Elective Dermatologic Procedures Flashcards
What wrinkles and their associated muscles are FDA approved for BOTOX injections
Horizontal forehead lines
- frontalis muscle
Frown lines
- glabellar complex
Crows feet
- orbicularis oculi
What other wrinkles can BOTOX be used on which aren’t FDA approved
Bunny lines
- nasalis
Nasolabial folds
- Levator Labii superioris alaquae nasi
Radial lip lines
- obicularis oris
Marionette lines
- depressor angular oris
Chin line
- mentalis
Contraindications to BOTOX
Body dystrophic disorder
Dependency on facial expression for livelihood (actors, singers)
Dermatoses in treatment in areas
( eczema, psoriasis, etc.)
Gross motor weakness in treatment area
(neuromuscular disorders)
Immunocompromised
Cellulitis
NMJ disorders
Pregnancy or breastfeeding
Sensibility to cow milk (component of BOTOX)
What must you ask your patient to do at least 2 weeks before injection
Discontinue aspirin and any medication or dietary supplement that has anticoagulant effects
What should you avoid after BOTOX treatment
Lying supine and following treatment for four hours
Massaging or applying heat to the treatment area
Activities that cause flushing on the day of treatment
all are used to reduce potential spread of the toxin
patient SHOULD exercise facial muscles every 15 minutes for 4 hrs to enhance binding of BOTOX
How to find glabellar complex muscle
Have patient frown actively and inject in between the eyebrows
- partial reduction in function of the targeted glabellar complex muscles are seen by 3rd day after BOTOX injections (maximal = 2weeks)
Complications of BOTOX
Anxiety Or vasovagal episodes
Infection
Blepharoptosis
Allergic reactions
Eyebrow ptosis
Headache/pain/paresthesia
Edema and tenderness
Contraindications to dermal fillers
Allergies
Cellulitis
Pregnancy or breastfeeding
Injection of robust substances into the glabellar complex
Body dystrophic disorder
Immediately after a life-changing event
History of coagulopathy or anticoagulant use
Things to do after dermal filler procedures
Apply ice immediately after injection
Apply topical vitamin K twice daily for 5 days
NO warfarin/aspirin or vitamin E for 48hrs
NO sun exposure for 48hrs
NO smoking
Avoid tanning beds completely
Complications of dermal filler use
Bruising
Erythema
Edema
Infection
Skin necrosis
Undesired results
Laser photorejuvenation
Multiple different types But all function to kill unwanted skin issues and regenerate the skin to normal
- 515-590 nm light = melanin and vascular structures
- 640-695 nm light = hair removal
- 755 nm light = skin tightening
All are used for both elective or actual medical causes
Contraindications of laser photorejuvenation
Patients with very dark skin
Patients who have history of getting bad burns and keloid scars
Active inflammatory/infectious process of skin
History of HSV W/ no antiviral prophylaxis
Patients on photosensitivity meds
- ESPECIALLY accutane (needs to wait 6 months)
Patient who actively have a sun tan
- should wait for it to go away before doing this
Laser hair removal
Really only destroys hair in the anagen phase (can still do other phases but less effective)
Best ideal candidate = fair skin with dark hair
Laser hair removal contraindications
Absolute contraindications
- history keloids
- accutane (isotretinoin) use in the past 6 months
Relative
- HSV with no history of antiviral meds
- cellulitis
- dermatoses in the area
- use of photosensatizing medications
- recent plucking/waxing/electrolysis and use of depilatory cream or bleaching product in last two weeks
- bleeding disorder/thrombocytopenia
- pregnancy or breastfeeding
- body dystrophic disorder
- white hair or seizures
- cardiac pacemaker present
- recently tanned skin and/or use of self-tanning product
Laser hair removal complications
Anesthesia complications
Discomfort
Ocular burns/blindness
2nd degree burns
Hypopigmentation
Post inflammatory hyperpigmentation
Scarring
Lack of satisfactory response with regrowth
**rarely can trigger regrowth of hair
