Keeping Your Skin Healthy
Skin rejuvenation can be divided into different
categories-light, medium, and deep treatments.
Light treatments involve lotions and creams.  
These are physically applied on a daily basis
and have the advantage of no "down time" for
convalescence.  One can apply these lotions
and continue normal daily and social activities
without any interruption.  The objective of this
first level of skin rejuvenation is to provide a
more refreshed appearance to the skin and
also, over time, remove some of the more
superficial skin contouring aging changes such as minor pigmentation,
scaling, and very fine wrinkling.

Effulgere® skin cream can be used to moisturize and refreshen skin that has
been damaged by exposure to the elements, sunlight or which has simply
been affected by intrinsic aging.  It can also be used to help maintain
beautiful skin tone and texture over the years.  In some cases, Effulgere®
skin cream also lightens age spots and other types of blemishes associated
with aging.
Skin Rejuvenation Techniques
The effectiveness of all skin care products is contingent upon delivery of the beneficial ingredients into the skin
structure.  This is normally a difficult proposition for water-soluble ingredients, such as ascorbic acid, because the
stratum cornea is an excellent water barrier.  The key to the effective action of Effulgere® is based upon
beneficial ingredients including an array of antioxidants, vitamin C, vitamin E, zinc, ethyl lactate, isoamyl lactate,
and phenylalanine.  Effulgere® facial cream was invented after many years of research and testing and is the
subject of patents pending in the United States and a number of foreign countries.

One is able to accelerate or jump start the results of their skin rejuvenation program by using serial skin
rejuvenation chemical peels.  This involves performing light TCA peels to the face every one to two weeks. We
find that six to eight "serial peels" performed at one to two week intervals results in affects similar to those
obtained by using Retin-A for a year.  In our experience, approximately 50% of individuals are able to obtain
affects similar to those of a light medium depth chemical peel, but without the 7-10 day down time.  These peels
help to remove some of the pigmentation changes that medically we call mild dischromia.  It can also be very
effective in cases of more severe acne.  While no two individuals heal or respond the same and while individual
results may vary, most patients find that they can accelerate their skin rejuvenation significantly with serial TCA

As part of an overall skin rejuvenation program a light TCA peel is frequently performed at three to four month
intervals to essentially act as a very deep facial and to further accentuate the results of the application of the
daily rejuvenation lotions and creams that have been prescribed.
Many people believe that a tan is attractive and conveys a healthy
appearance.  In reality, a tan actually reflects injury to the skin and is the
body’s response to ultraviolet skin damage.  Those who desire a cosmetic
tan can obtain one by using sunless or self-tanning lotions.  However, it is
important to remember that self-tanning lotions do not protect the skin, so
you can burn just as easily as if you have no tan.

While there are a variety of products available, only 2 types of tanning
lotions, bronzers and self-tanning, lotions-should be used. Tan
accelerators are a group of products which contain a natural enzyme that
stimulates production of melanin, the body’s natural pigment. They are
not effective.  Tanning promoters are groups of products which contain 5-
Methoxypsorsalen.  These products have been reported to cause cancer
in mice and severe skin reactions in humans. Tanning promoters are not
available in the United States.  Tanning pills have been banned by the
FDA because of life threatening side effects and blindness.  They contain
the drug canthaxanthrin and promote deposition of carotenoid in  the skin.

Bronzers are gel formulations that produce a darker skin color by means
of water-soluble dyes.  Bronzers color the skin immediately, but the color
fades with the first wash.
rejuvenated and usually has a pleasing red glow.  Most individuals are able to apply makeup and resume a
normal work and social schedule at that time.  Medium peels are used to treat degenerative skin, mild acne, and
moderate aging and environmental changes to the skin.  The results last two to five years for most individuals.

Deep treatments involved the use of carbon dioxide laser's and phenol based chemical exfoliation.  These
procedures provide the most optimal skin rejuvenation possible.  They remove the top layer of the skin and
stimulate increased collagen formation in the deeper layers of the skin over the following nine to twelve months.
Frequently patients see not only a refreshing of the skin by regeneration of a new top layer of the skin, but also
find approximately a 20% tightening effect to the skin over nine to twelve months.  Again, results will vary from
individual to individual and no one can guarantee results.  However, most patients find that carbon dioxide laser
or deep phenol chemical peels provide dramatic results in eliminating facial wrinkling, pigmentation changes, and
improving skin elasticity.  These treatments can be associated with some pigmentation changes. Phenol based
chemical peels are used to lighten areas of increased pigmentation, such as in patients with melasma (the so
called “mask of pregnancy”).  Patients who undergo a phenol based chemical peel need to accept the fact that
their skin may become lightened to the extent that they need to use makeup and cover treated areas.  Despite
this, the phenol peel is very popular because it provides the most dramatic reduction in facial wrinkling and the
most improvement in skin elasticity of any of the facial rejuvenation procedures.

Carbon dioxide laser resurfacing and phenol chemical peels normally require minor sedation. Procedures are
done on an outpatient basis, and patients are able to return home immediately following the procedure.  Similar to
the medium peel, there is very little if any discomfort associated with either of these procedures. As with the
medium chemical peel, a moist dressing technique is used following treatment.  Vaseline® petroleum jelly is
applied to all treated areas four to six times a day for seven days.  While these procedures can be repeated, we
find that most individuals respond very favorably to a single carbon dioxide laser resurfacing or phenol based
chemical peel treatment.  These procedures are indicated for severe acne scarring, patients with recurrent skin
cancers, deep facial wrinkling such as "smoker’s lines" and more advanced pigmentation and skin textural
Medium peels are used to remove mild to
moderate skin textural and pigmentation changes.
They may also be helpful in reducing minor acne
scars and to stimulate increased collagen
formation in the upper dermal layers. The
advantage of medium depth chemical peels is that
they have minimal chance of changing our overall
skin pigmentation.  Medium depth chemical peels
usually require mild sedation and are performed
on outpatient basis. Patients are able to return
home immediately following the procedure and
experience very little if any discomfort. However,
one needs to refrain from wearing makeup for one
week and daily apply a moist dressing, such as
Vaseline® petroleum jelly, to the peeled areas for
one week.  At the end of the week the skin has
Tanning Agents                             Advantage                                             Disadvantage

Bronzers                              Colors Skin Immediately                            Color Fades with First Wash
Sunless or                                FDA Approved &                         Requires Frequent Re-Application
Self-tanning lotion                     Provide Same-Day Tan                                

Tanning pills                     Not Available in the United States              Can Cause Blindness & Life             
                                                                                                   Threatening Reactions

Tanning Promoters             Not Available in the United States            Can Cause Severe Skin Reactions
                                                                                                    & may Cause Cancer    

Tan Accelerators                            None                                                      Not Effective
Sunless or self-tanning lotions were approved by the FDA in 1997 and can produce an aesthetically pleasing tan.  
The active ingredient in these products is dihydroxyacetone (DHA) which interacts with the dead surface cells in
the outermost layer of the skin to darken the skin.  DHA gives color to the skin through a browning reaction.  
When applied to the skin, DHA changes into a sugar that combines with amino acids in the skin to form chemical
compounds known as known "melaninoids" which are brown in color.
Application of self-tanning lotions is fairly
simple.  It is best to look for products that  
have a DHA concentration of 3% to 5%.  
These will give slower tans, but will not cause
the skin to turn an orange shade as some
stronger products do. Self-tanning lotions work
best for people with medium complexions.  
They are less effective in people with very fair
or very dark skin.  For those with sun damaged
skin, self tanning lotions produce an uneven
color-so do not use if you have a sunburn!
Also, in people with older skin or mottled or
freckled skin, these lotions can produce an
uneven effect. Hair and nails may color, but
not lips.   Scars will color poorly.  You can
improve the tan by buffing or rubbing the skin
lightly with a towel, then showering immediately
before applying.  Be sure to wash your hands immediately after applying to avoid staining your palms.  
Self-tanning lotions produce a color change within an hour.  Best results are obtained with 2-4 applications
several hours apart on the same day, with repeated use every few days.  The face usually requires fewer initial
applications, but more frequent re-applications to achieve the desired appearance.
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