JUL-AUG 2017

MedEsthetics—business education for medical practitioners—provides the latest noninvasive cosmetic procedures, treatment trends, product and equipment reviews, legal issues and medical aesthetics industry news.

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34 JULY/AUGUST 2017 | Med Esthetics WINNING COMBINATIONS TOP: IMAGES COURTESY OF CARL THORNFELDT, MD; BACKGROUND: © GETTY IMAGES Fruitland, Idaho-based dermatologist Carl Thornfeldt, MD, worked with his estheticians to develop an effective antiaging treatment that can be performed by nonmedical personnel in all 50 states. It involves using microneedling at a depth of 0.5mm to both stimulate epidermal reju- venation and improve the effi cacy of low concentration chemical peels. "The limitation is that a needle depth of 0.5mm may not rejuvenate the entire epidermis, particularly for people with deeper rete ridges extending into the dermis, for whom you need to affect the basal layer," says Dr. Thornfeldt. Combining microneedling with a peel boosts the effi cacy of both treatments. "Superfi cial chemical peels with a low pH can repair pho- todamage by diffusing through the entire epidermis to the basilar layer," he says. "However, most state licensure laws do not allow estheticians to apply a peel containing the concentrations of the ingredients neces- sary to do so. But microneedling 0.5mm prior to the peel produces a synergistic process that can help the peeling agent reach the basement membrane and basal epidermal cells." His esthetician's protocol is to perform the microneedling treatment per manufacturer's instructions. Then, while the patient is still numb, a light peel is applied (30% malic acid, 5% salicylic acid). The peel solu- tion is left on for 5 to 10 minutes and then removed by cleansing and rinsing the skin. The esthetician then applies a postprocedure fi rming mask to soothe the skin for an additional 5 to 10 minutes. "This combination therapy has virtually no downtime, and it is gentle enough to use on immunocompromised patients and those affl icted with chronic diseases characterized by atrophic skin such as lupus ery- thematous or diabetes mellitus," says Dr. Thornfeldt. Inga Hansen is the executive editor of MedEsthetics By combining superfi cial peels and microneedling, esthe- ticians can deliver more dramatic textural improvement. BEFORE AFTER Mitchel P. Goldman, MD Volunteer clinical professor of dermatology at the University of California, San Diego, and medi- cal director of West Dermatology. Jeannette Graf, MD Assistant clinical professor of dermatology at Mount Sinai Medical Center, and author of Stop Aging, Start Living. Tess Mauricio, MD Founder and medical director of M Beauty by Dr. Tess clinics with multiple locations in southern California, and host of The Dr. Tess Show. Carl Thornfeldt, MD Founder of CT Derm in Fruit- land, Idaho, author of Ideal Skin Health, and CEO and founder of Episciences. ESTHETICIAN PERFORMED: CHEMICAL PEEL + MICRONEEDLING

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