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Houston, Texas

2003

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New Treatment for Acne
Dec 2003, As appeared on HealthNewsDigest.com

Patients suffering from acne, especially of the face, have endured both physical and social trauma from the condition. Now there is a treatment that offers these patients new hope. On November 24th, the "Smoothbeam" Laser was granted additional FDA clearance to be used as the latest and most effective treatment for acne. One of the principal researchers in the quest to get this approval, Dr. Paul Friedman of DermSurgery Associates in Houston Texas says the approval is a truly wonderful thing for patients suffering from the condition. "Considering the fact that over 80% of the general population suffers from acne, the condition is the Number One reason patients see dermatologists in the first place. The ability to use the Smoothbeam for the treatment of acne one of the greatest advances of recent years for tackling the condition."

Acne is caused by an enlargement of the sebaceous follicles, which contain oil-producing sebaceous glands, the root cause of acne. A serious skin disorder, acne often goes untreated resulting in pain, scar formations and skin damage. For years, traditional oral and topical acne treatments haven't treated the direct source of acne - overactive, oil producing sebaceous glands. Frustrated patients have long been searching for alternatives to the traditional acne treatment methods.

Now, the Smoothbeam laser offers a long-term solution by directly altering the structure and function of the sebaceous glands, which drastically reduces acne lesions without significant side effects. The Smoothbeam creates a mild thermal injury just below the skin's surface, which alters the structure of the sebaceous glands, the root cause of acne. This allows for effective, long-lasting acne clearance.

The Smoothbeam emits a wavelength of light that is strongly absorbed by water in the skin. As the laser penetrates into the skin, heat is generated in and around the sebaceous glands in the upper layers of the skin. The integrated dynamic cooling device (DCD(TM)) also emits a cooling spray, which allows preservation of the skin, thus minimizing treatment side effects. Dr. Friedman says the treatment provides a very dramatic improvement in acne lesions. "It's cost-effective, safe and can drastically change patient's lives for the better. We're extremely glad that we can offer this exceptional treatment to patients as a result of our research here in Houston."

The results of a recent research study conducted by Dr. Friedman using the Smoothbeam laser for facial inflammatory acne will be published soon in the scientific journal of Dermatologic Surgery. In this study, clinical improvement was seen in all patients as early as after one treatment with continued improvements seen with additional treatments even in patients who were refractory to oral antibiotics and Accutane.

New Injection is Wrinkle Eraser
KPRC-TV, Nov 2003 News2Houston

It's an injection to erase wrinkles, but it's not bovine collagen or Botox. A Houston-area doctor said his patients see an immediate difference, News2Houston reported Wednesday.

Dr. Paul Friedman, with the DermSurgery Laser Center, 7515 Main, uses Cosmoderm.

"You come in with wrinkles and you leave without them," Friedman said. "The exciting thing about this product -- there's some instant gratification involved. You see immediate improvement of contours around lines of lips, smile lines, also improving acne scars."

Unlike bovine collagen, which is made from cow cells, Cosmoderm is human derived collagen made from purified human cells. There is little risk of allergic reaction.

Lori Connealy tried dozens of products to get rid of wrinkles. "I tried and spent a lot of money on superficial things that never seem to work," Connealy said. She tried Cosmoderm. After a few hours, she said her wrinkles vanished with one treatment.

"It wasn't a dramatic facelift, pulled tight ... funny looking. It was like you looked refreshed," Connealy said.

As for the pain, Cosmoderm has a built-in pain anesthetic. "(The doctor) said, 'There may be some pain.' I said, 'Honey, I've had kids. This isn't pain,'" Connealy said.

For more information on Cosmoderm, visit www.dermsurgery.org or call (713) 791-9966.

Laser Zaps Zits
KPRC-TV, July 2003 News2Houston

A Houston dermatologist is helping clear up the faces on those with bad acne, News2Houston reported Monday.

Acne can break out from stress or hormones and there's no cure, which makes it a frustrating problem for sufferers.

Dr. Paul Friedman, the director of laser surgery at the DermSurgery Laser Center, is now zapping zits. For Barbara Johnson, it changed her life.

"It's debilitating. It got really bad. (It was) hard to get up and go to work every day. I'd want to sit in the closet and close the door," Johnson said.

Johnson had severe acne all over her face, until she met Friedman. "The laser just really changed my life," Johnson said. She was treated with a Smoothbeam laser. During a laser treatment, a numbing cream is applied first.

"It's actually an infrared laser that penetrates the top layer of skin and heats up oil glands and shrinks it to prevent break outs," Friedman said.

The laser erases active acne and acne scars, according to Friedman.

So does it hurt?

"(It feels) like a rubber band popping you," Johnson said. Stephanie Keasler tried everything for her acne.

"I had tried facials, medicine," Keasler said. It started to seriously affect her confidence.

"I'm in sales so it was uncomfortable going into my clients' offices and very often they'd say, 'What's the matter with your face?''' Keasler said.

She said the Smoothbeam laser has made drastic changes to her complexion.

"I would have to say in the last month, I can't remember a break out," Keasler said. "It has been a world of difference."

"We're giving people back pride and respect, and more confidence in daily activities," Friedman said.

Battling Stretch Marks with a Laser
KHOU-TV, July, 2003 HOUSTON 11 News

About 90 percent of women get stretch marks after pregnancy. And while there's nothing that can make them go away completely, laser treatments can make them fade.

Stretch marks are a result of hormonal changes and stretching of the skin during pregnancy or weight gain. Treatment options although disappointing, include topical creams, steroid injections and laser therapy.

Six weeks ago Laura Cook gave birth to twin boys. "When I look into their faces every stretch mark was worth it," Cook said.

Cook went to dermatologist Dr. Paul Friedman for a laser treatment that will help fade stretch marks. "So the laser emits a cool spray just before the laser pulse, which decreases the pain and protects the top layer of skin," Dr. Friedman said. "That allows us to use higher energies so we get more effective clearing with each treatment."

"The laser causes collagen remodeling," Dr. Friedman said. "It improves the appearance of the scar, and also improves the redness that you see in new stretch marks."

The laser used in the treatment is called a pulsed dye laser. It helps turn the stretch marks from red to white.

Laura Cook will need to come each month for six months. While the stretch marks will never go away entirely, they can improve the appearance and the texture.

"The treatment for older white stretch marks is still evolving," Dr. Friedman said. "I think we're still looking for a more permanent solution."

The best time to get the best effect for the treatment of stretch marks is when they are new. Dr. Friedman said patients can expect a 25-50 percent improvement in that time. But remember, there are no treatments to make stretch marks completely disappear. The cost of each laser treatment is about $350-$400.

Houston Doctor Erases Children's Birthmarks
KPRC-TV, June 2003 News2Houston

Birthmarks, like port wine stains or strawberry hemangiomas, can do more than hurt a child's self-esteem, they can lead to other health problems later in life. So a Houston-area doctor found a way to erase those marks with little pain, News2Houston reported Wednesday.

Kenji Gonzalez is in the third grade. He was willing to put up with a little discomfort to remove the port wine stain on his cheek.

"This kid told me it looked stupid and that I looked like an alien," Gonzalez said. "It bothers me because when I was in kindergarten all the way to second grade, they kept on making fun of my birthmark, saying it looks weird."

His mother realized something needed to be done.

"One thing bothered me this year. At the start of the year they take a picture. He was the only one not smiling," said Lorenza Gonzalez, Kenji's mother.

Lorenza Gonzalez called Dr. Paul Friedman, with the DermSurgery & Laser Center, 7515 S. Main. "Children can be very mean. They often tell us kids make comments that upset them," Friedman said. Using a pulsed dye laser, Friedman targeted the birthmark with an intense but gentle burst of light. "The laser selectively heats up. In doing so, the body absorbs the stain during the healing process," Friedman said.

Tommy Etheredge, 12, had six laser treatments. "People will make fun of me sometimes," Etheredge said. "It was like an upside-down triangle. It got dark in (an) area."

But now the birthmark has vanished.

"It's state of the art -- best I've seen. If anyone else has kids out there concerned with it, now is the time to do it, the earlier the better," said Bill Etheredge, Tommy's father.

"To be able to offer them an effective treatment is very gratifying," Friedman said. With advancements in cooling sprays and gels, the doctor can use higher energies and get better results.

Most insurance companies cover the cost of the procedure for children, according to Friedman. Doctors said that it could be safely done on babies.

Easy-to-use Topical Peel Found Safe and Effective
May 1 2003 Cosmetic Surgery Times, Anaheim CA
By Cheryl Guttman

Anaheim, Calif. - A novel topical cream peel (S-caine) containing a 1:1 eutectic mixture of lidocaine and tetracaine is a safe, effective, and convenient method for providing dermal anesthesia in patients undergoing nonablative facial rejuvenation procedures, said Paul M. Friedman, M.D., at the annual meeting of the American Society for Lasers in Medicine and Surgery.

Dr. Friedman, clinical assistant professor of dermatology, University of Texas, Houston, presented the results of a double-blind, split-face study. It enrolled 20 patients who were randomized to receive the anesthetic peel on one cheek and placebo contralaterally prior to undergoing treatment with a 1450-nm diode laser (Smoothbeam, Candela). Applied as a cream, the agents dry quickly to form a flexible membrane that easily is removed. In the study, the membrane was peeled off after a period of 30 minutes.

Anesthesia is clear preference

Patients and investigators rated anesthetic efficacy using several outcome measures, and the results consistently showed statistical superiority favoring the anesthetic peel over placebo. The product was well tolerated. The only side effect reported was erythema, and although its incidence was higher in association with the anesthetic peel compared with placebo, it was in all cases mild and transient.

"Nonablative rejuvenation procedures performed with conventional topical anesthesia techniques have been associated with varying degrees of discomfort, despite the use of epidermal cooling techniques. Topical anesthetic creams can be messy to apply and typically must be kept under occlusion for 60 minutes. This peel product is highly effective and has several advantages. It is much easier to use and has a faster onset of action, thus allowing application time to be cut in half," Dr. Friedman said.

The ouch factor. Noting that the pain associated with nonablative rejuvenation increases with increasing laser wavelength, Dr. Friedman and colleagues purposely chose to perform their study using the 1450-nm diode laser. Patients were treated with a single pass using five to 20 pulses with a fluence of 10 J/cm2 to 14 J/cm2 and 250-millisecond pulse duration. The treatment was performed with a 4- or 6-mm spot size and cryogen cooling.

Efficacy from the patient's perspective was assessed through ratings of pain levels using a visual analogue scale where 0 mm represented no pain and 100 mm the worst pain imaginable. Those results showed a significant advantage for the anesthetic peel, which had a mean VAS score of 15 mm compared to 47 mm for placebo.

The anesthetic peel was also favored in an analysis of responses to the question, "Would you undergo the same procedure again?" Among the 20 patients, 90 percent said they would repeat the experience using the anesthetic peel while only 15 percent of patients would use the placebo peel again.

The investigator's efficacy assessment was based on perception of pain during the procedure. That rating showed 50 percent of patients experienced discomfort during the procedure performed on the placebo-treated side, while no patient was perceived to have pain during the laser treatment after using the anesthetic peel.

Dr. Friedman noted that because the anesthetic cream peel does not have to be kept under occlusion, it is better suited for use on contoured areas than conventional anesthetic creams. Furthermore, since the eutectic mixture dries quickly to form an opaque film, adequacy of coverage is easy to assess, and with careful application, ocular exposure is avoided.

"With periocular application, other topical anesthetic products may inadvertently come into contact with the eye during the waiting period," he said. "That is a significant concern since EMLA cream, which has an alkaline vehicle, has been reported to cause chemical eye injuries consisting of corneal abrasions and conjunctivitis."

The S-Caine Peel is currently in FDA Phase III clinical trials. Currently, only patients involved in clinical trials have access to the peel.

S-Caine Peel is a product of Zars Inc., which sponsored the study. Dr. Friedman has no financial interest in it.

A New Laser Surgery Can Help erase a Variety of Skin Problems
KPRC-TV, May 2003 News2Houston

The V-Beam laser treats problems with little downtime, according to Healthbeat reporter Krista Marino. "We treat a lot of patients with this laser with red scars, with rosacea, facial blood vessels, as well as leg veins," said Dr. Paul Friedman, director of the DermSurgery Laser Center. Friedman said that he has erased birthmarks on babies with the procedure.

"If you can intervene at a young age, you can really do some dramatic things with this laser," Friedman said.

Jill Harris had the V-Beam erase red splotches on her neck.

"After one treatment, I could tell that it was actually effective," Harris said. "All those years of laying out in the sun have come back to haunt me a little bit."

It also eliminates spider veins.

"It's nice because it allows patients with busy schedules to come in and have their conditions treated and then go right back to work," Friedman said.

The V-Beam works by heating and then shrinking the blood vessels underneath the skin. Four to six treatments are recommended at a cost of approximately $300 to $500 for each session.

Focus On Health: Melanoma on the Rise in Young People
KHOU-TV, May, 2003 HOUSTON 11 News

By Dr. Karen Johnson

In spite of all the awareness of skin cancer and how to prevent it; there is an alarming increase in melanoma in young people.

Melanoma, a very serious skin condition, can be lethal. But if detected early it may be treated successfully.

Doug White is a 26 year old missionary who underestimated his risk of melanoma because he wasn't much of an outside person.

"Unfortunately when I was younger I spent a summer with my dad and we went out to the beach in Louisiana and we spent probably eight hours straight in the sun. And I got the worst sunburn ever. I got blisters, and it was painful for a week," White said.

Doug is typical of young patients with melanoma.

Young individuals who go out on the weekends and are exposing themselves to the sun between the hours of 10 and 4 and getting blistering sunburns are at risk for melanoma at a later age," said dermatologist Dr. Paul Friedman.

Melanoma can strike anyone but Caucasians are 10 times more likely to be diagnosed with melanoma than other races. Other risk factors are if you are a redhead or blond, if you have many skin moles and if you've had excessive sun exposure during the first ten to 18 years of life. "Any changing moles is a concern especially lesions that are turning darker or becoming larger in size or irregular," added Dr. Friedman.

The American Academy of Dermatology urges everyone to examine their skin regularly. If there are any changes in the size, color or shape of a mole or the development of a new mole, you should see your dermatologist immediately.

New Treatment for Acne
Dec 2003, As appeared on HealthNewsDigest.com

Patients suffering from acne, especially of the face, have endured both physical and social trauma from the condition. Now there is a treatment that offers these patients new hope. On November 24th, the "Smoothbeam" Laser was granted additional FDA clearance to be used as the latest and most effective treatment for acne. One of the principal researchers in the quest to get this approval, Dr. Paul Friedman of DermSurgery Associates in Houston Texas says the approval is a truly wonderful thing for patients suffering from the condition. "Considering the fact that over 80% of the general population suffers from acne, the condition is the Number One reason patients see dermatologists in the first place. The ability to use the Smoothbeam for the treatment of acne one of the greatest advances of recent years for tackling the condition."

Acne is caused by an enlargement of the sebaceous follicles, which contain oil-producing sebaceous glands, the root cause of acne. A serious skin disorder, acne often goes untreated resulting in pain, scar formations and skin damage. For years, traditional oral and topical acne treatments haven't treated the direct source of acne - overactive, oil producing sebaceous glands. Frustrated patients have long been searching for alternatives to the traditional acne treatment methods.

Now, the Smoothbeam laser offers a long-term solution by directly altering the structure and function of the sebaceous glands, which drastically reduces acne lesions without significant side effects. The Smoothbeam creates a mild thermal injury just below the skin's surface, which alters the structure of the sebaceous glands, the root cause of acne. This allows for effective, long-lasting acne clearance.

The Smoothbeam emits a wavelength of light that is strongly absorbed by water in the skin. As the laser penetrates into the skin, heat is generated in and around the sebaceous glands in the upper layers of the skin. The integrated dynamic cooling device (DCD(TM)) also emits a cooling spray, which allows preservation of the skin, thus minimizing treatment side effects. Dr. Friedman says the treatment provides a very dramatic improvement in acne lesions. "It's cost-effective, safe and can drastically change patient's lives for the better. We're extremely glad that we can offer this exceptional treatment to patients as a result of our research here in Houston." The results of a recent research study conducted by Dr. Friedman using the Smoothbeam laser for facial inflammatory acne will be published soon in the scientific journal of Dermatologic Surgery. In this study, clinical improvement was seen in all patients as early as after one treatment with continued improvements seen with additional treatments even in patients who were refractory to oral antibiotics and Accutane.

For more information about Cosmoderm acne or any other service, please call Dr. Friedman at
DermSurgery Laser Center
(713) 791-9966

Click here to request an appointment for Cosmoderm or any other procedure