Is your skin aging faster than you are? For today’s busy lifestyles, we offer a wide variety of “no-downtime” facial rejuvenation and laser treatments. Beautiful, healthy skin is a critical part of your overall health, since your physical and emotional well-being often rely on the health and appearance of your skin.

Finding the right treatment and skin care specialist for your individual needs is an important decision. In Connecticut and Rhode Island, patients seeking exceptional care choose Dr. Daniella Duke.

To learn more about the cosmetic and laser treatments offered in Dr. Duke’s comprehensive skin care center, click on a treatment below. After you’ve reviewed this information, we invite you to contact our office at (866) 895-2955 to schedule a private consultation with Dr. Duke, and learn what treatment is right for your unique skin conditions.

Laser Hair Removal

Lasers are an effective treatment for eliminating unwanted hair. This new technology was approved by the FDA in 1997, and uses a high-energy laser with a long pulse duration (such as a Yag, Ruby, Diode or Alexandrite laser). These lasers are designed to allow the laser’s energy to be absorbed by your hair’s melanin pigment, located in the deeper layers of your skin, while minimizing damage to the superficial layers of the skin. The advantage of this type of treatment is the selective damage of the hair, with no permanent damage to other parts of your skin and, therefore, the avoidance of scars or permanent pigment changes.

At Coastal Dermatology, we own 3 laser hair removal lasers. This allows us to select the most appropriate technology for your unique conditions, and thus safely and effectively maximize your results. The lasers used by Dr. Duke can treat patients with any skin type, including tanned and dark skin, and is safe for both women and men. Common treatment areas include:

Information from clinical studies has shown that in order to achieve the best possible outcome, patients should receive four to six treatments spaced four to eight weeks apart. To achieve the best results, it’s important that laser treatments are done at regular intervals, to ensure that each hair is treated in its “growth” phase - when the laser treatment will effectively eliminate it. Different hairs are in this growth phase at different times; therefore, it takes four to six treatments to adequately treat all the unwanted hair.

Most people see a 50-90 percent reduction in the number of hairs after completing the series of treatments, with an average of 70 percent less hair. The hairs that remain typically become lighter in color, and less coarse (because dark, thick hair responds better to the laser than does light, fine hair). Complete hair removal is not guaranteed, yet most patients achieve a significant permanent reduction in the number of hairs - following completion of a series of intermittent laser treatments.

The number of treatments required to obtain optimal results varies from person to person – based on hair density, hair color, amount of hair, growth phase patterns, skin type, and treatment location. Many things, including your age, ethnic background, hormones, and medications, affect the density of your hair and its growth phase.

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Accent Tissue Tightening (NEW)

Accent is a new treatment for tightening sagging facial skin, as well as for tightening the skin in many other areas of the body such as the neck, upper arms, abdomen, thighs and buttock areas. The treatments are effective for body contouring and reducing the appearance of cellulite. Treatments with the Accent are quick, and do not require anesthesia or prolonged recovery time, patients can resume their normal activities immediately. The Accent treatment uses radio frequency technology to heat the deeper layers of the skin, and thereby tighten sagging skin areas.

To see a video on an actual treatment, please click on the following link:

www.accentyourbody.com/pages/video.html

What is an Accent treatment like?
Depending on the size of the treated area, a treatment typically takes 45 to 60 minutes. While pain tolerance is subjective, most people toleratethe treatments well, and have little or no discomfort. Patients often describe the sensation as a “warm massage.” The risk of significant side effects is low. Following each treatment, you can immediately resume all routine activities. You may notice a slight redness, which should disappear in less than 24 hours. Generally, six treatments are needed to see the expected results; the treatments are spaced approximately four weeks apart.

Is Accent safe?
Absolutely. Incorporating advanced safety precautions, Accent directs proven Radio Frequency energy to precisely the areas of your skin that you wish to improve. Thousands of patients have been treated safely and successfully worldwide using the Accent system.

Why It’s Different
From lotions and creams to high-tech devices and medical procedures, it seems like there are millions of so-called solutions to younger-looking skin. Every new development that comes along claims to be an earth-shattering breakthrough, but of course they’re mostly just gimmicks with minimal results. Let us explain the real scientific evidence that makes Accent Your Body truly different.

How do Radio Frequency treatments work?
During treatment, the Accent wands will precisely heat an area of the inner layer of your skin (dermis) using radio frequency technology. As the dermis is heated, a natural reaction occurs that promotes the creation of new collagen. The result: a return to the smooth, shapely and elastic skin of your youth. Basically, the bipolar module focuses on the surface layer of the skin, while the unipolar module penetrates further for deep dermal thermotherapy. The Bipolar treatment is well suited for areas where the skin is thinner and more delicate, such as the face, helping to smooth fine lines and wrinkles. The Unipolar treatment generates alternating electromagnetic fields that cause friction and heating in the deeper tissues, which leads to improvements in overall shaping and firmness. Taken together, these dual-layer treatments can create dramatic change without the need for invasive surgery. The deep heat of the radiofrequency encourages new collagen growth, with causes a firmer contour to the skin.

When should I see results?
The Accent treatment causes the deep structures of your skin to tighten right away; results are immediately visible. With time, new collagen develops, further tightening your skin and yielding even more beautiful, natural looking and firmer skin. While just a few treatments can produce good results, most patients achieve their best outcome after a series of six sessions. Future follow-up treatments can also be used to maintain and improve your body’s youthful appearance.

Intense Pulsed Light (IPL)

Accent is a new treatment for tightening sagging facial skin, as well as for tightening the skin in many other areas of the body such as the neck, upper arms, abdomen, thighs and buttock areas. The treatments are effective for body contouring and reducing the appearance of cellulite. Treatments with the Accent are quick, and do not require anesthesia or prolonged recovery time, patients can resume their normal activities immediately. The Accent treatment uses radio frequency technology to heat the deeper layers of the skin, and thereby tighten sagging skin areas.

An IPL machine works by delivering a broad range of colors of light at the same time, to treat multiple skin conditions occurring in larger areas. Filters are then used to selectively deliver light in various wavelengths. Different wavelengths of light are delivered to different layers (and depths) of the skin. So our IPL machine allows Dr. Duke to choose the best setting and wavelength for targeting your specific skin conditions.

These treatments are usually completed in 15 to 30 minutes, and no topical numbing cream is required, as the IPL is used at a comfortable energy level. Then skin may redden for a few hours and feel like a mild sunburn, but you can resume your daily activities immediately after - no downtime is required.

Over the course of the next 1 to 3 weeks, the brown spots that were treated may darken, then fade and flake off. After completing a series of 4 treatments spaced at 1 month intervals, you will see noticeable improvements in your skin’s texture and appearance.

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Brown Spots & Pigmentation

Dr. Duke personally performs all consultations and pigmented laser treatments, they are not handled by an assistant.

Age spots, sun spots, and pigmented lesions are skin conditions resulting from an increased number or type of pigment cells (“melanocytes”) in the skin in specific locations. Examples of pigmented lesions that can be treated with a laser are:

• freckles
• brown (“age” or “sun”) spots
• certain types of moles
• pigmentation resulting from trauma or sun damage

Lasers which remove pigmented lesions specifically destroy only the cells which contain pigment (“melanocytes”), and leave the rest of the skin elements untouched and therefore undamaged. This is what makes lasers the treatment of choice for removing certain types of pigmented lesions; the risk of scarring or damaging other parts of the skin is limited.

Removal of the pigmented lesion may take one or two sessions. The skin heals quickly following laser treatment and is only mildly crusty for seven to ten days following the procedure.

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Skin Rejuvenation/Laser Toning

There are now a wide variety of methods to rejuvenate your skin, including topical skin products, chemical peels, microdermabrasion and laser treatments.

Most skin rejuvenation programs include topical products that initiate the process of revitalizing your skin cells. These products often contain lower concentrations of some of the active ingredients that are used in procedures done by a dermatologist. Often, the first step towards achieving younger looking and feeling skin involves using higher strength skin care products, which have clinical data to prove they effectively treat the skin. They contain higher percentages of active ingredients than over-the-counter skin products, and they can only be used under the guidance of a physician. These topical agents achieve results on their own, they prepare the skin for more advanced skin procedures, and they are used to maintain the rejuvenated skin after the procedure. For a complete description of our skin care products,
click here.

The next step up in skin rejuvenation options often involves one or several of the following treatments. One option consists of a series of superficial chemical peels. They improve skin texture and even out irregular pigmentation. Another option involves a series of micro-dermabrasion treatments. Microdermabrasion is a non-chemical, non-surgical, non-laser alternative to rejuvenating the skin.

An excellent new option that we are now offering is Intense Pulsed Light (IPL) treatments. This light-based, no-downtime procedure can reduce many signs of aging skin caused by exposure to the sun -- including age spots and brown areas, skin redness (rosacea), and fine lines. IPL treatments are very effective, and are commonly used to treat the face, neck, upper chest area, and arms.

For more information on IPL, chemical peels and micro-dermabrasion simply follow their links.

Laser Skin Rejuvenation (“Non-Ablative”)

Traditional laser resurfacing (using a CO2 or erbium laser) has been a widely used procedure for almost a decade, and is the most effective treatment for smoothing out the fine to deep wrinkles on your face. Some patients, however, prefer alternative treatments -- since laser resurfacing involves a healing period of 1-2 weeks before you can return to your daily activities.

To remedy this lengthy and inconvenient healing period, a new treatment has been developed called “non-ablative laser rejuvenation.” This new procedure involves a series of treatments that can soften fine lines to deep wrinkles, and requires no healing period or “down time.” While non-ablative laser rejuvenation does not take the place of a facelift or laser resurfacing, it has a number of benefits.

This treatment has been called many names, including “the lunchtime facelift,” “Sub-surfacing,” “Photo Rejuvenation,” “Photofacial," “collagen tightening,” or “laser toning” by different medical equipment manufacturers and in different media. The different names help describe the goals of the treatment - to tighten the skin as in a facelift; to treat below the surface of the skin and tighten the collagen while leaving the surface skin intact; to tone and rejuvenate the skin using a laser that tightens up your collagen; and to promote new collagen growth.

During the procedure, your entire face can be treated, or specific areas. No anesthesia is required. The superficial top layer of the skin is not broken, and there is no open wound that needs to heal. The skin may be mildly to moderately pink for a few hours, and after-care only involves applying ice. The treatment is repeated once a month in a series of treatments. The number of treatments varies from individual to individual, based on your skin type, the extent of the wrinkles being treated, and your desired outcome.

The benefits of this treatment program are that it strengthens the deeper collagen skin layer – which helps soften wrinkles and tightens up the skin; there is no healing time involved; and the treatments are more gentle than laser resurfacing -- which is why it requires a series of treatments. One study demonstrated that 70% of the people had a 50% or more improvement in their wrinkles. Most people achieve a smoother, softer look. The newer laser toning systems (such as the one we use) also effectively reduce facial redness, improve skin tone, decrease pore size and smooth out acne scars.

Many patients combine non-ablative laser rejuvenation (which affects the layer of skin underneath the top layer) with a treatment to improve the top layer of the skin. Options for improving the top layer of skin include:

• Superficial chemical peels - of which there are now many different types;
• Diamond Tone medical microdermabrasion - which softens the skin texture, improves skin tone, reduces pore size, reduces brown spots, and evens out pigmentation.
• Intense Pulsed Light (IPL) - to reduce diffuse brown spots, sun damage, and skin redness.

Finally, there are a number of other lasers that can individually remove brown spots, or blood vessels, and rejuvenate the skin -- by making the tone and pigment more uniform. For more information on these treatments, click on the treatment listed in the index at the top of the page.

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BOTOX® Cosmetic

Dr. Duke personally performs all consultations and all BOTOX® Cosmetic treatments, they are not handled by an assistant.

BOTOX® Cosmetic is used to treat deeper facial expression lines and wrinkles. It can reduce the appearance of worry and frown lines on your forehead and between your eyes, and crow’s feet around your eyes.

BOTOX® Cosmetic has been used for more than a decade to treat multiple medical illnesses in adults and children, including: neuromuscular diseases (cervical dystonia, tremors, facial spasms, laryngeal dystonia), eye diseases (strabismus, eyelid spasms, nystagmus), and excessive sweating. BOTOX® Cosmetic is a diluted form of a man-made botulinum toxin.

Since 1988, BOTOX® Cosmetic has also been used to treat wrinkles. The product was the focus of a published study in medical literature in 1992. Since then, a large number of studies on BOTOX® Cosmetic have been done that document impressive results in reducing wrinkles -- unrivalled by the surgical alternative. The results also document its ease of application, high level of patient satisfaction, and strong safety profile.

There have been no long-term complications associated with the use of BOTOX® Cosmetic for either medical or cosmetic purposes. In 2004 alone, physicians in the U.S. performed approximately 3,000,000 BOTOX® Cosmetic treatments to reduce wrinkles, making it the most common cosmetic procedure. BOTOX® Cosmetic is FDA approved to reduce certain muscle spasm disorders and BOTOX® Cosmetic was FDA approved to reduce frown lines in 2002.

BOTOX® Cosmetic injections are used to reduce the appearance of lines on the face that are caused by repeated, deep muscular contractions. Wrinkles on the face that are primarily caused by facial movements and muscular contractions (rather than by sun damage or age), include frown lines (forehead, brow line, and in between the eyes) and crow’s feet (on the side of either eye). If these lines are mild, they can be treated by other methods such as chemical peels or laser resurfacing; however, they tend to recur as your facial movements are repeated. Therefore, a better treatment option for these areas is BOTOX® Cosmetic. BOTOX® Cosmetic will not eliminate your ability to show facial expressions or to have normal skin sensations. Only isolated muscles are “relaxed” so they do not create lines. The “relaxed” muscle’s strength and size is re-grown as the BOTOX® Cosmetic wears off.

The treatment involves injecting a minute amount of the solution into the muscles that cause the frown and squint lines. The solution temporarily weakens the muscles, and by doing so, makes the lines caused by these muscles less apparent. One or more sessions may be necessary to achieve the desired cosmetic result. The effect typically lasts for three to six months; therefore, injections are generally needed two to three times per year -- in order to maintain the desired cosmetic result. Some studies have shown that the duration of results from BOTOX® Cosmetic may increase with the number of injection sessions.

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Restylane®

Dr. Duke personally performs all consultations and all Restylane® treatments, they are not handled by an assistant.

Q: What is Restylane ®?
A: Restylane® is a safe and natural cosmetic dermal filler that is used to provide volume and restore fullness to the skin -- in order to correct moderate to severe facial wrinkles and folds (such as nasolabial folds).

Q: What is Restylane® made of?
A: Restylane® is the first and only cosmetic dermal filler made of non-animal based hyaluronic acid. Hyaluronic acid is a natural substance that already exists in the human body and is used to provide volume and fullness to the skin.

Q: How does Restylane® work?
A: As you get older, your face loses its shape. Over the age of 50, we lose one percent of our collagen each year, which leads to lines and folds in the skin. Restylane® simply restores fullness and provides a smoother contour to the face.

Q: How does Restylane® fill the wrinkles?
A: Restylane® works in two ways: Upon injection into the mid to deep dermis (the dermis is the middle layer of the skin), it adds volume and fullness to smooth facial wrinkles and folds. In addition, Restylane® integrates into dermal tissue, then attracts and binds to water molecules to help maintain volume.

Q: Is Restylane® safe?
A: Yes. Dermatologists and plastic surgeons have used Restylane® safely since 1996 worldwide. Because Restylane® is non-animal-based and fully biocompatible, allergy testing is not required. This quality virtually eliminates any risk of animal-based disease transmission or allergic reaction. The most commonly reported side effects are temporary redness, swelling, and bruising at the injection site. These effects typically resolve within two to three days.

Q: Is Restylane® approved by the FDA?
A: Yes. Restylane® is FDA approved for use in the United States.

Q: Have there been any scientific studies done with Restylane®?
A: Yes. A randomized double-blind study enrolled 138 subjects who received split-face treatment with Restylane® in one nasolabial fold and Zyplast® (collagen) in the other. After six months, more than twice as many Restylane® -treated folds continued to experience excellent results versus collagen-treated folds.

Q: How is Restylane® administered?
A: Restylane® is injected directly into the skin in tiny amounts using an ultra fine needle. After the injection, your physician may gently massage your skin to optimize contouring of the gel. Restylane® is a simple and convenient procedure and results are practically instantaneous.

Q: Do Restylane® injections hurt?
A: Restylane® is injected directly into the skin in tiny amounts by an ultra fine needle, resulting in minimal discomfort. To optimize your comfort during the short procedure, if you prefer, your physician may anesthetize the treatment area using either a topical gel or a nerve block.

Q: How can I be sure the needle used for the injection is clear?
A: Restylane® is prepackaged in a disposable glass syringe with a sterilized needle.

Q: Are there any side effects?
A: As with any injection, some common injection-related reactions might occur. The most common side effects are temporary redness, bruising, and swelling at the injection site. These typically resolve within two to three days.

Q: How long does Restylane® last?
A: The average treatment results last six months or even longer.

Q: How often should I have Restylane® treatments done?
A: Restylane® lasts twice as long as collagen, so treatments are typically scheduled twice a year. Evidence shows that having a touch-up treatment before the product fully dissipates from your last treatment will enhance the lasting effect.

Q: Can Restylane® be used anywhere on the face?
A: Although Restylane® has been used in more than one million treatments in more than 60 countries to smooth wrinkles and deep facial folds and to enhance the appearance and fullness of lips, in the U.S., it is currently indicated only for the correction of moderate to severe facial wrinkles and folds, such as nasolabial folds.

Q: How is Restylane® different from BOTOX® Cosmetic?
A: Restylane® is a natural, cosmetic filler. BOTOX® Cosmetic is a natural, purified protein that blocks nerve transmission and relaxes the underlying muscles. Many patients have been very pleased after receiving treatment with both products.

Q: How is Restylane® different from bovine collagen?
A: Restylane® is proven to deliver a longer-lasting effect than traditional collagen, with virtually no risk of animal-based transmission or allergic reaction. In addition, bovine collagen is derived from animals (cow) and requires an allergy test. Because Restylane® is a non-animal based product, it can be administered without pre-testing, so no waiting is required.

Q: How much does Restylane® cost?
A: Restylane® treatments are customized procedures based on specific individual needs, so the cost will vary from patient to patient. In general, the cost of Restylane® is comparable to the cost of similar procedures. Because Restylane® is longer-lasting, it proves to be very economical over the long term.

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Chemical Peels

Chemical peels have been used for hundreds of years to create an even and controlled shedding of damaged skin cells. In fact, Cleopatra applied a “sour milk” glycolic acid mixture to her skin! Now, hundreds of thousands of chemical peels are performed in the United States each year. They can be used for treatments on your face, neck, chest, hands, arms and legs.

A chemical peel uses a solution applied to the skin to remove dead skin cells and stimulate the production of new skin cells. The specific type of solution depends on your individual skin condition and goals. Chemical peels can achieve many different goals including the following::

1. Smooth the texture of the skin.
2. Give the skin a healthy, vibrant glow.
3. Soften fine lines.
4. Even out and fade brown spots and areas.
5. Treat acne and decrease pore size.

During your consultation with Dr. Duke, you will want to explain the level of skin improvement you hope to achieve. Dr. Duke will review your medical history and examine your skin type and pigmentation, in order to determine if you are a good candidate for a chemical peel. Together, you can evaluate the advantages and disadvantages of the different types of chemical peels, discuss your options, your expectations and determine the best treatment for you.

You should be prepared to give the doctor information on your medical history including viral infections, sensitivity to the sun, and prior skin treatments such as dermabrasion or Accutane® within the past six (6) months.

Depending on your skin type and your desired results, options include superficial, medium, or deep chemical peels, as well as a variety of different chemicals (including glycolic acid, lactic acid, salicylic acid, and TCA). The solution used may include one (or several) of these chemicals, and can be applied to various areas of skin.

Specialty Peels

The technology of chemical peels has advanced since the time when Cleopatra applied a sour milk mixture to her skin. Depending on Dr. Duke’s evaluation of your skin, there are many products, chemicals, and botanicals that can be applied to your skin (in a layered process) – in order to maximize the results achieved from your chemical peel. For example, if your treatment goal is to decrease brown spots and excess pigmentation, then chemical peels with specific pigment lighteners (such as lactic acid, salicylic acid, kojic acid, hydroquinone, and arbutin) are applied in layers to your skin.

Thanks to rapid advances in skin lightening and chemical peel technology, these treatments can peel the skin and actively treat the skin problem. If acne or pore size is the issue – different ingredients (such as lactic acid and resorcinol) can be added. Therefore, chemical peels can now be personalized to your unique skin conditions and concerns. As another example, if you have sensitive skin, there are now chemical peels that use mild botanicals and soothing emollients (along with the key ingredients) in order to more gently treat your skin.

Another advantage of the newer chemical peels is that they require very little downtime. After a chemical peel, you will leave the office with only mildly pink skin - the pinkness fades within a few hours. Later, the skin may or may not peel – peeling is no longer a requirement for the chemical peel treatment to be effective.

A series of chemical peels is recommended in order to maximize your results. Generally, the peels are spaced two to four weeks apart. Based on your skin’s response to the previous peel, each peel is either applied for a longer period of time or increased in strength. This allows you to gradually obtain maximum benefits as your skin develops a tolerance to the higher strength glycolic acid. In addition, the simultaneous use of certain at-home skin products, as discussed with Dr. Duke during your initial consultation, will increase the effectiveness of the peels.

Trichloroacetic Acid (“TCA”) Peels

TCA is a chemical peeling agent that can be used for superficial, medium, or deeper peels. The depth TCA penetrates into the skin depends on the concentration used. Lower concentrations at six to 20 percent remove part, or all, of the epidermal layer and achieve more superficial effects. Higher concentrations at 25 to 35 percent penetrate deeper and also treat the dermis. The lower concentrations of TCA can be combined with other ingredients (depending on your individual skin conditions and treatment goals) to produce a “no downtime” peel; there is only mild skin pinkness after the peel.

When used in higher concentrations, TCA peels are effective in removing excess pigmentation, significantly smoothing out the texture of the skin, and reducing fine to moderate lines. A stronger acid than those used in A.H.A. peels, TCA peels usually only requires one treatment to achieve desired results. At times, a second peel is beneficial but this should not be done for several months after the first peel. Following a deeper TCA peel, the skin is red, peeling, and slightly crusty for four to seven days and may stay red for several weeks. This procedure involves more of a healing period than superficial peels because it accomplishes more dramatic results in one session.

All of these different chemical peels are performed in the comfort and privacy of Dr. Duke’s conveniently located office in Mystic, Connecticut.

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“Diamond Tome” Medical Microdermabrasion

Discover how you can have smoother, more toned skin with a new skin renewal treatment called “DiamondTome.™ It’s not a chemical, laser, or surgical procedure. It’s gentle, safe and affordable technology. The procedure requires only 30 minutes of your time, after which you can return to your daily activities.

DiamondTome™ is an advanced microdermabrasion machine that removes the top most layer of skin by gently exfoliating the skin with natural diamond chips. At the same time, a suction pressure vacuums the dead skin cells away in a sterile and controlled manner. Removing this outer layer of dead skin cells leaves a smoother texture and promotes the growth of healthy new skin cells.

Resurfacing using DiamondTome™ is similar to particle microdermabrasion (which uses very small crystals) in its results, but without the adverse effects of loose particles, irritation and skin reaction. Unlike other microdermabrasion treatments, the DiamondTome™ Skin Resurfacing System does not use loose abrasives that can contaminate you or the environment.

Treatments using the DiamondTome™ System are painless yet effective. An adjustable vacuum and the coarseness of the DiamondTome™ Wands control the degree of treatment. After a series of treatments, the skin will adapt to the treatments so that coarser wands and a more aggressive vacuum can be used. Subsequently, the treatments become more and more effective. The DiamondTome™ System is more effective and gentler than other microdermabrasion systems (such as the “Crystal Peel”, “Power Peel”, “Derma Peel”, “Mega Peel”, etc.).

Your skin may look slightly flushed immediately after the treatment but should return to normal in 10 to 30 minutes. Normal activities may be resumed immediately. Your skin will have a radiant glow, and feel softer, smoother and cleaner after the first treatment, and will continue to improve with additional treatments.

DiamondTome™ Medical Microdermabrasion can be used in combination with other treatments, and requires no down time after treatment. The DiamondTome™ treatment regimen is repeated every two weeks in a series of treatments, usually between four and ten, depending on the condition being treated and the type of skin. The DiamondTome™ System works equally well on all skin colors.

Benefits of DiamondTome™ medical microdermabrasion include:

• renews and smoothes skin texture
• evens out skin tone and superficial pigmentation
• lightens brown-colored “age” and “sun” spots
• softens fine lines
• softens acne scars
• minimizes blackheads, whiteheads; and enlarged and oily pores

Medical microdermabrasion performed in Dr. Duke’s office is different than microdermabrasion done at a spa -- because she uses more powerful equipment than is allowed for use at a spa. While DiamondTome™ medical microdermabrasion requires no “downtime,” the treatments can be more aggressive. There is an actual biological effect on the skin that is treated with this type of equipment, rather than just a mild exfoliation. Medical grade microdermabrasion with the DiamondTome™ is a medical skin treatment, not just a spa experience that feels good.

There are a number of microdermabrasion systems now on the market. We feel DiamondTome™ is the best medical-grade microdermabrasion system for this type of skin renewal treatment.

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Photodynamic Therapy (PDT) – With Omnilux Red™ or Omnilux Blue™

Omnilux Red™ and Omnilux Blue™ are some of the newer laser treatments for controlling difficult to treat acne, diminishing oil glands overgrowth (called sebaceous hyperplasia), smoothing the texture of the skin, softening fine lines and evening out sun-damaged skin. An Omnilux Red™ treatment utilizes photodynamic therapy with amino levulinic acid (known as PDT with ALA).

The ALA is a topical solution applied to the skin for a short period of time – causing the skin to be more sensitive to light. When the Omnilux Red™ or Blue light is applied, the therapeutic benefits of the light are able to penetrate more deeply into the skin. This combination of the ALA and the red or blue light can reduce fine lines, wrinkles, and uneven skin tone, as well as lessen oil gland activity. It even can treat and eliminate pre-cancerous skin lesions.

Neither the application of the solution nor the laser treatments are uncomfortable or painful. The skin may be red for a few days, but makeup can be applied after the treatment so it should not interrupt daily activities.

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Spiders Veins (face, legs)

Dr. Duke personally performs all consultations and all spider vein treatments; they are not handled by an assistant.

Spider veins are small, dilated blood vessels that have a red or bluish color. They appear mostly on the legs, and occasionally on the face or elsewhere. They can be short, unconnected lines each about the size of a large hair, or connected in a scraggly “sunburst” pattern. Sometimes they occur in a small area, or they can cover a large area of skin.

Although unwanted blood vessels carry blood, the great majority of them, especially spider veins, are not necessary. If they are unsightly or uncomfortable, then they can be treated with lasers (or with sclerotherapy). The type of laser used is known as a vascular laser, and it produces a beam of yellow light that can selectively destroy blood vessels.

The energy from the laser is just absorbed by the blood vessels; the other elements of the skin are unaffected and therefore undamaged. This unique feature of lasers reduces the incidence of any scarring.

Spider veins usually require 1 to 4 treatments, spaced 1 to 2 months apart, to completely remove them. There are several different lasers available that treat blood vessels in the skin. Some lasers leave a temporary bruise-like purple mark for 7-14 days following the procedure. Other lasers which treat facial and leg veins leave only a mild redness for 1-2 hours, though sometimes more treatment sessions are required to achieve the desired results. Dr. Duke can discuss the pros and cons of the different laser systems and recommend which laser is the best choice for your situation.

TO FIND A VEIN SPECIALIST NEAR YOU, VISIT VEINSonline.com

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Sclerotherapy

Dr. Duke personally performs all consultations and all sclerotherapy treatments, they are not handled by an assistant.

Sclerotherapy is one method of treating spider veins that occur on the legs. Spider veins are dilated, small blood vessels that have a red or bluish color. They appear mostly on the legs, and occasionally on the face or elsewhere. They can be short, unconnected lines each about the size of a large hair, or connected in a scraggly “sunburst” pattern. Sometimes they occur in a small area, or they can cover a large area of skin.

Although unwanted blood vessels carry blood, the great majority of them, especially spider veins, are not necessary. If they are unsightly or uncomfortable, they can be treated by sclerotherapy. This involves the injection of a solution with a very fine needle directly into the blood vessel. The solution irritates the lining of the blood vessel, causing it to swell and stick together, and the blood to clot. Over a period of weeks, the blood vessel eventually becomes barely noticeable or invisible.

After a series of treatments, most patients can expect a 50 to 90 percent improvement.

TO FIND A VEIN SPECIALIST NEAR YOU, VISIT VEINSonline.com

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Birthmarks & Port Wine Stains

Dr. Duke personally performs all consultations and vascular laser treatments, they are not handled by an assistant.

Vascular lesions such as birthmarks, port wine stains, and hemangiomas are formed when a network of blood vessels are located close to the skin surface. They cause your skin to be colored pink, red or purple.

If these vascular lesions are unsightly, or if they cause discomfort, then they can be treated with lasers.

Lasers that produce a beam of yellow light can selectively destroy blood vessels and have been shown to treat vascular lesions effectively. Multiple laser treatments are usually necessary to effectively reduce or remove a vascular lesion. The treatment sessions are spaced four to eight weeks apart. The treated area is usually purple for two weeks following the treatment. Future lasers may leave less of this purple mark and still effectively treat the area.

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Acne Laser – Omnilux Blue™ Clears Up Acne

In the past, treatments for moderate acne have included topical antibacterial's and antibiotics, oral antibiotics, Retin-A®, Accutane®, astringents and exfoliants.

You may have heard that “blackheads are dirt”; “only teens have acne”; “junk foods cause acne”; or “it will just go away by itself”. These and other myths have prevented many from seeking the appropriate acne treatment for years. Now there is a safer, easier way to treat acne. Omnilux Blue™ is an effective alternative to topical and oral acne medications, including antibiotics and Accutane. It’s a new, pain-free way to treat acne in all age groups, including adult women and men.

Omnilux Blue™ is FDA-cleared to treat moderate inflammatory acne using innovative Blue Light (photo dynamic therapy) technology to effectively target and destroy the bacteria that causes acne -- without affecting surrounding skin. Treatments are fast and safe – with most cases being effectively reduced in eight quick treatments over a 4-week period.

Omnilux Blue™ is one of the safest acne treatments available. Its high spectral purity insures that patients will not receive UV, IR or inappropriate visible radiation – such as that received if other lasers and Intense Pulsed Light devices are used. Omnilux Blue™ therapy is both natural and non-invasive, and your glands will return to their natural state without being thermally altered. Pregnant women and people with photosensitivity should consult with their primary care physician.

Q: What causes acne?
A: Acne occurs when the oil gland (sebaceous gland) cells do not function normally and cause a blockage in the oil gland canal. Oil produced by the sebaceous glands cannot reach the surface of the skin and is trapped in tiny pores or follicles. This plug may close off the pore, causing the follicle wall to bulge, which creates a whitehead. If the pore stays open, the top surface of the plug may become darkened, causing a blackhead. In both cases, the bacteria acnes thrive in the clogged follicles. When bacteria and pus leak from the follicle into the surrounding tissue, pimples are formed.

Q: Why is it so hard to control?
A: Unfortunately, acne is something most of us have experienced at one time or another. Three out of four teenagers have suffered with acne to some extent. It is most prevalent during adolescence because hormonal changes stimulate the sebaceous glands (oil glands) into producing more sebum (oil), increasing the chance of acne. While most people outgrow acne in their late teens or early twenties, many continue to be affected much longer. Adult acne involves deeper pimples, often located on the sides of the face and neck, and may be difficult to control. Aggravation of acne in later life may occur with menstrual periods, use of birth control pills, changes in hormonal balance, use of oil-based products, and stress.

Q: How does Omnilux Blue™ work?
A: Omniliux Blue™ utilizes a panel of more than 1,700 focused diodes to ensure proper power density over a uniform beam profile. It delivers a unique 408nm wavelength blue light that closely matches the peak absorption qualities of the targeted acne bacteria. This blue light creates a highly toxic environment for the superficial acne bacteria, which induces bacterial death and clears the skin from acne.

Omnilux Blue™ pure blue light means that virtually all of the energy targets the bacteria, making it the most powerful, non-invasive tool available.

Dr. Duke also offers Omnilux Red,™ which is similar to an Omnilux Blue™ treatment, but the red light penetrates deeper into the skin. Some patients receive a combination of red light and blue light during their series of treatments.

Q: What actually happens during the treatment? Is it painful?
A: A typical Omnilux Blue™ treatment session takes only 20 minutes. You can relax comfortably on a bed during light application. Protective eyewear will be provided. There may be a slight warm sensation during treatment. Omnilux Blue™ treatment is easy, painless and safe.

Q: What results can I expect from a series of treatments?
A: Omnilux Blue™ can clear most moderate inflammatory acne in as little as eight treatment sessions (twice a week for four weeks). Most patients achieve up to a 70 percent improvement in breakouts. Improvement continues even after the series of treatments have been completed. The acne laser system offered by Dr. Duke involves blue light for more superficial acne and red light for deeper acne.

Q: Are there any side effects from the treatments?
A: In June 2003, FDA cleared Omnilux Blue™ as a safe and efficacious therapy for acne. There are no known side effects. Patients tolerate the procedure well with no discomfort, no redness or crusting after the procedure, and no post treatment downtime.

Q: How safe is the treatment?
A: Omnilux Blue™ is one of the safest acne treatments available. High spectral purity of the Omnilux Blue™ensures patients will not receive ultraviolet, infrared, or inappropriate visible radiation as with lasers and Intense Pulsed Light devices. Omnilux Blue™ therapy is both natural and non-invasive. The blue or the red light treatments provide an alternative for treating acne that does not involve oral medications such as oral antibiotics or Accutane® which carry the risk of systemic side effects. Many patients are opting to use laser treatments to control their acne as it is easy, safe, effective, and does not carry the side effects of many topical or systemic antibiotics.

Q: What are the benefits of treatments with Omnilux Blue™?

• It utilizes the latest technological advances in acne treatment.
• It has a short treatment regimen (treatments twice a week for 4 weeks) with impressive results.
• It eliminates the use of internal or topical drugs, which have possible harmful side effects.
• It is safe, painless, non-invasive, and has no side-effects.

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Tattoo Removal

Dr. Duke personally performs all consultations and tattoo removal treatments, they are not handled by an assistant.

A tattoo is created by depositing various colored pigments under the skin surface for decorative or cosmetic purposes. Many methods have been tried to remove tattoos, including surgical excision, use of various acids and bleaching agents, destruction by heat or cold, over tattooing with flesh-colored pigment, sanding or dermabrasion, and various older laser therapies. Many times, these treatments were ineffective or led to significant scarring.

Lasers more effectively treat tattoos and limit the possibility of scarring. The specific color, or wavelength, of the laser is targeted to a specific colored pigment particle. Ruby lasers treat green tattoos. YAG lasers treat red, and blue-black pigments. Therefore, the other skin elements are not affected. Multiple lasers are needed to treat a multi-colored tattoo.

Q-switched lasers represent the latest, state-of-the-art technology specifically designed for tattoo treatment. Multiple treatments are necessary, and are scheduled at four to eight week intervals. The eventual number of treatments required depends on the type and color of the tattoo, whether it is a professional or amateur tattoo, and your individual response. For amateur tattoos, typically two to six treatments are necessary. For professional, multi-colored tattoos, usually eight or more treatments are needed.

Anesthesia may or may not be required, depending on the location of the tattoo and your individual preference. There may be swelling, bruising or crusting of the treated area for one to two weeks following each treatment, and the tattoo may continue to fade for up to six months after completing laser treatments.

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Skin Care Products

Our office offers a wide variety of physician-strength skin care and skin rejuvenation products to both our patients, as well as non-patients.

These products contain higher concentrations of the active ingredient than that offered in similar products sold in retail stores and spas. Over the counter skin care products temporarily change the look of the skin; physician-strength products have an actual biologic effect on the skin, in order to achieve the goal of improving the health and appearance of your skin.

Dr. Duke selected these items based on a number of factors, and the products offered in our office are listed below. When you stop by our office, a skin care consultant, under the guidance of Dr. Duke, will evaluate your skin and recommend skin care products based on your unique skin conditions and goals.

Vitamin C antioxidant cream

Helps soften your skin and prevent sun damage. The active ingredient in this cream meets two important criteria - it is of a high concentration and is in a stable form.

Vitamin A (Retinol) cream

Lightens brown spots and smoothes fine lines.

Anti-redness serum

Clinically proven corrective serum that controls persistent flushing in sensitive or rosacea-prone skin. Contains several ingredients that improve micro-capillary stability.

Neocutis

Contains growth factors and other ingredients that stimulate collagen growth in the skin. It reduces the appearance of fine lines, and it smoothes skin texture.

Nectifirm

Contains several ingredients (lipopeptides, tripeptide, ceramide, bamboo, and hyaluronic acid) that firm lax skin, reduce wrinkles, tighten loose skin, reduce fatty deposits under the chin, and hydrate the delicate area of the neck and chest.

Auriderm Clarifying Gel

A physician-grade Vitamin K oxide gel, in nanosome formulation, that reduces the severity and duration of post procedure bruising. The active ingredients block the formation of dead red blood cells, clear dead red blood cells following a bruise, and strengthen the walls of the blood vessels.

Eye treatments

We offer several under eye treatments to improve hydration, lighten dark circles, and firm “baggy” skin.

Alpha Hydroxy Acid (AHA) creams and gels

These glycolic acid based products are used to exfoliate, lighten brown spots and improve skin tone and texture.

Cleansers

We offer a variety of specially formulated cleansers to match your skin type.

Moisturizers

We offer a variety of different moisturizers for different skin types.

Acne products

Designed to be incorporated into your at-home regimen.

Skin “lightening” gel

Lightens brown spots caused by sun damage and aging.

Prevage™

From the makers of BOTOX® Cosmetic, this antioxidant cream improves skin damage caused by the sun, aging and smoking, and improves the appearance of fine lines, reduces dryness, and smoothes skin texture.

Improves fine wrinkles, mottled coloring and rough, sun damaged skin.

Sun care and sunscreen products

We offer several oil-free, non-comedogenic products (several of which are “Quick Dry”).
Note: When out in the sun, use a SPF 15+ in winter, SPF 30+ in summer.

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Jane Iredale Mineral Makeup

In addition to physician-strength skin care and skin rejuvenation products, Dr. Duke offers her patients several items from the Jane Iredale Mineral Makeup line. She selected the Jane Iredale line of products because they are made from the highest-grade materials available, and are not available for purchase in retail stores.

The benefits of the products are as follows:

Non-comedogenic and oil-free: The skin is allowed to breathe and function normally.

Under a microscope, the mineral crystals look like overlapping fish scales. These crystals form a filter that allows the free exchange of gases. The minerals are non-comedogenic, and there are no oils in any of the base formulas.

Four-in-one: Micronized mineral bases are four products in one: foundation, powder, concealer and sunscreen, and will disguise almost any skin discoloration.

The micronized mineral bases are concentrated pigment. This means there are no fillers like talc to stretch pigment or dyes. (Pigment is defined as inorganic color insoluble in water,) as opposed to dyes which are organic (usually derived from petroleum) and soluble in water. Because the bases are concentrated pigment, the coverage we can achieve is far superior to normal makeup with a minimum amount of product. This is why mineral makeup should always look sheer and natural. This concentrated pigment also gives us the high rating we achieve with sunscreen protection.

Fast, weightless coverage: Because we use no fillers like talc to dilute the effectiveness of the pigment, one quick application of the minerals provides all-day coverage that doesn't fade, crease or smear. Apply with a brush or a sponge for coverage that would normally take three products to achieve. The result should look sheer, luminescent and feel weightless.

SPF 20 Loose Bases: Formulated with titanium dioxide and zinc oxide, the minerals give instant, broad-spectrum, chemical-free sun protection. They are also very water resistant.

Minimum allergy risk: We use no sensitizers like perfume or chemical dyes and preservatives in the bases, powders, blush or eye shadows. These are the top three sensitizers.

Substances that most commonly cause sensitivities are chemical preservatives, chemical dyes (usually labeled as FD&C), perfume and alcohol. Reactions are particularly common in skins that have been compromised in some fashion, as through a weakened immune system, sun damage, chemical peels, laser resurfacing, etc. The makeup contains none of these sensitizers. In fact, zinc oxide and titanium dioxide are anti-inflammatories and help calm the skin.

Coverage: Because the minerals are concentrated pigment, they give complete coverage and can be used effectively to camouflage large or small distractions.

The word “pigment” usually means a colored or white compound that is insoluble in a solvent. (The word “dye” generally refers to a chemical compound, most often of coal tar origin, which is soluble.) The pigments are made from micronized mineral elements only. Other cosmetics almost always contain a filler like talcum powder, which is used to stretch a small amount of pigment a long way. Talc is usually the first thing to appear on ingredient lists, which by law must be arranged in order of proportion of content from large to small. Talc is drying, translucent and cheap. It slides off the face, falls into cracks and accentuates lines because of its matte finish. (All matte finishes are aging.) Talc has no camouflage capability.

The reason these powders work so well as a natural-looking beauty makeup and/or a camouflage is because they are concentrated pigment that not only masks color but also reflects away light (matte finishes absorb light). An amazingly small amount of the minerals will cover any type of redness including acne, rosacea and erythema (redness).

Adhere: The minerals adhere to the skin until they are removed with a cleanser.

Because of the micronization process the mineral particles undergo, they bind together on application. When applied to a clean, moisturized skin the surface tension this creates overcomes gravity and holds the minerals tightly to the skin. The result is that they do not run, crease or smear and will only come off with a cleanser. No special cleanser is required.

Anti-inflammatory: The mineral bases have anti-inflammatory properties and are especially helpful for acne and rosacea-prone skins. Titanium dioxide and zinc oxide have anti-inflammatory properties and will help to calm erythema. Zinc oxide is also an anti-microbial.

Inert: The loose minerals are inert and cannot support bacteria.

Quality: Jane Iredale uses state-of-the-art cosmeceutical ingredients to ensure the finest performance in coverage, application and texture. The vitamins and antioxidants are pharmaceutical grade.

FD&C Dyes: This makeup line contains no petroleum or coal tar dyes.

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VISIA Computerized Complexion Analysis

VISIA™ is an exciting and effective visual communication system that allows Dr. Duke to evaluate and analyze the condition of your facial skin. A VISIA™ imaging session uses both regular and ultraviolet images to accurately capture, and objectively analyze, information in six key areas affecting the health and appearance of your skin.

During your consultation with
Dr. Duke, this new technology measures skin pigmentation, UV spots (resulting from sun damage), pores, pigmentation, porphyrins (bacteria in pores) and wrinkles. Using the digital pictures that it creates, your skin is analyzed and scored based on your age, skin type and gender. This allows Dr. Duke to design a customized treatment program based on your unique skin condition, and to evaluate your progress after a series of treatments.

At the end of your VISIA session, you will receive a full-color report with photos detailing your results, along with the customized recommendations from Dr. Duke. This analysis is safe and effective for patients of all ages, skin colors and ethnicities.

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55 Willow Street
Mystic, Connecticut 06355

To learn what will work for your unique skin conditions, we invite you to contact us at our new skin care center to schedule a private consultation with Dr. Duke

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