Acne, Acne scars, surgical scars and other scars, Ageing and sun damaged skin, Birthmarks, Broken Veins / Dilated Veins, Brown spots, Dull and blotchy skin, Eczema and dermatitis, Excessive sweating, Red marks & facial veins, Rosacea / flushing facial redness, Sagging skin, Skin Cancer, Skin lines & wrinkles, Warts and verrucas

Acne is a skin disorder that is characterised by pimples, blackheads, whiteheads, and, in bad cases, cysts (deeper lumps). Acne usually starts at puberty and is in response to our body’s production of hormones, called androgens. These hormones cause the sebaceous glands (oil-producing glands in the skin) to get bigger and produce more oil. The extra oil (sebum) mixes with dead skin cells and naturally occurring bacteria on the surface of the skin and blocks pores. Once a pore is blocked the bacteria multiply and cause inflammation, which produces the characteristic signs of acne. Acne commonly occurs on the face, neck, back and chest. Acne can lead to permanent scarring. Other causes of acne may include: genetics heavy makeup harsh and repetitive cleansing picking and squeezing certain medications diet. Acne Vulgaris is the most common form of acne. Adult Acne occurs in about 30% of people at some stage in their adult life. It is thought that adult acne also has some hormonal influences. Acne Roseaca is similar to acne vulgaris, with oily skin and spots, but also has flushing or redness of the skin in the affected area. The flush may be set off by certain spicy food or alcohol. Treatment Mild acne can be treated with prescription ‘rub on’ products designed to release the blocked pores and fight infection. More severe acne may require antibiotic tablets. Women may find that taking a special type of oral contraceptive pill is helpful. People with severe acne often benefit from a course of a special vitamin A derivative medication known as isotretinoin, which would be prescribed by Dr Le Grice. A series of gentle fruit acid skin peels combined with a special skin care programme designed for acne-affected skin will often clear or control acne without the need to resort to prescribed medication. Some people may find that a series of gentle pulsed dye laser treatments is all that is required to keep their acne under control.

Scarring, from acne, past surgery or trauma, can be improved in appearance by using lasers to reduce the redness or remove blood vessels in the scars. The scars can also be smoothed by laser treatment, to improve the scar texture and help blend the scars into the surrounding skin. Sometimes Dr Le Grice will combine laser scar treatments with other treatments such as minor skin surgery and skin fillers to excise or modify scars. Treatment While scars cannot be completely removed from the skin there are many scar treatments to minimise scar formation and to treat scars once formed, to reduce the visibility of scars. If surgical scars are treated by pulsed dye laser at the time of stitch removal there is a significant improvement in scar blending once healing has occurred. Scarring, from acne, past skin surgery or trauma, can be improved in appearance, by using pulsed dye laser treatment or copper bromide laser treatment to reduce the redness or remove blood vessels in the scars. These scars can also be smoothed by erbium laser treatment, to improve the scar texture and help blend the scars back into the surrounding skin. The newest fractional laser treatment will help disguise the scars and improve their contour. Sometimes Dr Le Grice will combine laser scar treatments with other treatments such as minor skin surgery and skin fillers to excise or modify scars.

Skin age and your age are not necessarily the same. Most New Zealanders are not aware that our harsh sunlight and our love of an outdoor life style can cause premature aging of their skin. Aging of the skin produces changes in skin structure, with damage or loss of important support products like collagen and elastin. The skin is thinned and becomes more fragile, losing its elasticity. This increases skin wrinkling. The blood vessels in thin skin may break with minimal trauma and leave purple marks known as ecchymoses. There is also increased unwanted pigmentation or pigmented growths and dilated blood vessels. Over time, with the loss of important facial fat, and the effect of gravity, there is skin sagging and this produces characteristic loss of youthful facial contour. The Auckland Skin Laser Centre has a wide variety of treatments for the various aspects of skin aging including treatments for loss of skin tone and blotchy, uneven complexion, for wrinkles, pigmentation and growths, dilated blood vessels and flushing, skin sagging and early skin cancer changes. For more information on treatment of specific aspects of aging skin click here: Brown spots and pigmentation Dull and blotchy skin Lines and wrinkles Sagging skin Skin redness and flushing

Unwanted brown spots may be brown birthmarks, marks and pigmentation caused by excessive sun damage to the skin or pigmented skin growths. These are usually harmless but may rarely be a type of skin cancer. Treatment The best treatment for these marks will be recommended, depending on the nature of the mark. Treatment of skin pigmentation caused by sun damage may include a skin care programme and gentle skin peels. Skin growths can be removed by a variety of treatments and the most appropriate treatment will be recommended. Some marks can be removed by freezing them off (cryotherapy). In some situations, the use of broadband light treatment to remove skin pigmentation and gently rejuvenate sun damaged skin, will be the best treatment. Alternatively a gentle microlaserpeel might be best for some skin pigmentation problems. Deeper pigmentation may be progessively faded by gentle fractional laser treatments. Some skin growths may be best removed by precise erbium laser vaporisation while occasionally the best approach to some lesions, particularly if they are skin cancers, is surgery.

Unwanted blood vessels - smaller ones are called spider veins - have a red or bluish colour and appear on the surface of the body, particularly the legs and occasionally the face or elsewhere. They may be visible as short, unconnected lines each about the size of a large hair, they may be connected in a scraggly, “sunburst” pattern, or they may resemble a spider web or tree with branches. In some people, they occur in a small area and are not particularly noticeable. In others, they may cover a large area of skin and be quite unsightly. Larger unwanted blood vessels may be raised above the skin surface and serpentine; they may occur in association with spider veins. These large veins are also called varicose veins, but differ from the more commonly known varicose veins which frequently occur in association with a poorly working valve in a large vein. A characteristic of unwanted blood vessels in some sufferers is occasional pain, ranging from a dull throbbing pain to a burning sensation. Though unwanted blood vessels do carry blood, the great majority, especially spider veins, are not necessary to the circulatory system. Thus, if their presence is distressing, they can be treated by injection of a solution that will cause them to disappear or at least become much smaller. What causes these blood vessels to become visible? The cause is not known, except that in many cases they seem to run in families. Identical twins may be affected in the same area of the body and to the same extent. The condition can also occur as part of a large number of different diseases, both genetic and non-genetic. Spider veins occur in both men and women, but more frequently in women. The hormone oestrogen may play a role in their development, because puberty, birth control pills or pregnancy often seem to bring them on. During pregnancy the enlarged uterus may restrict blood flow, contributing to their development. They may also occur after a blow to a certain area of the body or as a result of wearing tight girdles or hosiery held up with tight rubber bands. In addition, spider veins may occur in association with underlying large varicose veins. When they occur on the face, spider veins may be related to chronic sun exposure or a condition known as rosacea. They tend to occur on either the nose or the cheeks of fair skinned persons. Treatment Troublesome dilated facial veins can be very effectively treated and removed in several ways and the dilated leg veins can also, in many instances, be sealed by our expert clinical staff. Where there are larger dilated broken facial veins which give the face its ‘ruddy’ complexion, these can be carefully and precisely sealed up by means of copper bromide laser treatment. Widespread and persistent facial flushing associated with tiny dilated facial veins often requires treatment with the pulsed dye laser to seal up the many dilated blood vessels in the skin. Broadband light can also play a useful role in treating this condition. Larger dilated spider veins or the even larger varicose veins on legs are usually best treated and removed by using a technique known as sclerotherapy, which allows the body to gradually seal up these unwanted veins.

This is a general sign of aging skin, often particularly affecting the face and reflects a combination of skin thinning, loss of tone, dilated blood vessels and skin pigmentation. Treatments Revitalisation of your skin may involve treatments such as the use of a special skin care range and sunscreen, gentle skin peels, broadband light skin rejuvenation and microlaserpeel treatment to precisely remove the lifeless skin layer. Other treatments available: Ultherapy Clear + Brilliant

Eczema is inflammation of the top layer of the skin, called the epidermis. It is also known as dermatitis and can present in various forms. Genetic factors can make individuals susceptible to eczema, but numerous other factors can play a role in making eczema worse at certain times. Allergic factors are important to recognise, but probably less common than many people realise. These may include allergies to contact agents (i.e. nickel, fragrances, preservatives), certain foods, airborne allergens and even forms of ultraviolet light. Non-allergic factors (irritants) are very common, and need to be addressed in all patients with dermatitis. Common irritants to the skin include skin dryness, soaps/detergents, friction/scratching, solvents, and industrial fluids. Treatment of dermatitis often includes topical (rub on) agents (moisturisers, topical anti-inflammatory creams). Antibiotics and tablet medication are often considered in more severe cases. Dr Le Grice will individualise your dermatitis management plan according to the cause(s), severity and personal preferences.

Known as 'hyperhidrosis', this condition can be very distressing and may affect several body sites, for instance, under the arms and on the palms. The use of neuromodulation techniques to prevent the release of sweat fluid from the skin glands has revolutionised management of the condition in some cases.

Fine lines and wrinkles are a sign of aging skin; there’s no way to entirely avoid them. As we grow older, our skin becomes thinner and drier. However, this process is sped up by chronic exposure to the sun. Treatment Facial skin lines and wrinkles can be prevented by instituting a good skin care and sunscreen programme in consultation with our expert cosmetic nurse. Where these lines are already causing problems, they can be softened by the expert use of skin fillers, replacing natural skin constituents which have diminished over time. The use of neuromodulation (Botox / Dysport) to prevent active facial muscles from imbedding lines into facial skin is an important aspect of treating facial skin lines and wrinkles. Deeper lines may require gentle and progressive treatment with fractional laser or more dramatic skin resurfacing and tightening with erbium laser.

As we age, and even in younger people, the skin can develop growths and lesions, many of them benign and harmless but in some instances these skin lesions may be skin cancers. or precancerous lesions known as actinic keratoses. Skin lesions and growths require expert diagnosis to determine whether they are skin cancers or benign growths and Dr Le Grice will bring all of his expertise to bear in this regard. Should your lesion be a skin cancer then prompt and complete removal will be recommended by Dr Le Grice. Although most skin marks and growths are benign, they can be most unsightly and cause great distress. These lesions are usually red or brown in colour and may be treated by a variety of means. Read more about: Brown Skin Marks Red Skin Marks

Skin sagging occurs as a result of aging skin and loss of supportive fat and skin structures. Treatments Skin sagging can produce unwanted furrows and shadows in skin. The expert use of neuromodulation (Botox / Dysport) to counteract overactive muscles producing some shadowing will help soften shadows. The replacement of the lost skin support structures can be achieved with expert placement of a skin filler. Most critically, treatments to generate new active collagen to replace the lost and damaged skin collagen will restore the skin’s natural elasticity and support, to reverse the sagging effects of skin aging. ‘Skintyte’ broadband light treatment and the exciting new Ultherapy ultrasound skin tightening device are designed to promote new collagen formation deep in the skin support structures and are important treatment options for sagging skin.

New Zealand has a very high rate of skin cancer, when compared to other countries. The most common forms of skin cancer usually appear on areas of skin that have been over-exposed to the sun. Risk factors for developing skin cancer are: prolonged exposure to the sun; people with fair skin; and possibly over-exposure to UV light from sun beds. There are three main types of skin cancers: basal cell carcinoma, squamous cell carcinoma and malignant melanoma. Basal Cell Carcinoma (BCC) This is the most common type and is found on skin surfaces that are exposed to sun. A BCC remains localised and does not usually spread to other areas of the body. Sometimes BCCs can ulcerate and scab so it is important not to mistake it for a sore. BCCs occur more commonly on the face, back of hands and back. They appear usually as small, red lumps that don’t heal and sometimes bleed or become itchy. They have the tendency to change in size and sometimes in colour. Squamous Cell Carcinoma (SCC) This type of skin cancer also affects areas of the skin that have exposure to the sun. The most common area is the face, but an SCC can also affect other parts of the body and can spread to other parts of the body. The spreading (metastasising) can potentially be fatal if not successfully treated. A SCC usually begins as a keratosis that looks like an area of thickened scaly skin, it may then develop into a raised, hard lump which enlarges. SCCs can sometimes be painful. Often the edges are irregular and it can appear wart like, the colour can be reddish brown. Sometimes it can appear like a recurring ulcer that does not heal. All SCCs will need to be removed, because of their potential for spread. The removal and diagnosis is the same as for a BCC. Malignant Melanoma This is the most serious form of skin cancer. It can spread to other parts of the body and people can die from this disease. A melanoma usually starts as a pigmented growth on normal skin. They often, but not always, occur on areas that have high sun exposure. In some cases, a melanoma may develop from existing pigmented moles. What to look for: an existing mole that changes colour (it may be black, dark blue or even red and white) the colour pigment may be uneven the edges of the mole/freckle may be irregular and have a spreading edge the surface of the mole/freckle may be flaky/crusted and raised sudden growth of an existing or new mole/freckle inflammation and or itchiness surrounding an existing or new mole/freckle. Treatment The precursor actinic keratoses and some superficial skin cancers can be removed by a variety of means including cryotherapy, special treatment creams and, where rapid healing and precise treatment, along with scarless healing are important, by erbium laser. Most skin cancers require removal by surgery and some more difficult skin cancers may require a special surgical technique, known as Mohs Surgery. Dr Le Grice will recommend and perform surgical removal or Mohs surgery removal of your skin cancer where this is the most appropriate procedure.

There are three main types of wart infections that occur on our body: common warts, plantar warts and venereal warts (genital warts). Common warts These are caused by a slow-growing virus. Warts are more common in children and are caught from direct contact with someone else who has warts. Most people have had warts at some stage in their lives. To look at they have a rough, irregular surface and are usually round in shape. They often appear on the hands, feet or knees. Plantar warts Also known as verrucas, these occur most often on the soles of the feet. They can be very tender, as they take the pressure of movement. They are skin-coloured and have a slightly irregular surface. They can grow larger than a common wart. As these are painful, they usually need to be removed or treated. They are generally harder and more painful to treat than the common wart. Treatment There are many over-the-counter treatments available, but most warts will disappear over time (around 18-24 months) with or without treatment, especially in children. If the wart has become painful or unsightly, it can be treated. Types of treatment are as follows: liquid nitrogen (a freezing process) diathermy (burning away of the wart) laser chemical acid surgical removal. After most of these treatments, the area will need to have a dressing and to be kept clean and dry. If the wart is surgically removed a hole is left that will need to heal on its own. Once a wart has been removed or treated there is no guarantee that it will not return and in a number of cases they do recur. Remember to get your doctor to look over your warts next time you are visiting, as some skin cancers are very much like warts. Venereal Warts (genital warts) Venereal warts are caused by a virus called human papillomavirus (HPV). This condition is known as a sexually transmitted disease (STD). It is a common disease and has a higher occurrence in males. Genital warts can be passed on during a sexual encounter, even if no symptoms or warts are present. Warts appear from 1-6 months after initial infection. Genital warts look like small flat irregular shaped growths, often occurring in clusters that enlarge quickly. They usually grow on the shaft of the penis and on the vulva in women (the external female parts), but they can also grow around the anus and rectum. Treatment There are a number of treatments for warts, some of which are more successful than others. Dr Le Grice has many treatment options at his disposal to help you eradicate these unwanted skin infections. These include freezing, acid treatment and wart injection techniques. These can be painful treatments and are often unsuccessful. We are able to offer state-of-the-art laser treatments for stubborn warts, to increase the chance of removing them for good. In many instances a non-surgical pulsed dye lasertreatment can heat and kill the warts while with stubborn deep warts carbon dioxide laser surgery and removal will be recommended.

Mohs Micrographic Surgery, Ultherapy™ / Ulthera Focused Ultrasound, Clear + Brilliant Laser Treatment, Broad Brand Light (BBL), VBeam Laser, Erbium YAG Laser Treatment, Copper Bromide Laser, Fractional carbon dioxide laser, SkinTyte, Carbon dioxide laser, Skin cancer treatment, Sclerotherapy, Cryotherapy, Neuromodulators (Botox / Dysport), Skin fillers, Skin peels, Skin care programme

BBL is a new approach to photorejuvenation and the treatment of skin concerns associated with ageing, active lifestyles and sun damage. Varying wavelengths of light are used to treat a wide range of skin concerns including: • Fine lines • Age spots • Small facial veins (Telangiectasia) • Sun damage • Freckles • Rosacea • Pigmentation • Port wine stains • Enlarged pores Popular areas to treat include the face, neck, décolletage and chest. BBL is not actually a laser. It is broad-spectrum pulses of light which are absorbed into the skin. The light’s energy encourages the growth of fibroblast and collagen cells, which are formed in the dermis and then create skin that is even in texture and colour. They also help repair scarring and sun damage, decrease pore size and minimise fine lines. IPL is often used in conjunction with other treatments such as microdermabrasion and chemical peels for optimal results. We can discuss a combined treatment plan with you at your initial consultation. To find out more information about BBL Photo Rejuvenation, please contact us on (09) 520 3200 or Broad Band Light (BBL) Hair Removal BBL hair removal is the latest technology that sets new standards for the treatment of unwanted hair that’s quick, efficient, safe and comfortable. Any part of the body can be treated with laser hair removal, on both men and women, the most popular areas being: • Underarms • Legs • Arms • Back • Bikini line (including Brazilians) • Chest • Female and male facial hair removal For more information, please check BBL Broadband intense pulsed light.

What is a ‘Clear + Brilliant’ laser? A Clear + Brilliant laser delivers minute spots of laser light to the skin surface in such a way as to deliver a matrix of minute treatment ‘dots’ with all of the skin between the dots left untreated. Under a microscope, the effect looks something like this: • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • What is the advantage of a Clear + Brilliant laser treatment? Skin treated with a Clear + Brilliant laser heals very quickly. Typically healing of the dots of treated skin takes one day and results in no ‘down time’ during the healing process. Because such a minute amount of the skin surface is treated, there is a much-reduced risk of side effects from treatment, such as redness, pigmentation and infection. What is the Clear + Brilliant laser useful for? It is very effective in providing a gentle rejuvenating effect on skin without the down time of a more dramatic laser skin resurfacing procedure. It is also very effective in improving tone and texture of the skin. Is more than one treatment required? A series of four treatments is recommended, with treatments spaced at least two weeks apart. Many people choose to have periodic maintenance treatments to help minimise the ongoing effects of skin aging. Is Clear + Brilliant laser treatment painful? There can be slight to moderate pain. This will be managed by applying a topical anaesthetic cream to the face prior to the procedure. Following the procedure, patients may experience a mild ‘sunburn-like’ sensation on the treated skin, for several hours. Will my skin be bandaged after the procedure? There is no need for dressings after the procedure. Make up can usually be applied the following day. We do recommend oil-free make up. Please do not use retinoic acid creams on your face skin during your treatment programme. What is the healing process like? Initially the treatment site will feel hot, like sunburn. The face will initially be pink, and will feel tight and dry. Patients are asked to avoid sun exposure and use good sunscreen. To assist the skin's rapid recovery, a skincare kit is available to purchase if desired. What possible unwanted side effects can occur? There is a very small risk of skin infection, so we ask you to wash your hands before touching your face. Individuals who regularly suffer from herpes cold sores should take preventative medication to prevent an outbreak during healing. Rarely, the pinkness of the healing skin can be prolonged and in individuals who tan more readily or have an olive or darker complexion, there is a small risk of the healing skin darkening. This side effect can be treated with special ‘fading’ creams. Thick scarring of the treatment sites is very rare with Clear + Brilliant laser treatment.

The copper bromide laser is able to selectively treat dilated blood vessels in the skin without harming surrounding skin structures. The laser produces very short pulses of the special type of yellow light which is only absorbed by red blood cells in the damaged area and over the next 6-8 weeks they shrink so that they are no longer visible. Because the laser light is not absorbed by the skin itself, the laser is able to lighten the various blood vessel marks without producing any scarring to the skin. The copper bromide laser is ideally suited to treat the ‘broken’ capillaries (telangiectases) of the face which arise from inflammatory skin conditions or sun damage. It is also used to treat small blood vessel haemangiomas. This laser may even seal up broken veins on the legs, although an injection technique, microsclerotherapy, is usually needed for these in the first instance. This laser has a fine beam which can be delicately traced over the dilated blood vessels, sealing them up. What happens with treatment? At the time of treatment, the laser beam is pulsed and traced over the unwanted blood vessels. There may be a heat sensation and mild swelling of skin. Rarely there is some mild crusting or blistering. What results can be expected? Most patients will see improvement in their treated blood vessels after several weeks. However, as with any procedure, there is always a possibility that only minor changes will occur and in rare cases, there is no response. How many treatments are required? This depends on the size, location, depth and colour of your lesion. Spider veins on the face usually do well with one or two treatments, while darker or deeper marks may require additional treatments. Treatments should be placed several weeks apart to allow your skin to gain the greatest benefit. You will continue to see a lightening of your lesion as treatments continue. Is copper bromide laser treatment safe? Lasers have been used successfully in hundreds of thousands of treatments. Laser treatment performed properly, by a trained laser specialist, is safe and effective. The laser light penetrates the skin to a maximum of only about one to two millimetres, so cannot affect deeper structures. The exception is the eye, which can be readily injured; hence special eye shields or goggles are used when the laser is in operation. The laser does not produce any rays known to be harmful (i.e. X-rays, UV rays, Gamma rays, etc). It emits one colour of visible light – one part of the ‘rainbow’. Is treatment painful? There is a hot pricking sensation as the laser pulses on the skin. Treatment usually requires no anaesthetic but cooling ice may be used on the skin as treatment progresses. Some people may prefer to apply an anaesthetic cream prior to treatment. For some people an inhalational anaesthetic may be useful. To arrange an initial consultation, please contact us on (09) 520 3200 or (initial consultation fee applies).

Cryotherapy is the use of extreme cold to treat skin lesions. It is used for the treatment of benign (non cancerous), pre-cancerous and certain cancerous lesions. In the past ‘dry ice’ was used but today liquid nitrogen is the preferred cryogen. Usually the liquid nitrogen is sprayed onto the treatment area until the desired degree of freezing has occurred. This results in a ‘frost bite’ type of injury to the lesion and allows for new skin to heal from the sides and underneath. Healing is usually rapid and for lesions that are treated on the face, make-up can usually be worn within a week. Initially in the first hours after treatment the treated spots will look red and then they may crust up or even blister. Blistering is common in certain areas like the backs of the hands. If this occurs the blister is best left intact as it will act like a natural dressing. When the blister breaks, a dressing may be applied together with a little Vaseline or an antiseptic cream.

As your skin ages and is damaged by the sun’s harsh ultraviolet light, there is a gradual loss of skin volume, due to a reduction in skin collagen and elastin and some loss of vital deep fat and even bone structure. Like a slowly deflating balloon, this leads to skin sagging and wrinkles. Fillers can plump out wrinkles, and restore your facial and lip volume – giving you a more youthful and rejuvenated appearance. How does the treatment work? Dermal fillers can be used on lips, wrinkles and folds, facial areas where deep volume loss has occurred, cheeks and jaw line. A skin or deep tissue filler is applied through several fine injections into the treatment area – producing an immediate restoration of volume, and improvement in the general appearance of your skin. However, the full result can take some time to come into effect. Your wrinkles, creases and furrows may have been in place for some time, so can take several weeks to re-drape and ‘iron’ themselves out. Dermal fillers can be used to enhance or rejuvenate both the body and border of the lips. It can be used to create volume with a natural look and feel to the lip body, increase the definition of the lip border, decrease vertical lip lines that can cause lipstick to bleed, restore a more youthful and upturned angle to the corners of the mouth and create a stronger cupid’s bow. Dermal filler is placed below the skin’s surface to literally ‘fill in’ or ‘plump up’ the wrinkles and folds that are present at rest. It is used to diminish the depth of wrinkles and create a smoother, more refreshed facial appearance. Dermal fillers can also be used to enhance or restore volume in areas such as the mid face and cheekbone and to provide more youthful contours to the jaw line and lower face.

Erbium laser skin resurfacing is a powerful yet gentle surgical technique for the treatment of many skin conditions at a level of precision previously unattainable. The Erbium laser is an alternative to treatments such as dermabrasion and chemical peeling and has advantages over these procedures. Erbium laser treatment can also replace surgery for some skin tumours. Is Erbium laser suitable for you? The Erbium laser is used to treat pre-cancerous skin lesions and some skin cancers, severe sun damage including fine lines and wrinkles, acne scarring, birthmarks and a variety of other skin blemishes. For the first time, the delicate skin of the neck and backs of hands can also be successfully treated. How does it work? The Erbium laser uses very brief pulses of light to target the condition being treated. The pulses of light are so short and so specific for the skin cells being targeted that the energy delivered to the targeted tissue cannot spread to affect surrounding normal tissue. This minimises the risk of adverse side effects, such as scarring, and allows the treated skin to heal in a matter of days rather than the 2-3 weeks previously required. How long before I see results? Skin healing will take place over a few days. Final results may not be evident for several months. Most patients require only one treatment with this laser, but in certain cases additional treatments are helpful. Is the process painful? Laser treatment can be painful. A local anaesthetic injection, anaesthetic cream and sometimes an inhalational anaesthetic may be used to reduce discomfort. What should I do before treatment? Tobacco, alcohol, and aspirin are best avoided from 2 weeks prior to treatment. Sun exposure should be minimised. What will be required after treatment? Following any treatment a healing balm will be applied to the treated area. Skin care will be explained and detailed instructions provided for post treatment recovery. Good sun protection is important. What will the procedure cost? The cost is comparable to other laser treatments. However, the total cost depends upon the size, depth and type of skin condition as well as the number of treatments required. This can only be assessed at the time of initial consultation. What complications can occur? Prolonged healing or redness, increased or decreased skin pigmentation, infection, scarring (very rare).

What is ‘fractional’ laser? This treatment is the new gold standard in skin resurfacing that is safe for most skin types delivering dramatic ablative clinical results with minimal discomfort: #1 Anti-aging Breakthrough according to WebMD Outperforms any non-CO2 based laser and device Reverses signs of skin aging, wrinkles, sun spots and pigmentation Improves old acne and trauma-related scarring The FRACTIONAL technology delivers tiny spots of CO2 laser light in a pixel-like fashion where microscopic tiny holes are punched into the skin right next to each other via a computer-generated pattern. A matrix of tiny treatment ‘dots’ is created with all of the skin between the dots left untreated. The effect looks something like this: • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • Microscopic columns of laser energy are delivered across the skin barrier, treating up to 20% of skin surface area. The other 80% of non-treated skin surface provides a source of rapid healing of the small treatment zones. A recent study confirmed that the fractional CO2 deep dermal ablation resulted in collagen remodelling for at least three months after treatment. Energy of Fractional CO2 Laser mushrooms in the papillary dermis » Skin Tightening » Continual Collagen Production up to 6 months. What is the advantage of a fractional laser treatment? Skin treated with a fractional laser heals much more quickly than skin that has been completely ‘resurfaced’ i.e. all of the top skin layer removed. Typically healing of the dots of treated skin takes four to six days and results in minimal ‘down time’ during the healing process. Because such a small amount of the skin surface is treated, there is a much-reduced risk of side effects from treatment such as redness, pigmentation and infection. Cosmetic appearance continues to improve with stimulation of collagen production up to 6 months after the procedure. What is the fractional CO2 laser useful for? This laser has proven to be very effective in treating and improving acne scars and other scars. It is also very effective in providing a gentle rejuvenating effect on skin without the longer down time of a more dramatic laser skin resurfacing procedure. The gentle nature of this laser allows more delicate skin such as the neck, chest and hands to be treated. Is more than one treatment required? Usually, three or more treatments are required to ‘remodel’ scarred skin. Depending on the density and depth of ‘fractional’ dots chosen for a skin rejuvenation treatment, possibly three treatments will be needed for this procedure. After three to five treatments, it is realistic to expect 50% improvement in the problem being treated. Is fractional CO2 laser treatment painful? Depending on the density and depth of treatment chosen, there can be moderate pain. This will typically be managed with a combination of pre–procedure oral pain relief, topical anaesthetic cream applied to the treatment site prior to the procedure and possibly an inhalational relaxing medicine (Penthrox ™) at the time of the procedure. Following the procedure, patients may experience a mild ‘sunburn-like’ sensation on the treated skin, for several hours. There may be pinpoint bleeding from the treatment sites. These problems are easily managed with Vaseline dressings and pressure. Will my skin be bandaged after the procedure? There is no need for dressings after the procedure. A Vaseline ointment will be applied immediately after the procedure and should be regularly applied after the procedure as this speeds up healing time. What is the healing process like? The healing time varies according to the depth and density of the treatment ‘dots’ in the skin. For deeper problems such as acne scarring, the healing may well take four to six days but with more shallow treatments, three to five days of healing is likely. However, individual patient healing times vary. Initially the treatment site will feel hot, like sunburn. This will quickly settle and patients are asked to keep the area moist with Vaseline or other recommended ointments. The pinpoint treatment sites will form crusts, which will flake off after a few days. The treatment sites will initially be pink as they heal and this colour will fade over a short period of time. It can be readily covered with makeup, once healed. Patients are asked to avoid sun exposure or use a good sunscreen during this healing phase. What possible unwanted side effects can occur? With deeper treatments the healing can be prolonged, with oozing, swelling and crusting. There is a small risk of skin infection which can be countered by taking medication. Individuals who regularly suffer from herpes cold sores should take preventative medication to prevent an outbreak during healing. Rarely, the redness of the healing skin can be prolonged and in individuals who tan more readily or have an olive or darker complexion, there is a risk of the healing skin darkening. This side-effect can be treated with special ‘fading’ creams. Very rarely, this skin may heal a lighter colour. Thick scarring of the treatment sites is very rare with fractional laser treatment.

Expression lines, worry lines, crow's feet and smile lines – whatever you call them, wrinkles can be an unsightly by-product of aging skin. Anti-wrinkle injections, also known as neuromodulation, are a popular way to reduce the appearance of expression wrinkles, to counteract overactive facial muscles producing excessive facial shadowing. Neuromodulation treatment utilises botulinum (products such as Botox or Dysport), a natural, purified protein that when injected into the skin reduces the appearance of wrinkles, facial lines and furrows by relaxing the muscles that can cause them, to create a rejuvenated appearance. This active ingredient, a neuromodulator, is derived from bacteria in much the same way that penicillin is derived from mould. Neuromodulation can also help with other complaints like exaggerated neck bands, excessive sweating (hyperhidrosis), jaw clenching, teeth grinding and tension headaches. How does the treatment work? Neuromodulation treatment is a non-surgical procedure whereby a small amount of botulinum is administered into selected facial muscles by a trained medical professional using a very fine needle. The nerve impulse that stimulates muscle contraction is blocked and this relaxes the specific targeted facial muscles that cause dynamic wrinkles (these are the wrinkles that are formed during facial expression). Once the muscles are relaxed, you cannot contract them and continue to make an undesirable facial expression. As a result, the unwanted lines gradually smooth. Excessive muscle action from jaw clenching, teeth grinding and leading to tension headaches can also be controlled by this treatment. Neuromodulation injections can also be used to block the nerve impulses that lead to release of sweat from the sweat glands (particularly in the under arm area) and reduce the unwanted effects of excessive sweating or hyperhidrosis.

Injection therapy of unwanted blood vessels (sclerotherapy) Unwanted blood vessels - smaller ones are called spider veins - have a red or bluish colour and appear on the surface of the body, particularly the legs and occasionally the face or elsewhere. They may be visible as short, unconnected lines each about the size of a large hair, they may be connected in a scraggly, “sunburst” pattern, or they may resemble a spider web or tree with branches. In some people, they occur in a small area and are not particularly noticeable. In others, they may cover a large area of skin and be quite unsightly. Larger unwanted blood vessels may be raised above the skin surface and serpentine; they may occur in association with spider veins. These large veins are also called varicose veins, but differ from the more commonly known varicose veins which frequently occur in association with a poorly working valve in a large vein. A characteristic of unwanted blood vessels in some sufferers is occasional pain, ranging from a dull throbbing pain to a burning sensation. Though unwanted blood vessels do carry blood, the great majority, especially spider veins, are not necessary to the circulatory system. Thus, if their presence is distressing, they can be treated by injection of a solution that will cause them to disappear or at least become much smaller. What causes these blood vessels to become visible? The cause is not known, except that in many cases they seem to run in families. Identical twins may be affected in the same area of the body and to the same extent. The condition can also occur as part of a large number of different diseases, both genetic and non-genetic. Spider veins occur in both men and women, but more frequently in women. The hormone oestrogen may play a role in their development because puberty, birth control pills or pregnancy often seem to bring them on. During pregnancy the enlarged uterus may restrict blood flow, contributing to their development. They may also occur after a blow to a certain area of the body or as a result of wearing tight girdles or hosiery held up with tight rubber bands. In addition, spider veins may occur in association with underlying large varicose veins. When they occur on the face, spider veins may be related to chronic sun exposure or a condition known as rosacea. They tend to occur on either the nose or the cheeks of fair skinned persons. Can they be prevented? Wearing support stockings may prevent some unwanted blood vessels from developing in some people. Maintaining a normal weight and exercising regularly may also be helpful. Protection from the sun is important to reduce the number of unwanted vessels on the face. How are unwanted blood vessels on the legs treated? In the majority of cases, a procedure called sclerotherapy is used, in which a solution, called a sclerosing solution, is injected with a very fine needle directly into the blood vessel. This procedure has been used for spider veins since the 1930s and long before that for larger veins. The solution irritates the lining of the vessel, causing it to swell and stick together and the blood to clot. Over a period of weeks, the vessel turns into scar tissue that fades from view, eventually becoming barely or not at all visible. Depending on its size, a single blood vessel may have to be injected more than once, some weeks apart, but in any one treatment session a number of vessels can be injected. The solutions used vary somewhat with the size of the vessel to be injected. Your dermatologist will decide the solution that is best for your particular case. Occasionally larger varicose veins underlie spider veins. These vessels may be treated before the spider veins, either by sclerotherapy followed by compression or by a surgical procedure carried out by a vascular surgeon. Alternatively the spider veins may be treated by sclerotherapy as usual without worrying about the varicose veins unless they become troublesome. How successful is sclerotherapy? After several treatments, most patients can expect a 50-80% improvement in treated vessels. However, the fading process is gradual and perfection is seldom achieved. Can sclerotherapy be used on all skin types? Yes. All skin types and skin colours respond equally well. How much does treatment cost? Charges to the patient vary with the area to be treated and the number of treatments necessary. More than one treatment session is almost always necessary. Will insurance cover the treatment of unwanted blood vessels? Insurance coverage varies. If the treatment is solely for cosmetic reasons, it may not be covered. Sometimes, a second doctor’s opinion, laboratory studies or photographs is required by insurance companies before treatment is begun. Are there side effects to sclerotherapy? There are a number of possible side effects, including the following: Stinging or pain at the sites of injection, swelling of the ankles or feet, or muscle cramps. Muscle cramps almost always occur when injection takes place in the ankle area. All of these usually go away within 10 to 15 minutes after injection. Red, raised areas at the sites of injection. These should disappear within a day or so. Brown lines or spots on the skin at the sites of treated blood vessels. Probably composed of haemosiderin, a form of iron stored in the blood, these pigmented areas may result when blood escapes from treated veins, more often in patients who have larger veins treated. In most cases, they disappear within a year, but in about 5 per cent of patients they may persist for years. Laser treatment may remove this pigment. Development of “mats” - networks of fine red blood vessels near the sites of injection of larger vessels, especially on the thighs. Most resolve spontaneously, some resolve with injection treatment, and a few persist. Formation of small, painful ulcers at treatment sites either immediately or within a few days of injection. Sometimes these occur because some of the solution has escaped into the surrounding skin. These can be effectively treated but it is necessary to inform the dermatologist of them immediately. Bruises at the site where the needle penetrated the skin. These will disappear in a few weeks and are probably related to the fragility of blood vessel walls. Allergic reactions to certain sclerosing solutions. Although on rare occasions such reactions may be serious, they can be treated by immediate injections of adrenalin. Less serious reactions are treated with antihistamines. Inflammation of treated blood vessels. This is very uncommon but when it occurs it is treated with anti-inflammatory medications (such as aspirin), compression, bed rest, antibiotics or heat. Lumps in injected vessels, particularly larger ones, may develop. These actually are blood clots but are not at all dangerous. The dermatologist may drain the blood out of these. Will treated veins recur? Larger veins are likely to recur unless support hosiery is worn. Spider veins may recur. Often, however, it may seem that a previously injected vessel has recurred, when in fact a new spider vein has appeared in the same area. Is a history of blood clots in the lungs or legs a contraindication to treatment? Not necessarily, but the procedure must be done with caution to minimise the risk of blood clots. How are spider veins on the face treated? These are often better treated with the Vbeam or copper bromide lasers than by using sclerotherapy. What do I do after treatments? Depending on various factors, such as the size of the blood vessels injected, patients may be instructed to put their legs up for an hour or two and then walk. Others are asked to walk immediately. All patients are instructed to walk a good deal in the days following the procedure so that blood will be pushed through other vessels. In addition, the injected areas will be taped and patients may be asked to “compress” the treated vessels by wearing support hosiery; this may help seal the treated vessels, minimise the accumulation of trapped blood under the skin and the risk of hyperpigmentation, and reduce the possibility of recurrence. Between treatments, it may be helpful to wear compression or support hosiery that is properly fitted (not too tight), especially for people who must be on their feet a lot.

Skin cancer treatment involves more than just the surgical removal of the visible lesion. Your surgeon must be sure to remove all the cancerous tissue under and adjacent to the surface tumour to ensure that all the cancer cells are gone. This can be especially challenging when skin cancer develops on your face. Skin cancer treatment options depend on the type and stage of cancer, the size and location of the tumour, whether it has spread and your general health. Several types of procedure are available to remove skin cancers; these may be surgical or non surgical in nature, depending upon the individual patient circumstances. Dr Le Grice will advise on the most appropriate options for your situation. Read more about: Cryosurgery Curettage Laser surgery Mohs micrographic surgery Photodynamic therapy Radiation therapy Shave excision Topical chemotherapy

What is a skin peel? Chemical peeling is a technique which has been used for centuries to rejuvenate the skin and to remove various types of skin blemishes. The technique involves the application of natural acids of a variety of types and strengths to gently injure the skin layers, thereby encouraging renewal of these layers with skin of a better quality. The hydroxy acids have become accepted in dermatology as useful agents in producing a superficial chemical peel. The hydroxy acids are organic acids derived from a variety of natural products and are mild enough to be used to produce rejuvenation of the superficial skin layers. However, the depth of penetration of the skin by any of these acids depends upon the strength used and length of time for which it is applied to the skin. In a suitably weak formulation, repeated application of a hydroxy acid is able to produce beneficial effects by treating the signs of more superficial and milder skin damage and acne. A peel revitalises the appearance of your skin, often making the skin smoother and more radiant. The skin peel is sometimes used on other parts of the body, including the neck and hands. People undergo skin peels for a variety of reasons. At Auckland Skin Laser Centre, we offer a range of fruit acid peels to address several skin concerns. Skin peels performed at the Auckland Skin Laser Centre vary in strength depending upon the patient’s skin and degree of damage. Additional products may be recommended for use at home. What kind of conditions can skin peels help? Peels are often used to treat: Acne Blackheads and whiteheads Aging Skin Dull, weathered skin Excessively oily skin Blotchy pigmentation Sun spots Dark skin discoloration Wrinkles How long does the procedure take and how will it affect my skin? The procedure takes 15 – 30 minutes depending on the type of peel. Once activated the peel may feel a bit prickly and will warm the skin. There may be some mild discomfort with the stronger peels. Your skin may start to feel tight. You will have a “glow” immediately afterwards. You may put make-up on and return to work or daily activities. Your skin may start peeling / flaking on day two and this may last for a few days depending on the strength of the peel. Some of the gentler procedures give little or no skin flaking or visible peeling. After the series of peels, you may continue using any prescribed creams or ‘at home’ products. In fact, some prescribed products and the peeling products used together can give tremendous improvement in your skin. You should use a recommended SPF30+ sunscreen every day to assist the products to “break up” any brownish discolorations. These peels may make your skin sun sensitive and depending on the type of peel prescribed, may be able to be used in pregnancy or where pregnancy is contemplated. How long will the treatment last? Most people see a gradual and continual improvement after their first treatment. The total number of treatments varies depending on the condition of your skin. Most patients see improvement with 6 peels, but some need more. Many patients get a peel every two weeks for six treatments, and then once a month to keep the improvement at the maximum. The products you use at home maintain and accelerate the benefits of the office peels. When considering skin peels, it is important to discuss your concerns with the specialists at the Auckland Skin Laser Centre to determine which peel is right for you.

Nothing is quite as beautiful as soft, smooth, healthy-looking skin. Our advanced laser technology allows us to safely, easily and effectively treat many skin disorders painlessly, on an out-patient basis. How does a laser work? The word LASER is an acronym for Light Amplification by the Stimulated Emission of Radiation. The Vbeam uses an intense beam of light, delivered in long pulses, to gently remove unwanted, damaged, or diseased cells without harming the surrounding healthy cells. What is a vascular lesion? Skin blemishes due to abnormal blood vessels located directly under your skin’s surface that give the skin a red colour are called vascular lesion. Port Wine stains, strawberry hemangiomas and spider veins (talengiectasias) are all forms of vascular lesions. What is a pigmented lesion? Pigmented lesions are caused by a proliferation of melanocytes in the skin. Melanocytes are the cells that manufacture melanin, which is the dark pigment in skin. Most of us have some form of pigmented lesion. They include brown age spots (lentigines), freckles (ephileds), and moles (nevi) Lesion without colour are called non-pigmented lesions. They include warts and skin tags. What type of lesion can be treated with the Vbeam laser? Angiomas facial veins hypertrophic scars leg veins poikiloderma red birthmarks rosacea warts. What results can be expected? Most patients will see improvement in their vascular and pigmented lesions. The improvement can be quite dramatic. However, as with any surgical procedure, there is always a possibility that only minor changes will occur and in rare cases, there is no response. Are Vbeam laser treatment safe? Lasers have been used successfully in hundreds of thousands of treatments. Laser treatment performed properly, by a trained physician, are safe and effective. There are many benefits to laser surgery including little if any pain, no needles for most patients, less bruising and swelling and once removed, lesions do not return. Do treatments for skin lesion hurt? Some patients say they feel a slight sting, like the snap of a rubber band on the skin, followed by the feeling of sunburn. Many treatments do not require anesthetics. However, some patients feel more comfortable with a local numbing agent like ice or an anesthetic cream. For others, a local anesthetic injection may be beneficial. How many treatments are required? This depends on the size, location, depth and color of your lesion. Spider veins on the face and age spots general do well with one or two treatments, while darker or deeper birthmarks may require additional treatments. Treatments should be placed several weeks apart to allow your body to remove the maximum amount of pigment cells. You will continue to see a lightening of your lesion after each treatment as your body disposes of the pigmented cells.

Auckland Skin Laser Centre is proud to introduce its newest treatment, Ultherapy™. Ultherapy™ or Ulthera treatment is a breakthrough procedure that uses medical ultrasound for non-surgical cosmetic improvement of the skin. It works deep below the surface – without harming the outer layer of skin – for dramatic and long-lasting benefits of facial firming, skin tightening and super-lifting effects. What is Ultherapy? Ultherapy is a non-surgical ultrasound treatment for counteracting the effects of time and gravity on your skin by reducing skin sagging. The beauty of this 30-60 minute face and neck treatment is that it uses the body’s own regenerative response to gently and gradually restore memory to the skin and underlying tissue support. How does the Ultherapy procedure work? As with other ultrasound procedures, a smooth applicator placed upon your skin projects an image onto a screen that allows your practitioner to plan where the energy will be directed. This same applicator is then used to deliver low levels of focused ultrasound to just the right depth below the skin to achieve a tightening effect, all the while leaving the surface of your skin undisturbed. Your skin’s response to the energy is to stimulate the growth of new collagen. A gradual tightening and firming occurs, resulting in a natural lift of the skin over time. How is this procedure different from other cosmetic procedures? Ultherapy is the only non-surgical skin rejuvenation procedure that uses ultrasound to see below the surface of the skin and to specifically target the deep foundational layer of tissue that doctors address in facelift surgery. The ability to treat not just the skin but its underlying support very precisely, from the inside out, helps to ensure both safe and satisfying results, with no downtime. What does it feel like? There can be some discomfort while the energy is being delivered, but it is temporary, and a signal that the collagen-building process has been initiated. Comfort thresholds vary from patient to patient, and practitioners will discuss options for making the experience as pleasant as possible. What can I expect afterwards? You are able to return to your normal activities right away, and there are no special measures you need to take. Your skin may appear a bit flushed immediately after the treatment, but any redness should disappear within a few hours. It is not uncommon to experience slight swelling for a few days following the procedure or tingling / tenderness to the touch for a few weeks following the procedure, but these are mild and temporary in nature. There is the possibility of other less common post-procedural effects, such as temporary small areas of bruising or numbness, which your doctor will review with you. Is Ultherapy safe? Ultrasound energy has a proven track record, with over 50 years of use in the field of medicine and clinical trials have demonstrated the safety of this latest application. What kind of results can I expect? With just one treatment, the regenerative process is initiated, but the full effect will build gradually over the course of two to three months. Some patients may benefit from more than one treatment. Visible effects include a lifting and toning of sagging skin. In the FDA clinical trial for instance, nine of of ten patients had a noticeable, significant lift of the brow line. This resulted in reduced skin laxity on the eyelid and a more open, youthful look to the eyes overall. Patients reported firmer, better-fitting skin in other areas of the face and neck as well. There is also an invisible result from the procedure with the creation of new collagen, which can help to slow down the rate of skin aging. Who is a good candidate for Ultherapy? A good candidate for Ultherapy is someone with skin that has “relaxed” to the point of looking, and often feeling, less firm. A lowered brow line or sagging skin on the eyelids, for instance, is often the first sign of “maturing” skin. While it does not duplicate the results of surgery, Ultherapy has proven to be an inviting alternative for those who are not ready for surgery. For more information, please contact (09) 520 3200 or