Cosmetic Dermatology

Several cosmetic procedures are performed at The Warwick Medical Building and Rhode Island Hospital by University Dermatology staff members. All patients have a consultation appointment before any procedure. Because these procedures are cosmetic, insurance plans usually do not cover treatment costs.

 

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Cosmetic procedures include:

  • Lasers
    • MiniGentlelase for treatment of brown spots and hair removal.
    • Vbeam Perfecta for treatment of vascular, pigmented and certain non-pigmented lesions.
    • Fraxel for acne scarring and resurfacing.
  • Injectables
    • Botox
    • Dysport
    • Juvederm
    • Restylane
    • Restylane Lyft
    • Radiesse
  • Chemical Peels
    • TCA
    • Salicylic Acid
    • Glycolic Acid
  • Sclerotherapy (for spider veins)

Laser light is a revolutionary treatment option for spider veins and skin pigment problems.The most common laser procedures are treatment of spider veins on the face, legs, ankles or feet. Spider veins are reddish or purplish in color and can appear raised or flat, and treatment is primarily for cosmetic purposes. The laser can treat either single or matted spider veins.Cosmetic laser treatment can be used for

  • Broken capillaries
  • Age spots
  • Liver spots
  • Wrinkles
  • Acne scars
  • Birthmarks
  • Spider veins
  • Stretch marks
  • Unsightly hair
  • Strawberry hemangiomas
  • Warts
  • Rosacea
  • Scars

How it works

The cosmetic laser machine delivers an intense pulse of light that penetrates the skin. The light is absorbed by the vein and converted to heat, which destroys the blood vessel, taking the unsightly color with it. Despite the intense light, the procedure is remarkably gentle. The light is only absorbed by the vein, and the surrounding tissue is not affected. Because the treatment is so selective, it is considered safer than other treatment options, the most common of which is injection therapy. It is so safe that it can be used to treat infants. The recovery time is also shorter than other options.

Possible side effects

Immediately following treatment, the area that has been treated may appear redder than usual or discolored, and some patients report an increase in skin pigmentation. Skin color usually returns to normal over time.

How long does it take?

A laser light treatment session usually takes 15 to 30 minutes. For some conditions, such as small spider veins, only one session may be required. Additional sessions may be necessary depending on the condition and where on the body the treatment is needed.

Where do you put the Botox?

The frown line between the eyebrows is caused by the action of a muscle called the corrugator. You can feel this muscle as a thickening just below the inside of your eyebrows, when you purposefully make yourself frown. Injecting Botox directly into the corrugator muscle stops the ability to draw the eyebrows together when you frown. Once the muscle is paralyzed, it cannot contract, and the frown line gradually fades away.

When does Botox start to work, and how long does it last?

The results of Botox treatment start to appear in three to ten days. The treated muscles will gradually regain their action over three to five months. When the frown line starts to reappear, a simple repeat treatment is all that is necessary to maintain the desired results.

Who can perform Botox treatment?

Botox therapy should only be performed under the direction of a physician experienced and trained in the use of Botox.

Has Botox been tested?

Botox has been used since 1980 for the treatment of strabismus (lazy eye), and blepharospasm (uncontrolled eye blinking). Botox has been used for hyperfunctional facial lines since 1989. Major reviews of Botox therapy have been published in the Journal of the American Academy of Dermatology (1996; 34: 788-97), and Dermatologic Surgery (1998; 24: 1168-1254).

Sclerotherapy is an injection therapy used to treat spider veins and varicose veins. In this procedure the dermatologist uses a fine needle to inject a sclerosing solution directly into the unwanted blood vessel. There are several different solutions that can be used, depending on the size of the blood vessel and other factors.

The solution irritates the lining of the vein, causing the blood to thicken and block the vessel. It then breaks down into scar tissue, which is further broken down by the body over a period of a few weeks. Any resulting scar tissue is either completely invisible or barely noticeable, and the vein no longer exists.

Sclerotherapy has a long history, and has been used to treat spider veins since the 1930s. Recent advances in ultrasound-guided techniques allow dermatologists to use sclerotherapy on veins that are located more deeply under the skin and that previously could only be treated by surgery.

Side Effects

Possible side effects of sclerotherapy vary with the type of solution injected and may include:

  • Pain at the injection site
  • Swollen ankles or feet
  • Muscle cramps immediately after the injection (depending on the type of solution used)
  • Red, raised hive-like areas at the injection site
  • Differences in skin pigmentation around the treatment area (This occurs more frequently in patients who have larger veins treated.)
  • Smaller, red blood vessels that appear in the place of larger ones that had been treated. Additional treatment can remove these.
  • Small ulcers at the injection sites that can appear up to a few days after treatment
  • Bruising
  • Allergic reaction to the solution
  • Inflammation of the blood vessel that was treated (unusual)
  • A lump of coagulated blood in the treated vessel (This can be easily drained by the dermatologist.)
  • A history of blood clots is not necessarily a reason to avoid sclerotherapy or vein treatment. Patients should keep in mind that veins may reappear or new veins may form in their place after any spider or varicose vein procedure, including sclerotherapy.
  • There are several other treatment options for spider and varicose veins as well.

Spider and Varicose Veins

Both spider veins and varicose veins are enlarged, dilated, superficial blood vessels that can appear red or blue. They can occur together or separately.

Spider veins are smaller in size and commonly appear on the legs and face. They are about the width of a large hair and may appear as a single vein or in a matted, branched or webbed pattern. Spider veins are commonly treated with laser light or sclerotherapy.

Varicose veins are larger and may be raised above the surface of the skin. These may cause pain or discomfort most commonly described as a throbbing or burning sensation. Varicose veins can be treated with sclerotherapy, intravascular laser or radiofrequency. In some cases, unwanted veins are treated surgically by either tying them off or removing them.

Causes

The exact cause of dilated blood vessels is not known. Researchers do know that they occur in women more commonly than in men. Possible causes may be:

  •  A family history of spider and/or varicose veins
  • Female hormones released in puberty, by birth control pills, hormone replacement therapy or pregnancy
  • An injury
  • Wearing tight hosiery or girdles
  • Sun exposure
  • Other spider or varicose veins

Treatment for unwanted veins is between 50% and 90% effective, depending on the patient and the veins being treated. Because spider vein treatment is usually done for cosmetic reasons, most insurance providers do not cover it. Insurance may, however, cover all or some of the treatment costs for larger veins if there is a medical reason for their treatment.

Reduce Your Risk

Because some causes, such as heredity, are out of our control, the appearance of unwanted veins can’t be completely prevented. That aside, research suggests that the following steps may minimize their appearance:

  • Wearing support hose
  • Maintaining a healthy weight
  • Exercising regularly
  • Eating a low-fat, high-fiber diet
  • Using sunscreen, especially on the face
  • Avoiding high heels

Our Cosmetic Dermatology Specialists

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Nicole L. Grenier, MD

Assistant Professor of Dermatology, Clinician Educator
Cosmetic and General Dermatology

400 Bald Hill Road, Suite 526, Warwick, RI 02886
Phone: 401-738-1120

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Nicole Grenier, M.D. graduated from Providence College. She received her medical degree at The Warren Alpert Medical School of Brown University. Dr. Grenier completed an Internal Medicine Internship at Rhode Island Hospital as well as a Residency in Dermatology at The Warren Alpert Medical School of Brown University. She is board certified in dermatology. Her professional interests include cosmetic dermatology, general dermatology and surgical dermatology. Her cosmetic interests include Botox, Fillers, and a range of laser treatments for vascular lesions, hair removal, and resurfacing of the skin.

Newsha Lajevardi, MD

Assistant Professor of Dermatology, Clinician Educator
Cosmetic and General Dermatology

845 North Main Street, Suite 3, Providence, RI 02904
Phone: 401-521-7300

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Dr. Newsha Lajevardi is a board certified dermatologist who practices medical dermatology, pediatric dermatology, cutaneous surgery, laser surgery and cosmetic dermatology. Her academic interests include acne, rosacea, and skin pigmentation disorders.

Dr. Lajevardi completed her dermatology residency at the Brown University Department of Dermatology. She completed her internship in internal medicine at Saint Vincent Hospital in Worcester, Massachusetts. She received her medical degree from Michigan State University, master’s degree in medical sciences from Boston University and bachelor’s degree in psychology from Northwestern University.

 

During her time at Brown University she conducted research studies on skin cancer, alopecia areata, vitiligo, and dermatologic surgery. She has lectured to other physicians at both regional and national meetings and has published in several medical journals. She currently serves as the Quality Improvement Advisor to the dermatology residency program at Brown. As a member of the American Academy of Dermatology, American Society for Dermatologic Surgery, Women’s Dermatologic Society, Rhode Island Dermatology Society, and New England Dermatological Society, Dr. Lajevardi is very active in the dermatology community.

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Jennie J. Muglia, MD

Associate Professor of Dermatology, Clinician Educator
Director, Division of Dermatology,The Miriam Hospital
General and Pediatric Dermatology

593 Eddy Street, APC-10, Providence, RI 02903
Phone: 401-444-7959

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Dr. Muglia graduated cum laude from Bryn Mawr College with a Bachelor of Arts in Biology and Italian and received her medical degree from UMDNJ-New Jersey Medical School. She completed her internship and internal medicine residency at Roger Williams General Hospital (affiliated with Brown through 1997) in Providence, RI followed by a fellowship in immunodermatology and dermatology residency at the University of Colorado School of Medicine in Denver. She is board certified in internal medicine, dermatology and pediatric dermatology. Dr. Muglia is currently the Director of the Division of Dermatology at The Miriam Hospital in Providence as well as the Director of the Dermatopharmacology Unit at Rhode Island Hospital. She also volunteers her time in the Contact Dermatitis clinic at Rhode Island Hospital and holds a weekly pediatric dermatology clinic at Hasbro Children’s Hospital.

She is actively involved in teaching medical students, dermatology residents and primary care residents in her academic practice, outpatient dermatology clinics and on the inpatient dermatology consultation service at Rhode Island and Hasbro Children’s Hospitals. Her clinical research interests include acne, psoriasis, atopic dermatitis, fungal and viral
infections of the skin and cutaneous T cell lymphoma.

She is an active member of the Rhode Island Medical Society, serving on the Public Laws Committee and as the dermatology representative to the Rhode Island Medical Society Council.

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Jon Solis, MD

Clinical Assistant Professor of Dermatology
General and Cosmetic Dermatology

17 Wells Street, Suite 203, Westerly, RI 02891
Phone: 401-348-0660

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Dr. Solis graduated with Highest Distinction from the University of Rhode Island with a Bachelor of Science degree in Business Administration. He earned his medical degree from the F. Edward Hébert School of Medicine within the Uniformed Services University of the Health Sciences. Dr. Solis completed an internship in family practice at Dewitt Army Hospital and dermatology residency at the Walter Reed Army Medical Center in Washington, D.C. He serves as an attending physician in several resident dermatology clinics at Memorial Hospital and Rhode Island Hospital throughout the year. Dr. Solis’s clinical interests include medical dermatology and dermatologic surgery.