thereby reducing the chance that undetected pre skin cancer cells will be left untreated.

Photodynamic Therapy is usually scheduled in the doctors office because of the required photosensitizing prescription / physician applied medication and the special light activation equipments. Currently PDT procedures are generally performed with the patient waiting in the office during the 30 minute to several hours incubation time before the application of the light source.

What is a typical skin PDT session like?You may be given a written procedure consent form to read and sign before your first treatment. The medical staff may take some before photography prior to applying the photosensitizer medication.In the treatment room, you may be sitting or comfortably lying back on a table. This part is generally painless and comfortable. Often a thorough cleansing of the face is done using alcohol and or acetone to degrease the skin. The less oil on the skin, the more readily the skin will absorb the applied topical medication. In some patients microdermabrasion may additionally be performed prior to the application of the medication to further prepare the skin to optimally absorb the photosensitizer.The photosensitizer liquid or cream is applied topically to the whole area being treated (such as the entire face, scalp, back of the hands, back part of the forearms, legs, feet, scalp, chest, or back).The medication is allowed to air dry for a few minutes and then you will wait anywhere from 30-60 minutes for the incubation time. Some areas such as chest, back and particularly forearms and legs require longer incubation times of 2-18 hours for better results. No two people or skin on different areas of the body are exactly alike. PDT requires physician adjustments for specific individualized incubation times and treatment durations.After the proper incubation time, you are brought back into the light source room where the medication is activated with a specific wavelength light source. There may be sensations of warmth, tingling, heat, or burning in some patients. Frequently, you will have a fan to help cool off during the treatment.The treatment area is then washed off and sunscreen applied before leaving the office. Instructions and an appointment for follow up may then be given on how to care for the improved skin.

How much improvement can I expect?No two individuals are the same and results may vary. As with any medical procedure, some conditions can improve dramatically in some patients and not respond in others.

Overall, patients with severe sun damaged skin manifested by actinic keratosis, texture, and tone changes including mottled pigmentation, dull or sallow skin, and skin laxity may see good to excellent improvement with PDT. There have been reports of possible improvement of large pores, non- pitted acne scars, and active acne.

Depending on the area being treated and the recommended incubation time, different numbers of treatment sessions spaced 4-6 weeks apart may be required to achieve the desired improvement and reduction in lesions. It is not always possible to predict ahead of time how many treatments your specific condition may take or how you will respond to PDT.

Photodynamic Therapy requires your patience and your willingness to follow the post procedure instructions, including staying out of the sun for 24-28 hours depending on the area treated and your physicians requirements.

How many treatments will it take to see the best results?To achieve maximum improvement of pre-cancerous (actinic keratosis) sun damage, skin tone and texture, on average a series of 2-3 treatments 2-6 weeks apart may be quite effective. Some patients with milder actinic keratosis are happy with one treatment. More treatments can be done at periodic intervals in the future to maintain the rejuvenated appearance of the skin.

Where can I have Photodynamic Therapy?Photodynamic Therapy for skin therapy is usually comfortably performed in an outpatient setting like a doctors office and without any sedation or anesthesia.You may check the http://www.AAD.org for board certified dermatologist members of the American Board of Dermatology in your area or http://www.ASPDT.org for members of the American Society of Photodynamic Therapy. Additionally, oncologists and other physicians may be trained in this area.While these photosensitizer medications may currently only be available to medical personnel, it may be foreseeable or possible in the distant future where patients could be given a prescription for the topical or oral photosensitizer and a light source for physician directed home use.

How long does a skin PDT procedure take?You are generally in the medical office for several hours( average 1 1/2 hours) on the day of your Photodynamic Therapy. Facial PDT may take 10 minutes to apply the medication, 30-60 minutes to allow proper skin incubation, and 15-20 minutes for light application. Other areas may require longer incubation times and you may leave the office and come back when it is time to have the light.

Many patients prefer to schedule their treatment later in the afternoon so they may go directly home after the treatment. It is not usually advised to have any sun exposure such as from running errands or driving around after the treatment.

What kind of physician can perform Photodynamic Therapy?Most skin PDT is performed only by specially trained dermatologists and their medical staff. Other physicians including oncologists, family physicians, internal medicine doctors, plastic surgeons, or Ear, Nose and Throat ( ENT) surgeons and their medical staff who are trained and may also perform Photodynamic Therapy.While it is generally advisable to undergo this or any medical treatment in an established board-certified physicians office, there are medical spa type environments that may also offer these skin services with or without physician supervision.

Where can I find a doctor board certified in Photodynamic Therapy?There is no current Board Certification, residency, or fellowship training for Photodynamic Therapy. There is a new national organization called the American Society for Photodynamic Therapy (ASPDT). You may check the website for members of this group at http://www.aspdt.org. There are many other photomedicine interest groups and societies dedicated to this evolving field.

Some dermatologists and oncologists have received special residency or post graduate training for photodynamic therapy. Many other physicians may be trained by companies that manufacturer the photosensitizing material and /or the light source.

Is skin PDT only for pre-cancerous growths?No, Photodynamic Therapy is a widely used method of treating many conditions including pre-cancers (actinic keratosis), some types of superficial skin cancers, acne, rosacea, warts, sebaceous hyperplasia ( enlarged oil glands), fine wrinkles, psoriasis, and other cosmetic indications. It is currently not used to remove malignant melanoma or deeply invasive cancers. It is not used to remove moles or birthmarks.Less frequently, Photodynamic Therapy may also be used off-label for other less common conditions including hidradenitis suppurativa, porokeratosis, disseminated actinic porokeratosis (DSAP), and other investigational conditions.

What are the advantages with Photodynamic Therapy for treating skin pre-cancers?The greatest advantage of PDT is the ability to selectively treat an entire area of skin damage and pre-cancers (blanket or field treatment). PDT generally decreases the likelihood of lighter or darker skin spots ( post-inflammatory hyper or hypo pigmentation) caused by routine freezing with liquid nitrogen. Additionally, PDT frequently may facilitate smoother skin and an overall improved appearance, tone, color, and enhanced skin texture.

In several studies, PDT has been preferred by many patients for ease of use and recovery as compared to alternative treatments including freezing and chemotherapy creams like fluorouracil (Efudex). The PDT side effects may be milder with less down time than with fluorouracil.

For patients with many skin lesions, PDT may be generally more effective than repeated spot treatment with topical liquid nitrogen. Some patients are unable to tolerate the prolonged treatment required with fluorouracil (Efudex) or imiquimod (Aldara) because of the irritation, redness, and possible downtime with these topical creams.PDT has become a very well tolerated, essentially painless, non-invasive (no needles or surgery required) procedure to help reduce sun damage and enhance the overall cosmetic outcome (particularly in sensitive areas of the face and chest).

How many treatments of Photodynamic Therapy will I need?

No two peoples skin is exactly the same and therefore individual results and number of required treatments vary. On average, most patients may benefit from 1 to 3 PDT treatments for an area and annual touch up treatments. While the face tends to respond faster and to fewer treatments, areas like the forearms and legs are much harder ( resistant and tough skin) to treat and may require many more treatments.

There is no way to reliably predict ahead of time exactly how many treatments your condition will require. Photodynamic Therapy physicians always strive to treat your condition in as few treatments as possible without causing a severe burn.

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Skin and Medical Topics – The Skin Center

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