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Show Some Skin – Dr. Nedic

Show Some Skin – Dr. Nedic


HQ magazine – Dr. Nedic explains décolleté skin treatments…


Show some skin

Skincare experts let you know how to tackle skin imperfections

Ingredients like polypeptides, proanthocyanidins, isoflavonoids, and antioxidant vitamins A and C have all been found to help keep the chest area looking youthful

Blotchy chest

It’s likely that you’ll see signs of skin damage starting to show up on your décolletage area before you notice them on other parts of your body. According to Dr Sly Nedic, an aesthetic practitioner and owner of the 8th Sense Medi-Spa in Sandton, Johannesburg, this is because the skin on our chest is delicate (it’s thinner and less elastic than anywhere else on our body), which makes it especially prone to the visible effects of ageing and sun exposure. This area is also often neglected when it comes to beauty routines and sun protection. “People make the mistake of skipping the chest area when applying moisturisers and sunscreen, which makes this area more vulnerable to damage over the years.” While applying anti-ageing skincare products to your décolletage is useful in the early prevention of premature ageing, Dr Nedic says that these products don’t offer a marked improvement in the look of imperfections once they’ve already taken form. However, specific products do complement some of the aesthetic procedures that target chest imperfections. Ingredients like polypeptides, proanthocyanidins, isoflavonoids, and antioxidant vitamins A and C have all been found to help keep the chest area looking youthful.

“Due to the complexity of décolletage skin ageing, this area requires a variety of aesthetic procedures to get desirable results – the sooner you start treatment, the better the outcome.” Dr Nedic uses the following non-invasive procedures to treat the décolletage:

  • Intense pulsed light (IPL) therapy A series of laser treatments which can remove some of the evidence of sun damage like freckles, brown spots, abnormal redness, blotches and fine wrinkles. You’ll need to avoid unprotected sun exposure after your procedure to prevent discolouration and the return of imperfections
  • Cryotherapy The skin’s surface is rapidly chilled to between 10 and 18⁰C. The cold temperature stimulates circulation, encouraging better oxygenation of skin cells, which helps to reduce pigmentation and restore firmness and radiance.
  • Cryotherapy can be combined with mesotherapy and a 70% glycolic acid peel in a procedure known as the Cryo- Meso Peel, which rejuvenates skin that has lost firmness and elasticity
  • I Pixel Laser This is a laser treatment which triggers the body’s natural healing process and stimulates collagen production. After a single treatment, you can expect to see differences in your skin’s tone and texture such as softened lines and wrinkles, improved elasticity and firmness, and reduced pigmentation
  • Dermaroller Under local anaesthetic, a device comprising several fine needles is rolled over the skin to create tiny channels deep in the dermis. This boosts collagen production and has a rejuvenating effect. A potent cocktail of hyaluronic acid and growth factors is administered to further stimulate collagen production. The appearance of wrinkles and pigmentation will improve and your décolletage will look firmer and more radiant
  • Dermal fillers and Meso-Botox Dermal fillers minimise the appearance of deep lines and wrinkles, and Meso-Botox (tiny injections of Botox) relaxes the muscles that aggravate wrinkles.

Since treating imperfections on the décolletage area is such a timeconsuming and complex task, Dr Nedic recommends that you start taking care of this area now to cut down your chances of premature ageing. You can do this by avoiding anything that diminishes the skin’s antioxidant capacity and increases free radical formation, such as smoking, a nutrient-depleted diet, harsh skincare products (stay away from those that contain xenoestrogens), exposure to pollution and excessive sunlight, and lack of sleep and exercise. Don’t forget to include your décolletage in your daily beauty routine: applying moisturiser to young skin, or anti-ageing products to mature skin, as well as using broad-spectrum sunscreen, are the best ways to prevent premature skin ageing.

Varicose veins
Varicose veins affect up to 25% of adults, says cardiologist Dr Riaz Motara, who practises at the Heart Wellness Centre at Melrose Arch in Johannesburg. These swollen, twisted veins, which are caused by an abnormal collection of blood in the vessels and usually affect the legs, are hereditary – if one parent has them, Dr Motara says you have a 50% chance of getting them too; if both of your parents have them, your risk soars to 80%. Other factors that increase your risk include ageing, lack of exercise, vein injuries, excess weight, pregnancy and prolonged periods of standing or sitting. Varicose veins can spark more than insecurity. In some cases, they are associated with symptoms like aching, cramping, itching, leg swelling and blockages in the deeper veins (which is a serious condition known as deep vein thrombosis). If varicose veins are accompanied by these symptoms, they need to be treated, but even if all that they’re doing is making you too shy to wear clothing that reveals them, Dr Motara says that a new minimally invasive treatment called endovenous laser will get rid of them quickly and painlessly to prevent later complications. “It’s a 30-minute outpatient procedure, performed under local anaesthetic – walk in, walk out. Under the guidance of ultrasound, a laser fibre is inserted into the affected vein. Once positioned correctly, laser energy is delivered to heat up the vein wall. As the fibre is pulled out, the vein wall shrinks and seals closed, and blood flow re-routes to healthy veins.” The Heart Wellness Centre also offers treatment options like sclerotherapy (injecting a solution into surface varicose veins) and topical laser therapy. While these procedures are suitable for some individuals, Dr Motara says that they work on a superficial level, so there’s a good chance that the varicose veins will come back. In contrast, the endovenous laser treatment addresses the deeper problem by destroying the faulty ‘feeder’ vein. Although treated veins will never return, the underlying mechanism that leads to the formation of varicose veins can’t be fixed, so it’s possible that you will experience varicose veins again after treatment. Preventative measures include exercising regularly, losing excess weight, avoiding standing or sitting for long periods (if you have a desk job, Dr Motara suggests that you get up and walk around every half an hour or so), resting with your legs up, wearing elastic stockings during long-distance travelling, and staying away from clothing that’s tight around your waist.

We chat to two of Dr Motara’s patients who have had endovenous laser treatment … Forty-seven-year-old Carol* remembers how, before treatment, the varicose veins in her legs caused so much pain that it would wake her up during the night. Her feet and legs were always swollen and the bottom half of her legs were a reddish-brown colour. She says that the day after the procedure, which she describes as mildly uncomfortable, the familiar pain was gone, although the treated area was bruised and sensitive for about two weeks after treatment.

Another patient, 45-year-old James*, didn’t experience any symptoms in addition to enlarged visible veins, but opted for the treatment to stop the veins from worsening with age. He compares the experience to a visit to the dentist. “I climbed onto the ‘dentist’s’ chair, it reclined, and the doctor and his assistant got to work. First, he used ultrasound to find the right areas for entry of the laser and to identify the points where the deep veins were leaking into the surface veins. Then he administered a local anaesthetic and I felt my leg going numb. He made a relatively painless incision into the ‘leaky’ vein, which I saw on the ultrasound right next to me (If you’re squeamish, I wouldn’t recommend looking at that bit, but you don’t feel a thing). Next he inserted the laser fibre, and at the same time injected some fluid around the vein casing. I couldn’t see what it looked like, but in my mind I had an image of a high-speed mole burrowing a tunnel just under the surface of a patch of lawn. This was the most uncomfortable part of the procedure, but thankfully it didn’t last too long. Next came the part where the laser energy heated up the vein. Dr Motara asked me if I could feel anything and I said no. That was what he wanted to hear because the laser was in fact at 120⁰C and he said he could feel the heat in his fingers! Then before I knew it, the procedure was over. After two weeks, the results were incredible: my varicose veins had vanished. If you can handle having a filling at the dentist, you can handle this. Just remember to take your pain meds for the full two-week period after the procedure. Also, I would recommend doing this at the end of the week so you have the weekend to recuperate before heading back to work.

Body acne
Breakouts don’t only affect the face. In its various forms (from blackheads to inflamed pimples), acne can also spoil the skin on the neck, chest, back, arms, and even the buttocks. Although most people manage to shrug off pimples in their 20s, about 5-10% of men and women continue to have clinical acne until their mid-40s, says Dr Tessa Hoffman, a dermatologist at Ageless Lasers in Hyde Park, Johannesburg. Dr Hoffman says that dermatologists don’t view body and facial acne as separate entities, as acne’s triggers are similar regardless of where it’s located. “Basically, acne is a disease of the hair follicle caused by a combination of androgen-stimulated overproduction of sebum (a natural oil your body produces to keep your skin moisturised), excessive turnover of skin cells and a build-up of bacteria known as Propionibacterium acnes in pores,” she explains. “Factors which can exacerbate body acne include greasy, pore-clogging skincare products; medications like corticosteroids, steroids and lithium; and friction caused by tight-fitting synthetic fibre gym clothes.” Dr Hoffman says that the treatment of body acne is similar to that of facial acne, with topical and oral options. Topical options include prescription creams containing ingredients such as retinoids, antimicrobials, salacylic acid preparations and sulfur-based creams and gels. As applying creams to one’s back is rather impractical, however, oral agents are preferred, including antibiotics and isotretinoin. These medications are associated with potentially serious side effects and should be reserved for severe cases of acne. Once body acne has been successfully cleared, procedures like chemical peels, laser treatments and dermarolling can take care of any remaining marks. However, Dr Hoffman points out that treatment of scars on the back and trunk is cumbersome and expensive due to the large surface area involved.

Bumpy body parts

Rough bumps resembling goosebumps that cover the upper arms, thighs and buttocks may be a symptom of a common hereditary skin condition called keratosis pilaris, or KP (one in four adults is affected). “KP occurs when the body produces too much keratin, a type of protein in the skin. The excess keratin surrounds and entraps the hair follicles in pores, which leads to the formation of small bumps,” says dermatologist Dr Lushen Pillay, from Dermology in Sandton, Johannesburg. “KP can look similar to other skin conditions like acne and eczema, though, so it’s advisable to have bumpy body parts checked out by a dermatologist.”

Although KP is a harmless condition that’s limited to the skin, you may find the bumps embarrassing, especially if hair follicles become inflamed, causing tiny red or brown polka dots to form beneath each mound of keratin. “While some cases clear on their own, most people will require treatment to get KP under control, although the condition does tend to improve with age.” Dr Pillay says that there’s no universally effective treatment; each person needs to be treated based on their skin type and the severity of their condition. For a start, use pH-balanced soapless cleansers and keep your skin moisturised at all times – Dr Pillay recommends Cetaphil’s lotion. Other treatment options, which need to be ongoing to avoid a relapse, include:

  • Prescription lotions Topical treatments containing ingredients like alpha-hydroxy acids, lactic acid, salicylic acid and retinoids can improve the appearance of KP
  • Scrubs and peels Regular microdermabrasion sessions or chemical peels can give your skin a smoother feeling
  • Topical immunomodulators More severe cases may need to be treated with immunomodulators (medications that regulate the skin’s immune response).

Since KP is hereditary, there’s no surefire way to prevent the little bumps, but by maintaining a healthy weight (being overweight increases your risk of inflammatory KP), keeping your skin moisturised, and avoiding harsh soaps and scrubbing your skin aggressively, you can stop the condition from worsening.

Tattoo regret?
If it’s an unwanted tattoo that’s making you cover up your skin, be aware that tattoos don’t need to be permanent. Mazanne van Staden, general manager of Laserderm Dunkeld, has removed well over 1 000 tattoos during the 12 years that she’s been in the aesthetic industry. The laser used (called Q-Switched ND:Yag) delivers intense energy which attracts the tattoo’s pigment and causes it to expand and break up into particles. These particles are then naturally eliminated by the body. Over time, the pigment will lighten. “You’ll need an average of eight to 12 sessions, six to eight weeks apart, to provide good clearance,” says van Staden, “but there will always be something left on the skin after treatment, whether it’s a slight lightening or darkening effect, or a textural change.” The laser works on black and coloured ink – the darker the ink, the better the result – and on all skin types. However, yellow and green tattoos are not easily removed and sometimes even change colour when lasered. “We recommend a test patch before starting treatment.” “When working on the human body and skin, there are always risks but risks and side effects can be avoided. Always choose professional establishments when having any form of laser treatment and adhere to pre- and postprocedure guidelines,” advises van Staden.