Saturday, June 30, 2012

New FDA Rules for Sunscreens

   This year the FDA 's new labeling regulations for sunscreens will go into effect. Say goodbye to SPFs higher than 50, and forget looking for the words "water proof" and "sunblock" on the labels. 

   "I think the goal is to make labeling of sunscreens easier to understand and, frankly, more honest," according to Amanda Bell, MD, owner and medical director of Plush Medical Spa in Dothan, Alabama. "There is no clear evidence that SPFs above 50 provide additional protection from sun damage."

   The words "broad spectrum" may now only be applied to sunscreens that contain both UVA and UVB protection. Ultraviolet-A (UVA) rays primarily cause aging, and UVB rays cause tans and burns. While sunburn is primarily caused by UVB rays, we now know that both UVB & UVA can cause cancer and premature skin aging. The effectiveness standard most of us associate with sunscreens - SPF or sun protection factor - measures only how well they block UVB rays, because scientists used to believe UVB rays acted alone in causing skin cancer

   Beach and pool days are not the only time to think of sunscreens, and Dr. Bell recommends wearing sunscreen daily, applying a layer in the morning before any makeup or moisturizers. "Aging UVA rays penetrate glass and will bombard you through windows and in your car. Living in the South, we tend to get plenty of UV exposure without even trying." 

   "The ultimate goal here is not cosmetic," says Dr. Bell. "We need to do all we can to drastically lower the incidence of melanoma." Melanoma is the most dangerous type of skin cancer and is the leading cause of death from skin disease. It is the most common cancer in 18-20 year old women, but with the appropriate protection, it is also very preventable.”
To help protect your skin, the new FDA regulations on sunscreen labels include:

  • Skin cancer/ Skin aging alert: SPF 2-14 will be labeled with a warning that reads: “Skin Cancer/Skin Aging Alert: Spending time in the sun increases your risk of skin cancer and early skin aging. This product has been shown only to help prevent sunburn, not skin cancer or early skin aging.”
  • Water resistance claims: Sunscreen labels must tell how much time a user can expect to get the declared SPF level of protection while swimming or sweating. Two times will be permitted on labels: 40 minutes or 80 minutes.
  • No false claims: Manufacturers cannot make claims that sunscreens are “water proof,” “sweat proof” or offer “instant protection,” nor can they identify their products as “sun blocks.”
  • SPF 50+: Sunscreens can no longer carry an SPF label greater than 50. There are no known benefits for SPF higher than 50.
   Dr Bell recommends avoiding overexposure to the sun and following these tips to reduce your risk of skin cancer:

  • Reapply sunscreen. Reapplication is necessary and should be done depending on SPF protection. If the SPF is a higher number, it means it can be used less frequently.
  • Moderation is key. Avoid sun exposure during its peak times, from 10 a.m. to 4 p.m. and enjoy the sun in moderation.
  • Dress appropriately. “There’s nothing wrong with wearing a light, long-sleeve shirt or a wide-brimmed hat in the sun,” Keidan said.
  • See a dermatologist. Self-examination of the skin is recommended for young adults as well as seeing a dermatologist annually.

   Obagi Medical Skin Care has 5 sunscreens to meet your individual needs, ranging from SPF 32 to 50. Their newest offering is the Nu-Derm Sun Shield SPF50. Their lightest yet most powerful sunscreen to date, it goes on like a moisturizer, easily layering under make-up without feeling greasy or heavy. 

Through August 2012, ALL Obagi sunscreens are 30% off at Plush Medical Spa!

Plush Medical Spa, LLC
548 Westgate Parkway
Dothan, AL 36303

Sunday, May 20, 2012

The Latest Dermal Filler!

There is a new filler available in the United States,
 and we have it at Plush Medical Spa!

   Last fall, the FDA approved this hyaluronic-acid filler, known as Belotero, which can be used to treat moderate-severe facial wrinkles and folds.
   Belotero has been used for years in Europe and Canada, and it is very similar to other hyaluronic fillers, such as Juvederm and Restylane. However, there are some key differences you should know about. Belotero come to us from Merz Aesthetics, the company behind the Radiesse filler and the botulinum toxin Xeomin, both also approved by the FDA for cosmetic use in the USA.

#1. Belotero is for superficial wrinkles and folds.

The main difference between Belotero and other products like Juvederm and Restylane, is that Belotero is designed to help treat superficial lines and wrinkles that are closer to surface of the skin. This is important because other HA fillers, like Juvederm, Restylane, and Perlane, can produce a bluish hue under the skin if they are injected too superficially. This is called the Tyndall Effect, and can be a significant problem when inexperienced practitioners are doing the injections. The problem has supposedly been solved with Belotero, but everyone should remember that the Tyndall Effect occurs very rarely in the hands of experienced injectors. 

#2. Belotero may last longer than other HA fillers

Nasolabial folds Before & After Belotero 
The key word here is “may”. The duration of effect after treatment will entirely depend on factors like age, treatment, correction undertaken and the accuracy of placement by the practitioner performing the operation. Most HA filler manufacturers say that their products last up to 12 months, but in reality, 6-12 months is probably a better estimate. The company that makes Belotero says that it lasts 6-12 months on average, compared to 6-8 months with Juvederm. Time will tell if this is true or not. 
 According to Belotero manufacturers, "The creation process involves using cohesive polydensified matrix (CPM), a technology that involves a unique process that is capable of giving the product remarkable elasticity. It is this elasticity that gives the product its monophonic nature. Compared to biphasic products, this product can yield better results in terms of volume increase and wrinkle reduction." 

Side Effects of Belotero.

The most common side effects from Belotero and other hyaluronic acid fillers, are bruising, swelling, and redness around the area that was treated.  This is common after any injection, and usually resolves after about 1 week. While it is possible to develop an allergic reaction to any filler, this is extremely rare with Belotero and the modern HA fillers.
 The Bottom Line about Belotero
Crow's feet treated with Belotero
Overall, Belotero may fill a gap in the filler industry by allowing practitioners to use it to treat superficial fine lines without having to worry about the possibility of the bluish hue. This quality may make Belotero useful for treating superficial lines between the eyes, around the mouth, or under the eyes where the skin is thin and the Tyndall Effect is more common.

How can I get more information about Belotero?

If you have any questions about Belotero, or about any of the other fillers such as Juvederm, Restylane, Perlane, Radiesse or Sculptra, feel free to give us a call at 334-702-6869 to schedule your FREE consultation with Dr. Bell, or  send us an email at, or visit our website:

Plush Medical Spa, LLC
548 Westgate Parkway
Dothan, AL 36303

Wednesday, January 4, 2012

All about Chemical Peels!

 Chemical peels treat a host of skin problems including acne, discolorations and fine lines and wrinkles. The treatment involves a liquid chemical formula (usually containing some sort of acid) applied to the skin, which causes the removal of the damaged outer layer of skin and leaves softer, smoother skin. These procedures take less than an hour to perform, usually with minimal discomfort during the treatment, and may require as little as a few days or up to several weeks of recovery time, depending on the strength of the peel.
There are a variety of chemical peels offered today, which allows you and your skin care specialist to partner together to find the best formula for your specific needs. Come in for a free skin care consultation with our licensed estheticians at Plush Medical Spa, and they can talk with you and evaluate your skin's individual needs. 

Plush's list of the top five chemical peels, from the lightest to the deepest peel available:

1) Alpha Hydroxy Acid Peels
Alpha hydroxy acids, also known as AHAs, are one of the most popular ingredients in a mild chemical peel. Glycolic and lactic acid are the most common AHA used for this purpose. AHA peels rarely need any sort of anesthetic to perform, and the discomfort during and after the procedure is minimal. This peel is typically used to reduce the appearance of fine lines, smooth rough skin and produce a more even skin tone. 

Glycolic acid (extracted from sugar cane)
Lactic acid (extracted from milk)
Malic acid (extracted from pears and apples)
Citric acid (extracted from oranges and lemons)
Tartaric acid (extracted from grapes)

Lighter chemical peels for acne do not require much recovery time, although it is normal for people to experience slight redness and irritation and may also experience some crusting which will eventually subside as the body adjusts to the treatment. The peeling is similar to sunburn. Most people can continue their normal activities. Make-up can be applied a few hours after the procedure. These lighter chemical peel treatments are usually repeated every six weeks and patients generally undergo five to eight light chemical peels to achieve optimal results.

2) Beta Hydroxy Acid Peels
The most common beta hydroxy acid used in chemical peels is salicylic acid. This substance is also frequently used in acne products, which is why salicylic chemical peels are often used to treat acne-prone skin. Salicylic acid is more potent than glycolic acid, so it provides a slightly deeper chemical peel with longer lasting results. Because beta hydroxy acid chemical peels are also considered mild resurfacing treatments, no anesthesia is needed and the recovery time after the procedure is relatively short. However, it may take more than one treatment session to achieve desired results, and the procedure will need to be repeated periodically to maintain softer, smoother skin.

Obagi Medical has created a new chemical peel called the Blue Peel Radiance. Often confused with Obagi's well-known Blue Peel (which is a TCA peel, see below), the Blue Peel Radiance can be used on any complexion and is suitable for most skin types, except those with severe Rosacea. Those with blemish prone skin, acne scars, wrinkles, unwanted pigmentation, scars, large pores, and sun damage are the most ideal candidates. Blue Peel Radiance fades hyperpigmentation (sun spots) well for darker complexions. As with other peels, it works by forcing dead skin cells up to the surface, then kick starting collagen production underneath. Moreover, a mixture of peel ingredients such as salicylic, glycolic, and lactic acids work to clean out pores and stimulate cell renewal.
  We at Plush love the Blue Peel Radiance and the glow it provides after just one peel. As with all light peels, there is almost no downtime and results improve with subsequent treatments. We highly recommend a series of 6 Blue Radiance peels followed the Obagi Nu-derm system with prescription-only tretinoin to maximize your skin transformation.

3) Jessner's Peel
Jessner's peel is actually a combination of ingredients mixed into a single formula. It is considered a light chemical peel that is slightly stronger than both the alpha and beta hydroxy formulas. Jessner's peel uses lactic acid, salicylic acid and resorcinol, which is also used in treating several skin conditions. It is applied to skin that is too damaged to respond well to an AHA peel, but does not require a medium to deep treatment. Jessner's peels are applied typically after the patient has used topical Retin-A cream (tretinoin) nightly for 2-3 weeks, and complete recovery after the treatment takes about a week.

4) TCA Peels
Medium chemical peels, usually trichloroacetic acid (TCA) chemical peels, provide more dramatic results than light chemical peels, and they don’t require as much extended recovery time as deep (phenol) peels. A medium chemical peel can be used to treat any area of the body and take only minutes to complete. Depending on the size of the area being treated, a medium chemical peel may take from 15 to 60 minutes to complete, though most treatments can be completed within 30 minutes.  

TCA can be used in many concentrations, but it is most commonly used for medium-depth peeling. It is ideal for the removal of acne scars, and for removing shallow tattoos and age spots. It is also recommended for large pores, but not for deep furrows. It helps remove the layers of dead skin that can cause acne infection to get blocked and releases the impurities allowing the skin to heal with a much healthier look. TCA chemical peel also helps increase the blood flow and circulation, which in turn stimulates your skin cells allowing them to rejuvenate and build up collagen and elastic fibers which strengthen the skin.
 The treatment is somewhat painful and treated areas may be swollen and red. The skin will tighten and crust, and begin to peel after several days. You must NOT pick the loose skin! It is strongly advised to wear sunscreen daily in the months following a TCA chemical peel. The results of TCA chemical peels are usually less dramatic than and not as long-lasting as those of a phenol peel. More than one TCA chemical peel may be needed to achieve the desired result.
 At Plush Medical Spa, we use at 15% TCA solution applied in layers with a purple dye, called the Plush Purple Peel.

Obagi Blue peel & Plush Purple peel
These chemical peels are TCA blended with a blue or purple dye to accurately determine where and how evenly the chemical has been applied. This chemical peel has the same benefits as any TCA chemical peel; however, it is often recommended as a treatment for skin discoloration. This peel is accompanied by home treatment with hydroquinone and tretinoin.

5) Phenol Peels
Phenol is the substance of choice for deep chemical peels that provide the most dramatic results. In addition to treating skin imperfections, this type of chemical peel may be used to remove precancerous growths or completely diminish deep wrinkles. Because the formula works more deeply than other types of chemical peels, most phenol peels require an hour or two in the doctor's office and usually involve a local anesthesia during the procedure and pain medication afterward. Phenol peels can take up to a month to recover from completely. We do not perform phenol peel at Plush Medical Spa. Please contact your dermatologist if you have had other chemical peels and are interested in a phenol peel.

After the peel...
After a superficial peel, there may be slight redness, but there are no long-term effects, other than slight peeling in some patients. Diligent sunscreen use is important after any chemical peel.

After a deep peel, the skin develops an exterior crust, which lasts for about a week. During the initial healing period vigorously moisturizing the skin helps to minimize any dryness or tightness. The skin will initially have a reddish color that may take six months to fade away completely, but the average person can start wearing makeup and return to work and his or her social life in a couple of weeks.
A deep peel can be a painful, emotionally difficult process to endure, but the end result is a remarkably smoother, relatively wrinkle- free skin that lasts for 15 years or more.

 A Plush Medical Spa esthetician performs a microdermabrasion and chemical peel. 
Dr Bell discusses the purpose and importance of these procedures.


548 Westgate Parkway
Dothan, AL 36303