Erase Hyperpigmentation: Tips for Clearer Skin

In this insightful episode of “Anti-Aging Insights,” Dr. Teri Fisher joins forces with Dr. Gidon Frame from Anti-Aging Medical and Laser to tackle the pervasive issue of acne. Originally recorded as an engaging Instagram Live session, the duo unpacks the complexities of acne, diving into its causes, impact on self-esteem, and the multifaceted treatment approaches available at their clinic. From understanding the role of sebum production and bacteria to exploring groundbreaking solutions like AviClear laser treatments and the powerful BBL Forever Clear light therapy, this episode offers a comprehensive overview of acne management. Additionally, they discuss traditional methods, such as exfoliants and antibiotics, and introduce the revolutionary Winlevi cream for hormonal acne. If you’re searching for effective acne solutions or seeking to understand more about skin health, this episode is packed with valuable insights and practical advice for everyone. Join Dr. Fisher and Dr. Frame as they share their expertise and invite you to explore the personalized care options available in their Vancouver clinic.

Today’s Guest

Dr. Gidon Frame

Dr. Gidon Frame is a kind, ethical and compassionate doctor and one of the most experienced and respected cosmetic injectors in British Columbia. He has a wonderful “chair-side manner” and a good sense of humour, which immediately puts his patients at ease.

Dr. Gidon Frame’s mission is to manage and reverse total body and brain aging, while optimizing facial rejuvenation. He also has a passion for preventative medicine.

Dr. Frame loves to coach and teach people how to make their face, body and mind “shine”. He is a University of British Columbia Clinical Assistant Professor and often gives educational talks to the general public. After 13 years of performing regular, cosmetic injectables and laser treatments, Dr. Frame has become recognized as an expert and teacher of balanced aesthetic rejuvenation.

Episode Summary

In this engaging Anti-Aging Insights podcast episode, Dr. Teri Fisher collaborates with Dr. Gidon Frame from the Anti-Aging Medical and Laser Clinic, discussing comprehensive insights into acne and its treatment. The conversation offers a detailed exploration of acne’s causes, its impact on individuals, and innovative treatments available at the clinic.

Acne is more than a skin dilemma; it significantly affects self-confidence and mental well-being. Dr. Fisher and Dr. Frame delve into the biological mechanisms leading to acne, including increased sebum production, bacterial growth, and inflammation. Various non-invasive to minimally invasive treatments are highlighted, providing listeners with a comprehensive understanding of available solutions.

Topical treatments like salicylic acid and benzyl peroxide are effective initial strategies for exfoliation and oil control. However, the introduction of AviClear, a state-of-the-art laser treatment, represents a breakthrough in acne management. AviClear significantly reduces sebum production by targeting sebocytes, offering long-lasting results without the side effects associated with traditional systemic medications like Accutane.

For bacterial mitigation, the clinic offers BBL Forever Clear, using broad-spectrum light to eradicate bacteria and reduce inflammation safely, circumventing antibiotic resistance issues. For topical emergencies, cortisone injections provide rapid relief from severe breakouts.

The episode also addresses post-acne scarring and pigmentation. Treatments such as CO2 lasers, PicoWay, and radiofrequency microneedling help restore skin texture and tone. Moreover, Winlevi, a novel topical solution, provides an alternative to oral hormonal treatments, specifically targeting hormone-related acne on the skin.

Listeners are encouraged to understand that acne deserves serious attention due to its social and psychological implications. Dr. Fisher and Dr. Frame advocate for early intervention to prevent long-term scarring, emphasizing personalized treatments at every acne stage. They warmly invite listeners to consult with their team at the clinic for tailored acne solutions, enhancing skin health and confidence.

Key Insights

• Dr. Teri Fisher and Dr. Gidon Frame discuss the significant impact of acne on self-confidence and social interactions, emphasizing the importance of effective treatment.
• The initial cause of acne involves increased sebum production due to follicle proliferation, attracting bacteria and leading to inflammation. Treatments like exfoliation and topical acids can help manage these symptoms.
• AviClear, a laser treatment targeting sebaceous glands, has been highlighted as a recent advancement in reducing oil production significantly, with results lasting multiple years.
• Broadband Light (BBL) treatments, under the program “Forever Clear,” effectively kill acne-causing bacteria without antibiotics, utilizing blue and red light components to reduce inflammation.
• Various options for treating acne scars and pigmentation include CO2 lasers, PicoWay lasers, Halo lasers, and Radio Frequency Microneedling, while hormonal acne can be managed with a topical cream called Winlevi.

Episode Transcript

Dr. Teri Fisher: Hey there and welcome to this episode of the podcast. Today this is a recording of an Instagram live video that I did with my colleague, Dr. Gidon Frame at Anti-Aging Medical and Laser. We talked all about acne today. It was a great overview of what acne is, what causes it, and the various different ways that we can treat acne at the clinic.

And so if you are somebody that has acne, if you know somebody that is suffering from acne, this episode is for you. We cover it all in this episode. I hope you’ll get lots out of it. And without any further ado, let’s get right into the episode. Here’s Dr. Gidon Frame and I at Anti-Aging Medical and Laser talking all about acne.

Dr. Gidon Frame: Hello there, Dr. Gidon Frame here at the Anti Aging Medical and Laser Clinic in almost sunny Kitsilano, not quite, it was sunny last week, but hey. And with me today is my colleague here at Anti Aging.

Dr. Teri Fisher: Hi, I’m Dr. Teri Fisher, and uh, we’re going to chat about acne.

Dr. Gidon Frame: Absolutely, back to school, back to university, back to college, we’re all going back, we’ve had acne, you know, going on and off, but now it’s clearing up and we’re heading back to school and what are we going to do about it?

Dr. Teri Fisher: So one of the first things that comes to mind actually is, why are we talking about this? Why is it important? And for those of you that know somebody that has acne or suffer from some acne at some point in your life, you know that it can have a significant impact on how you feel about yourself and your confidence.

The good news is that there are very effective ways to treat it. And that’s what we want to share with you today.

At a basic level, why do we get acne? There’s a couple of things that are going on. You get this proliferation, so you get more follicles that are increasing in number. That then can cause what’s known as sebum, increased sebum production, which is the oil that is being excreted from your skin. When you get that, then the bacteria love that stuff. So you get more and more bacteria that are starting to grow in that area. And then as a result of that, your skin becomes inflamed. And you can see lots of different ways that acne can present itself with the cysts, with the redness, with pustules, with various things. And so a lot of the treatments that we do are hitting those different ways that acne is forming.

Dr. Gidon Frame: Right. So how do we stop this buildup of keratin and proliferating of the follicles? How do we deal with that?

Dr. Teri Fisher: So there’s ways that we can do that. One way is through exfoliation. There are different topical things that we can use. Acids, salicylic acid, benzylperoxides and some of you that may have used these types of things, you’ll know that it does dry the skin a little bit. It actually helps to exfoliate the skin a little bit, and that’s one of the ways that that can help.

Dr. Gidon Frame: Yeah, we have products, PCA, ZO. We have some really nice products that some of them come individually. Some of them come in a kit. It’s like a two, three month kit. You buy it, it’s got your wash, it’s got your toner, it’s got your exfoliant, it’s got your alpha hydroxy acids, your salicylic, it’s got the whole shebang in it. Some of them even have benzyl peroxide and they’ll help you to clean up and and exfoliate nicely. So what’s the next step? Okay, so now things have got blocked up and the oil is starting to build up.

Dr. Teri Fisher: This one is really interesting and it’s very exciting ’cause when then when we’re talking about the oil that’s being caused, until recently, just in the last couple of years, there wasn’t as effective way as we have right now, other than medications like Accutane, where you have to do blood tests, there’s a lot of potential side effects with that.

Dr. Gidon Frame: Mood effects, liver effects, cholesterol effects. There’s a whole bunch of things thatAccutane can do. You know, it works, it’s good stuff, but it needs monitoring and it’s a hassle. So finally this is the magic device, the magic device, AviClear. AviClear, this is a type of laser, it hits the sebaceous gland and shuts down the oil production, cuts it back. It’s incredible. And this is actually, this treatment over here was an AviClear treatment, three AviClear treatments, a month apart, and shebang, a month later, you get a bit of a purge each time, and at six months, you’re looking much, much better, and you can even top it up after that.

So finally, we have a machine that cuts down on the sebum, on the oil production, in your face.

Dr. Teri Fisher: It’s really fascinating because lasers will target a specific type of cell, and this laser has been designed to specifically target the sebacytes, the cells that are creating that sebum. Wow. So that’s why it is so effective for acne, and as more and more data comes Available to us after another year of data, another year of data, we’re just seeing that the results continue to be there.

Dr. Gidon Frame: Previously it was predicted that it would last for a year or two, now they’re talking three to five years. The effect of the AviClear oil reduction laser is going to be. Okay, so now the oil is there, you’ve cut it down, where it’s still growing and producing, and that oil starts to get bacteria, as Dr. Fisher mentioned, and it gets infected. Alright, so now what are we going to do about the infection?

Dr. Teri Fisher: So infection, we’re going to use some antibiotics. That is certainly one of the options for acne. It can be applied as a topical, you can even take oral antibiotics. So those are some of the ways that we can also combat the overproduction of bacteria.

Dr. Gidon Frame: And, funnily enough, blue light kills bacteria. Yes. Yeah, you can get a dinky little LED thing on Amazon and sit in front of it with a blue light. We have a super powerful light device called a BBL, Broadband Light, and we have a setting and a program on that BBL called Forever Clear. You use BBL, you come in for quite a few treatments, and zap, zap, zap, zap, zap, and it kills the bacteria in your skin. Does it without antibiotics, without creating resistance, because often antibiotics create resistance, and it’s a great adjunct. So we’ve got the AviClear to stop the production of oil. We’ve got the BBL Forever Clear to kill the bacteria and stop inflammation, because it’s got a red light component as well.

Now you’ve got an emergency. You’ve got like a major monster zit developing and you’re about to have a hot date in four days time, or you’re going to a graduation, or you’re going to school, or you’re meeting someone, you’ve got a business meeting. What do you do? Like, it’s an emergency. Anything we can do for an emergency?

Dr. Teri Fisher: Certainly. So in those circumstances, what we can do, we’re talking again about inflammation, and we can take a potent anti inflammatory, which is essentially cortisone, a type of steroid, and we can inject it directly into that lesion. And these go away very quickly with that type of treatment.

Dr. Gidon Frame: It’s miraculous. You can have a monster zit developing over there, that thing is going to rupture. We pop a little bit of corticosteroid into it, within 12 hours, it’s already shrunk down and the redness gone away. So that’s like your emergency rescue, acne treatment for one or two or three active inflammations. Okay? So now you’ve either, you’ve treated the acne you’ve hit it with AviClear, you’ve hit it with BBL forever clear, you put on a ZO and the TCA topical solutions, and you’ve got it good. Okay you’re in a good state you’re in this state here you know or you’re in this state over here and you’ve got two things happening. Either you’ve got holes, scars, or you’ve got pigment. You know, you get PIH, post inflammatory hyperpigmentation. So when you get to that what do you do?

Dr. Teri Fisher: So there are ways that we can deal with the texture of the skin now, and that involves a variety of different machines that we have here. A good example is, for example, using a CO2 laser where we can create and encourage the body to reform, to regrow some of that collagen, and essentially resurface the skin.

Dr. Gidon Frame: Yeah, it’s like a little pixelated fractionated, little spikes of laser that go into the skin cause damage, control damage which then heals.

The CO2 laser is great, but you’ve gotta have skin that’s up to a medium Caucasian. If you’re Asian, African, Latino, you’re gonna need something else for that. And usually then we pivot to either the PicoWay laser, which will smooth and deal with some of the pigment, without overstimulating and causing rebound pigment, which is crazy.

Okay, so we can use the PicoWay for that. And if you want to get a little bit more aggressive you can go with the Halo, which is a pixelated laser. It’s got two lasers in it. Or, if you don’t want laser, because you’re worried that the laser, or if it’s summertime and you’re tan, or you have darker skin, then we’ve got the Radio Frequency Microneedling. And the brand that we have is an excellent brand of RF microneedling, is Secret Pro. And that’s, again, microneedles, the needles go into the skin, the microwave energy, the radio frequency energy goes down the needle, cooks a little bit, comes back out, and that causes controlled damage, and then healing. So you want to smooth your skin, you go with radiofrequency microneedling orCO2 laser, or even halo laser, and if you want to deal with the pigment, you go with PicoWay laser.

Dr. Teri Fisher: So it gives you an idea, there’s really a whole spectrum of treatments that we have that hits the acne at all the different stages, from the very beginning, like I said, in that proliferation, to the sebocytes, to the bacteria, to the inflammation, to the PIH, to the pigment and to the texture.

Dr. Gidon Frame: And let’s not discount what Dr. Fisher was mentioning at the beginning. Acne is not a mild little peripheral disease. You know, people scoff at acne and I call it acne shaming. Well, ah, you know, it’s just acne, don’t worry about it, you know. The adolescent or the 20 something person is concerned about it and the parent or the partner or the friends they discount it and say, ah, but it has a social toll. It really, really does. To have inflamed skin and to have marks is socially limiting and can have an emotional damage to the person that has it.

Dr. Teri Fisher: Particularly with the age that we’re talking about. Although acne can affect people in various ages, most often it’s gonna be younger people, where their social interactions are so important to them at school, with their friends, the way they’re seen, the way they see themselves, so it’s something that we take very seriously.

Dr. Gidon Frame: Correct. That’s why we do AviClear and BBL Forever Clear for the oil reduction and for the inflammation reduction. We do it on all ages. Adolescents, you know, as long as you’ve got parental sign off on the consent, you can do it from age 14, 13, 14 and above. There’s no reason to wait until you’re 18 when you’ve really got permanent scars, because those scars are permanent. It’s much easier to prevent and to treat the acne in the early stage than to have the permanent scars which are going to take months and months of treatment and thousands and thousands of dollars worth of treatment. So a little bit of money spent and energy and time spent on dealing with your acne now when it’s active will prevent you having to spend thousands later on when you’ve got acne scarring.

You’re not going to become President of the United States, and you’re not going to become a CEO if you’ve got terrible acne scars, because people judge based on your appearance. It’s unfair, it’s nasty, it’s shameful, but it’s reality.

Now, there’s another type of acne that we didn’t mention that people sometimes get, it’s hormonal acne. Hmm. And young women sometimes go on birth control pills for that. They go on spironolactone, which blocks the testosterone expression in the skin. And it was always difficult to control this, and especially for men and women who don’t want something internal, there is a new cream. It’s Winlevi. It’s a cream that actually blocks the testosterone expression in the skin. So, you can Winlevi your cheeks and jowls where you get the hormonal acne and the cyclic acne that happens with periods, or the hormonal acne with the adolescent boys that gets it like this.

This is the classic, like your period’s about to come and you start getting acne over here. And you don’t want to mess with your hormones, but you can take Winlevi and it’s a prescription. Talk to us and you can come in for a consult and get prescribed, and you can put Winlevi over here. I’m sometimes wondering, what happens if I put Winlevi on my scalp? Is it going to block the testosterone over here and I’m going to grow more hair? Jokes aside, they’re actually doing studies for Winlevi on hair growth. You know, because you want testosterone to be expressed in your whole body, but you don’t want it expressed here to get acne and here to make this hair fall out.

So we’ve got AviClear and BBL Forever Clear if you don’t want to take oral accutane or retinoids. We’ve got creams, and we’ve got exfoliants, and we’ve got retinols, and cleansers on topically, and we’ve got the hormone blocking Winlevi, topically on your face if you don’t want to take oral stuff as well.

So whatever suits you, and whatever type of acne you’ve got, at whatever stage you’ve got, is it forming follicles, is it too much oil, is it bacteria, is it causing scarring, is it causing pigment? Whatever ails you with your acne, come in and see us here at Anti Aging Medical and Laser Clinic.

Come and see Dr. Fisher, Dr. Govindasamy, myself, Dr. Gidon Frame, and we will certainly help you out. Signing off from Anti Aging Medical and Laser Clinic in beautiful Kitsilano, Vancouver, British Columbia. Have a great one. See you soon.

There you are. I hope you enjoyed that episode. Hope you learned a ton about acne. And feel free to come and meet with any of us at Anti-Aging Medical and Laser Clinic. We would be only too delighted to help you out.

Until next time, hope you are doing well. Take care. And I’ll talk to you again very soon.