Seven Questions for a DermatologistOn this episode of Seven Questions for a Specialist, The Scope speaks with Dr. David Smart, a dermatologist at University of Utah Health. What is the best and worst thing for your skin? How can you…
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May 31, 2017
Health and Beauty Announcer: Seven questions, seven answers. It's "7 Questions for a Specialist" on The Scope. Interviewer: We're here with Dr. David Smart, dermatologist at the University of Utah and these are seven questions to ask a dermatologist. Dr. Smart, what is the most common skin issue in Utah? Dr. Smart: Brown spots. That's what I'm going to go with. Brown spots is the most common issue in Utah. Interviewer: What is the absolute best thing I can do for my skin? Dr. Smart: Don't smoke and protect from the sun. I'm going to go with two. That's cheating but that's all right. Interviewer: What is the absolute worst thing I can do for my skin? Dr. Smart: Smoking. Interviewer: What is the one thing you know about skin that everyone should know? Dr. Smart: Protecting your skin from sun damage will keep you looking better, younger for longer. Interviewer: Is there any foods that are particularly good for my skin? Dr. Smart: Yes. Foods that are high in antioxidants, mostly fruits and vegetables do a lot to protect your skin and rejuvenate it. Interviewer: What is the best technique to keep my skin moisturized? Dr. Smart: Frequent application. Interviewer: Why do you chose to specialize in dermatology? Dr. Smart: The doctor patient relationship. Patients have very visible concerns that they're very worried about that. So they're happy to come to the doctor. It's very gratifying. The interaction is very positive. Announcer: If you like what you heard, be sure to get our latest content. Sign up for a weekly content updates at thescoperadio.com. This is The Scope, powered by University of Utah Health Sciences. |
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Physician Profile: David SmartDr. David Smart talks about his medical philosophy and what makes his practice unique.
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Listener Question: Should I be Concerned about Moles?Dermatologist Dr. David Smart answers the question about when you should be concerned about moles. He goes over the “ABCDE’s” of what a dermatologist looks for in moles and when you…
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September 14, 2016
Health and Beauty Announcer: Need reliable health and wellness information? Don't listen to the guy in the cube next to you. Get it from a trusted source, straight from the doctor's mouth. Here's this week's listener question on The Scope. Interviewer: This is actually from several listeners with describing in detail their moles. Some have different colors, some have different shapes, some are in weird places. The basic question is, should I get this checked? What should we be looking for, and when should we go to a dermatologist? Dr. Smart: That's a great question. I think a lot of people struggle with this because sometimes you'll go into your dermatologist, he'll look at it for two seconds, and say, "Nothing to worry about. What are you doing here?" Or that's how you feel, but you're still doing the right thing. That's why dermatologists go to medical school, and years of training because sometimes it does take years of training to be able to identify that is nothing to worry about, and this, this one is. But unless you spend that five seconds in front of a dermatologist, you will never know. So any time, you're really noticing a mole or a spot that's growing or changing to the point where you are noticing it, then it's legitimate to have that chat. Now if it's something that's been present for many, many years of your life, and it's changing very minimally, the chance that, that's something truly concerning is exceedingly low, nevertheless, it can be. So whenever you are noticing something like that, there's never a wrong answer, there's never a time when you should say, "Oh, I shouldn't go to my dermatologist for this because you don't know. Interviewer: So you're saying if it's growing in size, if it's something that you notice, what about color, place? Dr. Smart: The very classic things that every dermatologist will tell you this, there's the A, B, C, D, E's of growing and changing lesions. And A is asymmetry, B is border, C is color, D is diameter, and E is evolution. So if any of those things are happening to any given spot, if one side is getting bigger than the other, or its starting to get little projections, so that it's not symmetric, that's concerning. If the border is starting to become funny rather than smooth, then that's a possible issue. If the color is changing. It used to be tan, used to be just this normal beige, and now all of a sudden now there's a little bit of red, and a little bit of dark brown, well that's an issue too. And then diameter, if it's getting past a certain size, or measurements, so if it's getting big then that's something to change. And evolution is just thrown in there just for a cover-all. If it's changing, then come get it looked at. But I think it's really simple, if something's concerning you, then there's no reason to lose sleep over it. It's easy to come get it checked out. Announcer: You're listening to The Scope, powered by University of Utah Health Sciences. This is The Scope. Find us online at thescoperadio.com. |
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Two Medical Treatments for Reducing Fat in Problem AreasYou diet. You exercise. You do everything you can to live an active and healthy life, but you still have fat in those ‘problem areas.’ Those love handles, muffin tops and stomach rolls.…
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June 01, 2016
Health and Beauty Announcer: Health tips, medical news, research and more for happier, healthier life. From University of Utah Health Sciences, this is The Scope. Interviewer: Sometimes it just doesn't seem right. You exercise. You're leading a healthy, active life. Maybe in another life, you have a little too much fat, but you fixed that, right? You're trying to lose it, yet some of those stubborn areas just won't go away. Well, I want to talk about two non-invasive fat reduction techniques. One is called the CoolSculpting; the other is Kybella. Dr. David Smart is a dermatologist with the University of Utah Health Care. First of all, I always get little bit skeptical when I hear about non-invasive fat removal. I mean, I kind of hear the ads on the radio. I'm told there's no such thing as a quick fix. So your job . . . Dr. Smart: Yet, here I am with quick fixes. Interviewer: So your job is to convince me. Dr. Smart: Got you. Let's take CoolSculpting. That's a great example. Cool Sculpting is a machine that was invented and developed by dermatologists. It's all based on this principle: fat cells are more sensitive to cold than skin cells, and muscle cells, and all the cells around it. Interviewer: So they freeze easier? Dr. Smart: They freeze easier and then they die from being frozen more easily. This has been well known in dermatology for some time. With frostbite, even sometimes, equestrians, it's called equestrians. It's equestrian fat loss. When they're riding horses in the very cold, those inner thighs that are really cold on that saddle, they'll actually start to lose fat on the inner thighs. Interviewer: Because their fat's freezing? Dr. Smart: Because their fat's freezing. Also, little children with popsicles, those popsicles sometimes will cause . . . if the popsicles been in the mouth too long, it will cause a fat loss in certain areas. So it's just this cold is killing off the fat. CoolSculpting has been around now for a long enough time, several years. There have been hundreds of thousands of cases of CoolSculpting done and the results are very reliable. It's not a brand new fad, although there are a lot of machines in the same sector of non-invasive fat loss that I personally do not believe in and have used and thought, "Hey, this doesn't do anything." CoolSculpting is not one of those. CoolSculpting does show results. Interviewer: So as a doctor, I would think that you would be more to encourage somebody to exercise to get rid of that fat. You know? That last five pounds or those little stubborn areas, "Just keep going and you'll get there." Dr. Smart: It's important to remember or at least recognize that you can't spot treat fat when you're working out. No matter what exercise video says, you can't do more sit ups, necessarily. "If I really do crunches just very hard, I'm going to get rid of that fat right around the belly button or I'll do these side bends and that would get rid of my love handles." That's just not how the body works. You don't spot treat fat when you exercise. The ideal candidate for one of these procedures, whether it's Kybella, CoolSculpting, is a person that is in relatively good shape, you haven't just started your weight loss journey, you're not necessarily more than 30 pounds outside of your weight goal, but you have a few stubborn pockets of fat that just don't seem to go away. Interviewer: Because each one of us has our own little . . . Dr. Smart: We've all got. Interviewer: No matter how lean you are, like for example mine is right here on the backside, right? Dr. Smart: Exactly. So are mine. Interviewer: I could have a six-pack and I'd still have this roll a little bit. Dr. Smart: On the back. This little love handle, it just wouldn't do away. Interviewer: Is that what the CoolSculpting would treat? Dr. Smart: Precisely, that is what is why it's developed to treat. It was rigorously studied by the scientists that made it in Harvard. It was not created by some company looking to make a quick dollar. Interviewer: So there's actual evidence-based support? Dr. Smart: Significant evidence to support this. It is a really great treatment for those areas. For men, right around the love handles, that's a very common area for men to have little pockets of stubborn fat. Women, outer and inner thighs and around the belly button. All these places are potential areas of opportunity to get rid of. Interviewer: So can I use multiple treatments to treat multiple areas? Dr. Smart: You sure can. Now CoolSculpting, that treatment was not designed to be a treatment course in the sense that very reliably with one treatment of the area that's treated, about 20% of the fat will leave. But depending on how much fat you have, you might need to do more than one. Interviewer: So CoolSculpting works different areas of the body. Kybella works primarily for fat under the chin? Dr. Smart: True. Now that's because it's FDA approved for that area. Kybella is actually a very, sort of groundbreaking, very exciting product. It's less than a year old now, as far as the FDA is concerned. It was FDA approved less than a year ago for the treatment of the submental fat pocket, which is just the double-chin area. That doesn't mean that fat in other areas doesn't respond to it, it just means that the studies were done to get FDA approval were done just there. Interviewer: Is it the same technique? Is it freezing the fat or is it different than CoolSculpting? Dr. Smart: It's different. So Kybella is a liquid. It's a chemical that's naturally found in the body. It's produced by the liver and helps to absorb fats in your diet, but if you inject it directly into the fat, it dissolves fat cells. So it's been done for many years in different countries, but it's not just been regulated. Finally, a company here developed a formulation and went through the very rigorous testing to get it safety and efficacy approved by the FDA. You inject it in a series of injections, so similar to Botox, in very small needles under the chin and it dissolves fat. Most people need to do that injection anywhere from two to four times and it really sharpens the jaw and gets rid of the fat under the chin. Interviewer: Side effects for either one of these two treatments? Dr. Smart: With CoolSculpting, there's no cutting, there's no downtime, there's no nothing. As you can imagine, it's destroying some of the fat there. You do get some bruising and a little bit of tenderness that would come from feeling like, "I got a good bruise in this area." Those are the most common side effects. They happen pretty regularly. Interviewer: What about Kybella? Dr. Smart: Kybella, those are injections. You do have to be okay with some very small needle pokes. And then I would say that the most common side effect with Kybella is swelling. Most of the time, it's pretty mild. But about one in 10 get a good amount of swelling under the chin, to the size of almost like a golf ball or an Easter egg. So you definitely don't want to do Kybella right before you have some sort of event or some pictures to be taken. You'll most likely be okay, but pretty normally, like I say, about 10%, one out of 10 people, I feel like, get pretty appreciable swelling under the chin. Interviewer: If somebody is interested in the Kybella treatment, that's physician only. Dr. Smart: That is available only to physicians and specifically only to physicians that have been trained in Kybella. Allergan, the company that owns Kybella, was very particular about this when they released the medicine. A lot of things in cosmetic medicine get taken up by people that don't know how to use them and it gives the product a bad name because they're using it incorrectly, getting side effects and that's bad for the product, it's bad for the company. So the company was very sure to only release it to physicians that they have specifically trained to do this that have the pathology knowledge to handle any potential side effect that may come up and that aren't going to use it irresponsibly. Interviewer: So with the case of CoolSculpting and Kybella, what else would a listener need to know to make an informed decision about using one of these procedures? What do they need to know? Dr. Smart: The amount of people that could benefit from these procedures is enormous. We all have these areas of fat that really tend to bother us. What they should know is that it really does work. It is not a substitute for weight loss and that's probably what I would say to someone who's interested in CoolSculpting. Whenever anyone comes in and they're interested in body shaping, whether that's liposuction, CoolSculpting, Kybella, we have a discussion about what your outcomes are and where you're starting from, as long as your expectations are realistic. It is not going to change your weight. If you're looking to lose weight, these aren't the treatments for you. If you're looking to simply sculpt some areas of the body, you're the perfect candidate. Announcer: TheScopeRadio.com is University of Utah Health Sciences Radio. If you like what you heard, be sure to get our latest content by following us on Facebook. Just click on the Facebook icon at TheScopeRadio.com. |
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Remove More Tattoo In Less Time With New TreatmentThe picosecond laser is the most precise piece of laser technology available to dermatologists, capable of bursts as small as one-trillionth of a second. In skilled hands this laser can remove tattoo…
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April 20, 2016
Health and Beauty Interviewer: The picosecond laser is the first advancement in laser tattoo removal in the last 20 years. Faster recovery and fewer treatments. Coming up on The Scope, more about the laser capable of bursts as short as one-trillionth of a second to better remove your ink. Announcer: Health tips, medical views, research and more for a happier and healthier life. From University of Utah Health Sciences, this is The Scope. Interviewer: The picosecond laser is one of the most advanced pieces of dermatological equipment in decades. There's only a handful of these lasers in the state, and we have one. We're here with Dr. David Smart, dermatologist at the University of Utah. Dr. Smart, how common is tattoo removal in this day and age? Dr. Smart: Tattoo is extremely common. Just go ahead and look around at how many people you know or see that have tattoos. Just as many of those people end up thinking, "Maybe I should've done something differently with this tattoo" and they like it altered, changed, or removed somehow. Interviewer: So how exactly does laser tattoo removal work? When we're talking about, you know, it's in the skin. How do you just make it disappear? Dr. Smart: So, we'll talk a little bit first about how tattoos stay in the skin because I think that's probably the most important part. So what happens, there are certain cells in the skin that don't go anywhere. They stay there, they're always there. They don't go, they don't change, and they eat up the tattoo pigment that's placed deep in the skin with needles. The tattoo artist puts the pigment deep in the skin. It gets eaten up by these permanent cells and then it stays there for years and years and theoretically forever. The lasers are designed to attack the pigment particle within those cells, to get them to break up into small enough pieces that the cells will then clear them rather than just keep them around. Interviewer: And you said lasers there, so there's multiple lasers? It's not just like you have one? Dr. Smart: Oh you bet, yeah. And sort of what we mentioned in the first, the newest technology, which is actually very exciting, is the picosecond lasers, of which there are a few different companies making them. The picosecond lasers are very, very short. The way lasers work for laser tattoo removal, they target these very small pigments. To make that target more specific, you try to make the laser pulse, meaning the length of which the laser is on, as small as possible. The same size or smaller than the particle you're going after. So picoseconds are a trillionth of a second. If you think about that, a trillionth of a second, a picosecond is to a second what a second is to 32,000 years. It is incredibly, incredibly small. And the picosecond lasers do a much, much better job than their previous counterparts. Interviewer: In what ways? Like what are we talking about here? What can someone expect if they're getting a picosecond Ferrari laser versus a . . . Dr. Smart: Very much the Ferrari of tattoo removal. So laser tattoo removal in general, imagine if you were at a shooting range. You've got this laser, and you've got a target 20 feet down. And you're trying to hit just the bullseye, but your laser is in fact bigger than the entire target so you're shooting this bazooka down and hitting the target. You hit your target, you hit the middle, you hit the bullseye, but you also took out the entire target, everything surrounding it as well. That's similar to what older, longer pulse lasers used to do. They would take out the target, not as effectively, but also you'd get quite a bit of other damage: blistering, redness, and burn. Picosecond lasers are able to be much more precise and hit their targets with less surrounding damage. Interviewer: And what does that mean in the end for a patient? Is that quicker recovery, less damage, you know what are we talking about? Dr. Smart: Definitely. So you're dealing with a quicker recovery and a speedier time to resolution of your tattoo. Laser tattoo removal is not a once and done tattoo treatment. In fact, the average black tattoo probably takes, with older technology, around 6 to 10 different treatments. The picosecond laser is able to remove those black tattoos in less than half of that in most cases. So rather than 10 treatments, you're doing more like 4. It's really quite impressive. Interviewer: The patient's going in to get their tattoo removed, what kind of side effects or risks are they going under by wanting to get their tattoo removed? Dr. Smart: The biggest risk in laser tattoo removal is it not working. There are some patients, especially with the older lasers, where they will come in 20 times or even more, and we'll treat it again to try and get it to lighten further and further. And some are just resistant. That hasn't happened quite with the picosecond laser because when they become resistant to those older technologies, well, the picosecond laser will get better improvement than what you've gotten before. So the biggest risk is it's not going to work. Second biggest risk is that you are shining, you're firing this powerful laser on the skin, trying to hit the color, the pigment. And like I said before, you also get some surrounding skin burn-type injuries, so blistering and like a really good sunburn - not just a light one, but a good sunburn appearance is not that unusual of a side effect from laser tattoo removal, especially with the older technologies, less so with the pico. Interviewer: So what you're saying is that some of these older lasers have a bigger chance of causing this type of damage? Dr. Smart: They're less specific. They're hitting everything in their path, so you're getting more blistering. Interviewer: And considering those types of dangers and . . . what would you say to a patient. You know, do you hop in a laser center at the mall? Like why is it important with dealing with this type of stuff to go to a real dermatologist rather than just a laser center? Dr. Smart: Going somewhere that's inexperienced . . . so laser technology is fascinating. Clearly, I love it. I'm biased. I'm a skin doctor. But there are a lot of intricacies, a lot of nuances with what you're trying to hit and why. For example, the picosecond lasers they're pigmented in general. We use them to treat birthmarks of all kinds, scars, moles, and just aging - age spots, sunspots - they work phenomenal for just rejuvenation of the skin, evening out tone and pigment, not just tattoos. But you have to know what you're treating. You have to know what's in there - what pigments, what birthmark. And you tailor your laser settings and your laser choice, what laser you'll actually use, based very much on that. The laser companies do a very good job to give you a rote cookbook. Say, if person A comes in, here are settings. Use these settings. It's in their best interest to make it so that anyone can use these lasers. But be careful. Interviewer: That's actually one of the bizarre things I came across while I was researching for this segment, was there are places online that are selling these lasers and like anyone can do it with a quick 19-hour course. How do you respond to that as a dermatologist? Dr. Smart: Well, I think the biggest issue is that you get into it. There's a lot of people that are doing these lasers and we could get into a discussion about state laws and who can actually operate these Class 4 lasers and you can't. But I think most importantly, you will be able to tell if you're going to someone who has the knowledge and the science underlying what they're trying to do because they will be able to tailor the treatment very much to you and your situation. The better chance for a good outcome and less chance of negative side effects. Interviewer: How would a patient know? How would a patient know that they are getting a good laser and they are going to a person who knows how to use this laser? Dr. Smart: So honestly I would say talk to your dermatologist because while not all dermatologists do these things, all dermatologists know about these things because they're trained in it. It's on their board exams. They know about skin. They are the experts on skin, so they will be able to recommend and say, "Hey, what laser is this medi-spa using? Well, we don't have one, but if you're wanting to get this laser done at a medi-spa of some kind, tell me what they're doing. What settings are they using? I can help you out that way." As far as it relates to the picosecond laser, there are only a handful of those. I'd be very surprised if there were more than literally three or four in the entire state of Utah. They're very expensive. The downside of the new technology is you're paying for it. Not very many places can afford that kind of investment. So with the new toys, you want to have the new knowledge to handle them. Interviewer: All right, so have a patient want to get their tattoo removed, what should they be doing? Dr. Smart: The picosecond technology, that will get you the best results fastest, no question. There's a lot of great scientific evidence behind that. There's not a lot of picosecond lasers available so do your research and talk to your dermatologist. Announcer: Thescoperadio.com is University of Utah Health Sciences Radio. If you like what you heard, be sure to get our latest content by following us on Facebook. Just click on the Facebook icon at thescoperadio.com |
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How Laser Therapy Could Help Your Skin TroublesToo much hair? Too little hair? Brown spots? Light spots? Wrinkles and fine lines? Dermatological laser therapy might be an answer to your skin problems. Your skin protects you from the environment,…
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April 05, 2016
Health and Beauty Interviewer: What types of skin conditions can laser skin therapy treat? How does it work, and why you should have a dermatologist do the procedure? That's next on The Scope. Announcer: Health tips, medical news, research, and more for a happier, healthier life. From University of Utah Health Sciences, this is The Scope. Interviewer: Your skin protects you, and just like any other protective cover it takes damage from the sun, the wind, even pollution. The result a lot of times is fine lines, wrinkles, pigment problems on the face, acne scars, sun damage, the stuff you look in the mirror, you see, and you're like, "I wish that could go away." Well, you don't have to live with all those things. Dermatologists can use lasers to take up to five years off the skin by treating surface issues. We're with Dr. David Smart. He's a dermatologist with University of Utah Health Care. I want to learn more about your lasers and this skin therapy. So what are some of the common conditions that lasers can treat? Dr. Smart: Well, that's a great question. I think people don't quite realize, there are many different types of lasers, and different types of lasers treat many different skin conditions. I like to describe lasers as being a modality or a treatment to help normalize the skin. Meaning, when you have too much hair, lasers can remove it. When you have too little hair, lasers can help grow it back. If you have too many brown spots, lasers can help get rid of those brown spots. If you don't have enough, if you have some light spots, lasers can help bring back that color. So there are a variety of lasers that go after many different targets, and in the end they really help normalize or bring that skin back to health. Interviewer: That's pretty amazing. How long has this technology been around? Dr. Smart: It is quite recent in the grand scheme of medicine. In the last 20 or 30 years, there have been many really impressive, remarkable breakthroughs in laser medicine. Interviewer: So is it fair to say that if you have some sort of a skin issue that bothers you and you're thinking to yourself, "Oh, I wish I could do something about that," lasers might be able to offer a solution? Dr. Smart: There's a solution for that. It's certainly a possibility. Interviewer: All right. Get a little geeky for me here. Tell me how does a laser . . . What's going on? Like when the laser hits my skin, how is it fixing problems? Dr. Smart: Light. When we're dealing with the spectrum of light, not all light is the same. You've got a wide spectrum of light, and that light comes in different sizes. The sunlight is a specific size, and then you get into visible light, blue light, all the colors that you see, that's a different size. You get into ultraviolet, infrared. So there is a spectrum of light. On that spectrum of light, there are certain things that absorb different wavelengths of light with different sort of affinities, meaning, this brown spot, that's going to absorb this wavelength of light. But really, that other one is not going to even touch it. Fat cells absorb different wavelengths of light, color-making cells. Tattoo pigment absorbs different wavelengths of light. So what's happening is, depending on the medical condition that you have, someone who knows about laser medicine is choosing a specific wavelength of light, a specific type of laser to treat your condition, because your condition responds to a specific band of light. When that band of light hits that target, the light is absorbed preferentially by that target and not by the surrounding tissue so that that target can be effectively heat-damaged without damaging everything around it. Interviewer: When you say "that target," this is a cellular level? Dr. Smart: Yeah. We're talking real small. We're talking particles. Like the molecule that makes brown in your skin, that's a possible target. The molecule that makes red in your blood vessels, that's a target. Interviewer: So let's just take the molecule that makes brown. The laser hits it, then what happens to that? Dr. Smart: The laser hits it, and depending on what setting you've chosen on the laser, you're either warming it up or you're shaking it to the point of disruption or explosion, essentially. Interviewer: If you want to get rid of it, I would imagine you explode it. Dr. Smart: Explode it, exactly. Interviewer: If you want to make it more pronounced, you would warm it up. Dr. Smart: Yeah, precisely. You would warm it up slowly, and that decreases the inflammatory pathway around it. That can result in improvement in conditions like psoriasis, vitiligo which is a color problem, and even that's why hair loss seems to be helped with certain types of lasers. Interviewer: What about wrinkles? How are you getting rid of those wrinkles? Dr. Smart: That's a great question, and while we're geeking out about this the target that you use to get rid of wrinkles is actually water. So you deliver the laser energy at a very specific depth. So you're telling the laser how deep you want to go, and you're essentially exploding, or removing, or damaging all cells that have water, which is all cells, in them in a specific pattern at a specific depth. So when you've calculated that out, you are effectively controlling which skin you're removing and which skin you're leaving. Like aerating a lawn, the tool that you use is you really just cut it out. With the laser, the laser uses a wavelength that targets water and removes everything with water in that area so that the skin underneath can say, "Yeah. We are looking a little bit old. We are starting to get a little bit thin. We should rejuvenate this area," and the skin really does the rest. It's pretty remarkable that you cause the damage, the skin is what heals and cures itself. Interviewer: Oh, so you're intentionally damaging skin in order to motivate it. Dr. Smart: Force it to say, "Hey, step up to the plate here. Start working," and it does. Interviewer: Very cool. Tell me a little bit about using these lasers, because I think I've heard ads for a lot of organizations that might use lasers for skin treatment. You're a doctor, a physician, a dermatologist, this is your area of expertise. Do you receive some special training, or is there an advantage to coming to you to use this technology? Dr. Smart: Oh, you bet. So lasers were invented by dermatologists. Back on the East Coast, sort of the grandfathers of laser medicine are dermatologists out of Harvard, and they in fact own many of the companies back there that have created these layers to treat a variety of skin conditions. So there is specialty training both in residency, and there is specialty training in post-residency. For me, myself, I completed a laser and cosmetic fellowship, extra training after residency for over a year in Manhattan, and those kinds of things do exist. But they're just getting started, and mostly just in dermatology. Some very important issues, lasers are fairly powerful. Every now and again, more regularly than I'd like to see, a lot of people come in with complications that they've received at medi-spas, or somebody that decided they wanted to stop being whatever their profession was and start treating skin problems and call themselves a laser center. So you do have to watch out for that, because there is specialty training and not every laser is created the same. Some lasers are Ferraris and some lasers are the Kia Souls, the very cheap type of lasers. There are more side effects for the lasers that claim to do absolutely everything. And for people who are running them that really don't know the difference in how the chest skin is different from the face, and how the face skin is different from the scalp, what laser settings need to be used to treat those areas, and sometimes to the patient's detriment. Interviewer: I think the important thing to remember is you've got the technology, and then you need to have the skilled technician that understands how the technology works, how the skin works, how the body is different. Dr. Smart: Yeah, definitely. Interviewer: Are the treatments for the various skin conditions relatively the same, in so far as how many treatments you're going to need, how often you need to go in, how long it's going to take? Or does it vary quite a bit? Dr. Smart: It varies quite a bit. I'll use one specific example, and that's laser resurfacing. Laser resurfacing does a great job at, those lasers that you mentioned before, taking five years off the skin, those are resurfacing lasers. Interviewer: How do you take five years off the skin? What exactly is going on there? Dr. Smart: So like you said, skin takes a lot of the brunt of the damage, pollution, time, weather, sun, all of that, and it starts to get blotchy overtime. The pores start to get larger. The texture is not as smooth. It's more cobblestone-y, "crepe-y" we like to call it, a sort of fine paper type of appearance with a lot of wrinkles. Removing those things, normalizing the color, taking away the brown spots and the red spots, making it a smooth tone, and also smoothening out the texture, that's taking at least five years in many cases off the skin. Interviewer: It sounds like to do something like that, you're probably using a lot of different lasers. Like you've kind of got to mix and match for each patient that comes in, "What are the issues we're trying to solve?" Dr. Smart: Certainly. Interviewer: And put together a treatment regimen. Dr. Smart: Yeah. It's very, very personalized, which brings me back to that point before that not one laser is going to do all of these things. Some of the lasers actually do take quite a bit of time, a course of them. You are going to want to repeat some of these lasers four to six times. Some of the other lasers that have a little bit more bang right up front as far as their efficacy, they also have more downtime. So there are some lasers that are going to get you five years off the skin with just one treatment, but you're probably going to not want to leave the house for a week. You're going to be a little bit red. It's going to be apparent that you had something done for several weeks after that treatment. Whereas, some of the other lasers that do the same thing in a more conservative, more elegant fashion, they get you the same result, but it might take six months, nine months of repeating this laser treatment on a regular basis. But your downtime, much better. Interviewer: There again, that's where having somebody that really understands the skin and how these lasers work, and the best laser for the job. Are there side effects to these treatments? Twenty, 25 years down the road, am I going to have less skin now and I'm going to be more vulnerable to the elements? Dr. Smart: That's a great question. Surprisingly, no. To be totally fair, we haven't been doing these treatments on a very large scale for more than a few decades. So we don't have quite that much evidence. But going back to what I said, normalizing the skin, so the skin actually becomes healthier, stronger, and thicker with repeated laser treatments, rather than thinner and less skin. Interviewer: This is such a crude analogy. It's not like sandblasting? Dr. Smart: No, it's not like sandblasting. Interviewer: It actually makes the skin healthier. That's fascinating. Dr. Smart: Yeah. It's more like aerating a lawn, actually. You're removing certain places, but leaving healthy patches to grow in, fill in that area. Interviewer: Then, overtime it becomes a healthier lawn. Dr. Smart: It's even healthier, yeah. Interviewer: The skin becomes healthier with laser treatment as well. Dr. Smart: Precisely. Interviewer: Are there any side effects? You had mentioned that some treatments you might need to take a few days off, because somebody would be able to tell that something happened. Dr. Smart: Oh, yeah. Most definitely, and of course depending on the laser entirely. But laser energy is essentially, when it all boils down to it, heat. So burns are the most common side effect, burning, blistering, and most of the time you're trying to get a mild burn. You're going for a light sunburn appearance, because that's what the result is to show efficacy. You really do want to have some appearance that something's been done. Generally speaking, that can go away in anywhere from 30 minutes to a day, a few days, and that just depends on the laser you choose and what you're going after. Interviewer: What should a listener know to make an informed decision about this? I think we've covered a lot of the bases. Is there anything that I forgot? Dr. Smart: There are many different lasers, and there are many different problems, tattoos, scars, and a variety of medical treatments that can effectively be treated by laser. So you really just have to go somewhere that has some experience. Announcer: TheScopeRadio.com is University of Utah Health Sciences radio. If you like what you heard, be sure to get our latest content by following us on Facebook. Just click on the Facebook icon at TheScopeRadio.com. |