Suntanning, Tanning, Sunscreens

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During the Victorian era pasty white skin color was in vogue. Tanned bronze skin was popularized by fashion designer Coco Chanel in the 1920s. During World War II troops stationed in the south Pacific suffered from sun exposure and were then issued white skin cream (zinc oxide) for protection from the sun. These early sunscreens were heavy, greasy and opaque (easily visible after application). They also stained clothing. In the 1970s the FDA began to approve specific substances for use by manufacturers in sunscreens. These can be divided into 2 groups:
1-chemical sunscreens that react with sunlight converting it into heat to decrease damage (benzophenone, homosalate, methyl anthranilate, octyl methoxycinnamate, oxybenzone, avobenzone)
2-physical sunscreens that reflect the sunlight (zinc oxide, titanium dioxide, kaolin, ichthammol, iron oxide).

The physical sunscreens are more chemically stable and have less risk of causing skin contact sensitivity.

Mesotherapy, Lipo-Dissolve, or Injection Lipolysis, Lipozap, Kybella

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Mesotherapy involves the injection of medications under the skin. It has been widely used in Europe for years to treat cellulite, psoriasis or spot reduce fat, amid unsubstantiated claims. One subset of this treatment modality is injection lipolysis where a mixture of phosphatidylcholine(lecithin), isoproterenol, deoxycholate, blood vessel dilators, nonsteroidal anti-inflammatory agents, enzymes (such as collagenase or hyaluronidase), aminophylline, caffeine, L-carnitine, buflomedil, calcitonin, vitamins, minerals and hormones in varying combinations are injected into the fat layer under the skin to destroy fat cells. Some of these medications stimulate fat cells to break apart fat molecules contained in the cells. However fat cells in some areas like the thighs and hips are more resistant to this stimulation. The true mechanism of action of some of the medications remains unknown. Multiple injections are made into the treated area per session and sessions are performed a few weeks apart. Some or all of the injected medications are frequently not FDA approved for injection.

Facial Implants - cheeks, chin, jaw

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Breast implants at least in the US come in only 2 forms, a silicone (plastic like shell) containing either salt water or silicone gel (a mollases or jello thick substance). Facial implants for bone augmentation come in greater variety of materials - silicone, goretex and porex medpor. The first 2 do not develop tissue ingrowth by surrounding tissue, thus they are easier to remove at a future date should the need arise. However they can also shift in position at any future date since there is little or no ingrown tissue to keep them in place. Porex Medpor does develop tissue ingrowth or incorporation thus the potential for shifting or infection are much less at a future date. In the absence of infection porex implants are fixed in position within a few weeks after placement by this ingrowth. Those patients with silicone or goretex need to take antibiotics prior to any dental procedure while porex patients do not. This is because the body does not treat incorporated ingrown implants as foreign bodies.

SKIN INFECTIONS

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Over the last 10 to 20 years there have been increasing changes in the bacteria normally present on the skin surface. They are becoming resistant to antibiotics (methicillin resistant Staph Aureus - MRSA) & this resistance as well as the problems they cause are different than what is seen with bacteria that become resistant from exposure to medications in hospitals. You can think of this as an infection from yourself vs. an infection that comes from someone else or some surface contact (door knobs, tables etc). The flesh eating bacteria that has been mentioned in the media is due to bacteria that produce a chemical that kills tissue at deeper as well as superficial levels. These bacteria may or may not be antibiotic resistant. If caught early enough all are easily treated.