The Photofacial is offered by Dr. Fisher


	FotoFacial/RF and FotoFacial/RF with Levulan: For Beautiful, Shining, Youthful Looking Skin Do you spend hundreds or even thousands of dollars each year at the cosmetic counter buying products to camouflage sun damaged, old looking skin? Is your face, hands, neck, or chest covered with dilated capillaries, blotchy brown spots, areas of pigmentation or freckles? Are you embarrassed when flush or blush unpredictably and uncontrollably? Is your face constantly red? Is the texture of the skin of your face coarse and orange peel-like? Are you plagued by rosacea, that chronic skin disease that makes your skin red, blush, and break out? If so, there is a new treatment, one without any 'downtime' that can substantially improve these problems and make your skin look young again-the Fotofacial/RF. Introducing The FotoFacial/RF In the 1990's many treatments emerged to rejuvenate sun damaged and aging skin. Most of these treatments, such as Laser Resurfacing were quite effective but involved the destruction of the epidermis or outer layer of skin in order to exert their rejuvenating effect. When the epidermis is destroyed, a long and often arduous healing time is required before the skin recovered. Additionally, there can be many complications, such as loss of skin color (hypopigmentation), darkening of the skin (hyperpigmentation), and even scarring. Towards the end of 1990's, a novel revolutionary new approach to facial rejuvenation, using Intense Pulsed Light (IPL) was discovered and perfected by Drs. Patrick Bitter Sr. and Jr., of California, Dr. Stephen Mulholland of Canada and others. This treatment involved flashing pulses of very bright light in a controlled fashion onto the skin of the face, neck, chest, and/or arms while simultaneously cooling the epidermis. In doing so, the light energy passed through the epidermis without damaging it to the dermis below. There, the light energy exerted its beneficial effect of reducing redness, blotchy patches of hyperpigmentation, brown spots, and to a lesser extent, improving wrinkles and skin texture. This IPL treatment was known as the FotoFacial and became very popular. Because the epidermis was not damaged, there was nothing to heal, no recovery or "downtime." Patients could return to work or other activities immediately after a treatment. In the last few years experiments were done adding radiofreqency energy or RF to IPL. RF is synergistic with IPL and together they increase the positive effect of either energy alone. Not only are red and brown skin abnormalities significantly decreased, but much more than just IPL alone, wrinkles, texture, scars, and skin laxity may be improved. This new skin treatment that combines IPL and RF together, technically known as selective radiophotothermolysis has been dubbed the FotoFacial/RF. The FotoFacial/RF like its predecessor does not damage the epidermis and therefore requires no recovery time-no "downtime." Dr. Richard Fisher and his staff were among the very first to study this new treatment directly under its innovators, Drs. Bitter and Mulholland and to bring it to Arizona. Who Are Candidates For FotoFacial/RF? Sun damage is very prevalent in residents of Arizona. Most people who live here for even a few years exhibit some evidence of sun damage in the form of dilated capillaries, brown spots, diffuse redness over the face, neck, chest, and hands. Sun exposure also accelerates wrinkles around the eyes, cheeks, and mouth. Those people who have noticeable signs of excessive sun damage including redness, dilated capillaries, wrinkles, brown spots, areas of diffuse pigmentation, and coarse skin texture are all ideal candidates for FotoFacial/RF. Rosacea, a exceedingly common skin affliction affecting nearly 13 million people in this county is manifest by facial redness, spontaneous uncontrolled flushing and blushing, and acne breakouts. While topical and oral antibiotics reduce the associated acne breakouts, until IPL there was no effective treatment for the redness, flushing, and blushing. Now this common skin disorder is readily and effectively treated by FotoFacial/RF. Flushing, blushing, and redness can be reduced as much as 80% in many cases, and acne breakouts improved substantially as well. What Is A FotoFacial/RF Treatment Like? How Long Do They Take? Are They Painful? FotoFacial/RF treatments are simple, convenient, quick, and painless. After covering your eyes with protective glasses, we place a thin layer of cool gel over the treated area, press the IPL/RF device onto your skin and flash. The flashes are repeated until the entire area has been treated. Depending on the size of the area, a FotoFacial/RF treatment usually takes between 15 and 30 minutes. Any pain associated with the flashes is reduced to a bare minimum with a special device that cools your skin. After a treatment, you can put on makeup immediately and return to your regular activities. Do I Need More Than One Treatment? FotoFacial/RF does not exert its full beneficial effect in only one treatment; they must be repeated over several weeks. Five or more treatments over the span of fifteen weeks are often required. That is, one treatment every three weeks. To optimize results, we often combine treatments with superficial skin peels between the FotoFacial/RF treatments. What Type of Results From Fotofacial/RF Can I Expect? How Much Improvement Will I See? Our FotoFacial/RF Program consists of five FotoFacial/RF treatments, three weeks apart over fifteen weeks. In the interval weeks between FotoFacial/ RF treatments to maximize the benefits, we combine FotoFacial/RF with four superficial peels, either Microderinabrasion or a light chemical peel. These superficial peels remove the layer of dead skin that can decrease the IPL/RF penetration of the skin. Additionally, we treat the skin with a variety of skin care products, based on our patient's skin type. Some individuals, particularly those with darker skins and/or heavy pigmentation may require several weeks of skin care products prior to initiating the FotoFacial/RF Program. What Type Of Results From Fotofacial/RF Can I Expect? How Much Improvement Will I See? We see usually a 75% improvement in redness, dilated capillaries, brown spots, hyperpigmentation and skin texture with FotoFacial/RF. Improvement in fine wrinkles, is variable. Overall, your skin will look brighter, fresher, and more youthful. It will shine again as it once did when you were younger. Are There Any People Who Cannot Undergo FotoFacial/RF? Fotofacial/RF is not indicated in patients with connective tissue disease or auto immune disorders. It cannot be done during pregnancy, nor can it be done on recently sun-tanned skin (we wait until the tan fades) or in those who may receive excess sun exposure for a few weeks following treatment. It cannot be used on patients taking Accutane. You must have stopped Accutane for at least two months prior to starting Fotofacial/RF. The procedure is not usually done on patients with active acne cysts, large pustules or highly active rosacea. Most photosensitive medications such as antibiotics, anti-anxiety drugs, sulfa drugs, birth control pills and anti-hypertensive medications are not a contraindication. Care must be taken in patients who get fever blister attacks on the lips (cold sores). An anti-herpes medication can be taken to avoid activation of this virus. There is no age limit for FotoFacial/RF. How Long Will the Beneficial Effects Of Fotofacial/RF Last? Will I Need Additional Treatments To Maintain the Results? After your initial treatments we recommend maintenance treatments every 4-6 months. However, even without regular follow up treatments, the positive results of our Fotofacial/RF treatments can last a considerable length of time. Of course, sun exposure, smoking, aging, etc., can reduce the longevity of these benefits. What Conditions Will This Treatment Not Help? Fotofacial/RF won't treat frown lines, sometimes known as lines of expression on the face, especially the forehead and between the brows. These are very effectively treated by Botox injections which we provide. Fotofacial/RF is not a substitute for a face-lift and will not help baggy or sagging skin. It will not cure the puffiness around the eyes for which blepharoplasty surgery is usually performed. It is not a treatment for skin cancer, but can reduce pre-cancers called actinic keratosis. It won't remove bumpy moles, but can reduce their pigment. Although, it will remove acquired freckling, genetic freckles usually return after treatment. It will not remove seborrheic keratosis including the tiny genetic ones on the upper cheeks and around the eyes sometimes called dermatosis papulosa nigra. It also will not remove sebaceous hyperplasias, a benign growth of oil glands in the skin. Are There Any Side Effects? Most side effects of Fotofacial/RF are mild and of short duration. These can consist of short-term discomfort during and after the actual treatment. There is usually additional redness immediately following treatment, lasting less than 24 hours in most people, on rare occasions it may last up to three days. Mild blistering and bruising is possible but in our experience occur in less than 1% and usually clear very quickly. A post treatment increase in pigmentation (hyperpigmentation) has been noted on occasion, but is highly treatable and uncommon. Even more rare is a decrease in pigmentation (hypopigmentation) of the skin after treatments. We have never seen a scar or an infection of the skin after treatment, but these can occur. Swelling of the face for 3-5 days occasionally occurs and is most common in severely sun-damaged skin due to reduced quality of connective tissue around the blood vessels. What Requirements Are Necessary To Have This Treatment? All patients must have a consultation prior to the procedure. At the time of the first treatment, each patient will be tested to properly evaluate the correct settings for the patient's skin condition and skin type. These parameters will then be recorded in the patients chart for future reference. Pre-treatment, and post treatment photos will be taken. An informed consent document must be signed prior to the initial treatment. What If I Have A Low Tolerance For Pain Or Sensitive Skin? The application of cold air to the treated area with our cooling device reduces any pain to a minimum. We have extensive experience with patients who have sensitive skin, always listen to their concerns, and treat accordingly. Who Administers The Treatments? All patients will be evaluated by Dr. Richard Fisher as to their suitability for FotoFacial/RF. The treatment itself is performed by an experienced technician who has either attended the Advanced Fotofacial/RF Training Certification Course conducted by Drs. Bitter and Mulholland or has been individually trained by Dr. Fisher. Is There Anything Special I Have To Do Prior To A Fotofacial/RF Treatment? Prior to your appointment, all make-up or creams must be removed. Men will be asked to shave on the day of treatment, prior to their arrival at the office. If any herpetic lesions (cold sores) or bacterial infections are noted on the day of the procedure, the treatment will be canceled until the condition has resolved. Can I Accomplish The Same Results With Laser Resurfacing As Fotofacial/RF? No. Laser Resurfacing may very well help wrinkles, but it does not affect or remove blood vessels or flushing and deep pigmentation. Further, it usually requires time away from work and your usual every day activities. Downtime is at least two weeks and up to a few months of redness in the treated areas can occur. Laser resurfacing has a valuable place in the treatment of certain conditions of the face, but it is not a substitute for the Fotofacial/RF. Can I Accomplish The Same Results With Chemical Peels, Or Microdermabrasion? No, these treatments by themselves cannot achieve the results of FotoFacial/RF. Microdermabrasion and light chemical peels enhance the benefits of FotoFacial/RF and are used in conjunction with FotoFacial/RF treatments. Will FotoFacial/RF Treatments Help My Acne Scars? Shallow scars including fine lines may be improved, but "ice pick" type acne scarring and deep scars will not be helped. Laser resurfacing or dermabrasion are usually indicated here. What If The Redness And Sun Damage Extends To My Neck, Chest, Hands, And Arms? Can These Areas Be Treated? Yes, these areas can also be treated successfully, much like the face. Many women especially are delighted to get rid of the "V-neck" effect of sun-damage that has accumulated in these areas from years of sun exposure. What Do Treatments Cost? Experience has shown us that we cannot predict how many treatments any patient may need. Therefore, we charge for FotoFacial/RF on individual treatment basis only and do not offer packages. Currently, the charge for treating the face alone is $250 per treatment. There is an additional charge for the neck, chest, or hands. The FotoFacial/RF With Levulan A “Supercharged” FotoFacial/RF As good as the FotoFacial/RF is that we offer to rejuvenate sun damaged skin, remove pigment, redness, and reduce rosacea, there is a new addition to the procedure that can substantially enhance the results of the FotoFacial/RF. Known as Photodynamic Therapy or PDT, a photosensitizing agent in the form of topical cream is applied to the area undergoing a FotoFacial/RF for a short time before it. The photosensitizing agent we use is Levulan (aminolevulinic acid). Levulan is absorbed selectively by those cells in the skin that produce pigment, the blood vessels that make our skin red and cause rosacea, superficial premalignant skin lesions known as actinic keratosis, and cells infected with acne causing bacteria. When the IPL energy from the FotoFacial/RF device hits the skin, the Levulan in the affected cells is converted into a chemical that releases free oxygen radicals destroying these cells into which it has been taken up. Levulan multiplies the effect and therefore the benefits of the FotoFacial/RF treatment by targeting specific cells for destruction. PDT is a new treatment that is just coming into its own. The results reported by many cosmetic and non cosmetic dermatologists around the world researching PDT have been very impressive. After one to three treatments, resistant cystic acne has resolved, actinic keratoses have disappeared, pigment, skin redness and rosacea have all improved. New benefits of PDT are being discovered almost daily. Patients report a substantial improvement in the texture of their skin after PDT. In fact, most physicians who have performed both consider the FotoFacial/RF with Levulan in many cases equal to about three standard FotoFacial/RF treatments. In short, the FotoFacial/RF with Levulan is a real advance in skin rejuvenation, one that doesn’t injure the skin or require a great deal of healing. How does the FotoFacial/RF with Levulan procedure differ from a standard FotoFacial/RF? The only difference between the standard FotoFacial/RF and one with Levulan is in the preparation before the FotoFacial/RF. Prior to the procedure, your face (or any other area to be treated) is cleaned with acetone. Then the area treated is covered with Levulan for about 60 to 120 minutes. After this incubating period, the Levulan is wiped off and the FotoFacial/RF proceeds in standard fashion. Where the standard FotoFacial/RF treatment takes 30 minutes or so depending on the area treated, adding Levulan requires about an hour or two more of your time to allow it to absorb into the skin. What is the downtime with the FotoFacial/RF with Levulan? Anybody who has undergone a FotoFacial/RF knows there is virtually no downtime. After a FotoFacial/RF with Levulan you can expect 3-7 days where you will not look your best. Redness and mild to moderate swelling of the treated area followed by light peeling can be expected after PDT with Levulan. The intensity of the post treatment redness and swelling depends on how long the Levulan is left on prior to the FotoFacial/RF, an individual’s sensitivity to Levulan, the degree of sun damage, active acne and other underlying skin conditions. As with the standard FotoFacial/RF, pigmented areas of the treated skin will darken temporarily and disappear in a few days after the treatment. Although you may feel self-conscious after the treatment, your activities are not limited, as long as you either avoid direct sunlight entirely or protect yourself from the sun for 48 hours following the treatment. Are there any special requirements before and after a FotoFacial/RF with Levulan? You will be required to take antiviral pills for several days after the treatment to prevent an outbreak of oral herpes virus infection (cold sores). Additionally, you must avoid the sun entirely or very carefully protect your treated skin from it for 48 hours after treatment. When will I see the results of a FotoFacial/RF with Levulan? The results will begin to be apparent as the post treatment redness and swelling subside in five to seven days. After this time, active acne resolves, rosacea improves, pigmentation lightens, and chronic redness and oiliness of the skin reduce. Within two weeks after a PDT treatment, your skin will feel noticeably smoother. Any actinic keratosis you may have had will largely disappeared. Within months of a FotoFacial/RF with Levulan treatment, fine lines and wrinkles usually show definite improvement. How many FotoFacial/RF with Levulan treatment are required? Although there is increased post treatment downtime with Levulan, as compared with a standard FotoFacial/RF treatment, less treatments are required to achieve desirable results. Some patients are completely satisfied after only one treatment. How often can repeated treatments of FotoFacial/RF with Levulan be done? FotoFacial/RF with Levulan treatments can be done about three to five weeks apart. How much more expensive is the FotoFacial/RF with Levulan than the standard treatment? Each FotoFacial/RF with Levulan treatment costs about 50% more than the standard FotoFacial/RF. Can FotoFacial/RF with Levulan treatments be combined with the standard treatment? We can combine one or two FotoFacial/RF with Levulan treatments in a course of standard FotoFacial/RF treatments. If I am interested in seeing if this new treatment can benefit me, how do I proceed? Simply call 623.876.9494 and arrange a complimentary consultation with Dr. Richard Fisher in our office.