Combination Treatment: Dr. Shamban

Dr. Ava Shamban:
I'm Dr. Ava Shamban, board-certified dermatologist from Beverly Hills in Santa Monica, California. My talk this week here at the fantastic Maui Derm, where so much creativity comes out, is on essentially layering treatments using a combination of energy-based devices as well as peels, as well as laser-assisted drug delivery to achieve what we used to think was impossible. So it's all about combination treatment. So the patients that I presented had laxity and tissue changes in their upper arms, which is a terrible problem that people experience as they go through life later in life. Get ready. So one thing we did was we decided to combine an advanced no-peel peel called the PRX, which is a combination of TCA with benzoyl peroxide, along with an energy-based device designed to accomplish tissue tightening. In this case, we used focused ultrasound, which the one we used was the Sofwave. So doing a series of treatments, we were able to really affect a nice improvement in the overall quality of the skin, as well as achieve some tightening of the tissue laxity.

The second case we presented was an acne case in a younger woman who was in her mid-twenties, and we also used a combination of the PRX peel, which is a modified TCA peel, which uses benzoyl peroxide as well as a series of, once again, Sofwave treatments. As it turns out, that energy-based device is approved for these indications, so it was very successful. In addition, I presented the treatment of the lower calves. We have a big problem in Southern California with people looking like a leopard with a lot of spots on their legs from cumulative sun exposure. As you can see, I'm wearing a hat. I took my sun-protective jacket off for the camera. But anyway, so in this case, using a series of both peels, a combination of an Erbium-Yag laser, as well as a Neodymium-Yag laser, as well as laser-assisted drug delivery using tranexamic acid.

We were able to really improve the appearance and quality of the lower legs in a woman who is in her mid-seventies. So what I suggest to all of you is that you really look at all the devices that you have and all the other topicals so that you can think of creative ways to use them in combination to achieve your goals. And remember, always tell the patients it's not just one treatment, it's a series.