 Tech NeckTech neck is a relatively new term for a condition that is becoming exceedingly more prevalent in our tech dependent society. Many of us spend hours everyday bent over ill-placed computers or scrolling the "Black Mirror" causing the delicate skin on our necks to form creases where it folds. "The more time we spend bent over our devices, the more the neck ages. The symptoms of tech neck can be aches, stiff neck, and WRINKLES on the front of the neck." Dr. Lani Doser, DNP According to data by Pew Research Center, 88% of women between the ages of 30-49 own a smartphone. And that number is even higher for those between 18-29. Moreover, an Asurion Insurance survey showed Americans check their phones an average of 80 times per day or every 12 minutes while awake!⠀⠀⠀⠀⠀⠀⠀⠀⠀ ⠀⠀⠀⠀⠀ The more time we spend bent over our devices, the more the neck ages. The symptoms of tech neck can be aches, stiff neck, and WRINKLES on the front of the neck. "The remedy for tech neck is NOT throwing away your phone. It’s getting treated when you recognize the first signs." Dr. Lani Doser, DNP The remedy for tech neck is NOT throwing away your phone. It’s getting treated when you recognize the first signs.
So, what can be done other than switching to a rotary phone? Step one is to modify your behavior to help prevent the signs of tech neck. Spend less time staring at our cellphones and tablets and adjust your work monitor so that the center of the screen is eye level. And listen to your mother - "Sit up straight." Once you've addressed the causes of tech neck, visit SkinWise Rx for a consult. At SkinWise Rx we can look at your nonsurgical options and give you experienced and educated recommendations. Depending on the area and severity of symptoms, toxin injections such as Botox or Jueveau will help. And laser treatments (Lutronic Genius), fractional resurfacing (Erbium YAG Laser or Er:YAG), and/or dermal fillers like Juvederm or Restylane all have unique benefits to address the signs of Tech Neck.
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 Prejuvenation is a term that has suddenly thrust itself upon the aesthetic world. But what is prejuvenation? And why is it important? “There are two types of aging: Intrinsic, which is inevitable thanks to our DNA, and extrinsic which is brought on by exposure to environmental factors.” Dr. Lani Doser, DNP Prejuvenation is addressing signs of aging BEFORE they become a problem. The goal of an aesthetician is to prevent signs of ageing before they occur rather than correcting them once they appear. Dr. Lani Doser, DNP tells us, “There are two types of aging: Intrinsic, which is inevitable thanks to our DNA, and extrinsic which is brought on by exposure to environmental factors.” Extrinsic factors, which are typically avoidable, include sun/UV damage, smoking, poor diet, lack of sleep, etc. Preventative steps - “Your body is a temple. Treat it as such.”The first step in prejuvination is prevention - Avoiding the extrinsic factors that can cause aging. Avoid the sun The most effective action one can take is to wear sunscreen daily and apply it frequently throughout the day. Wearing a hat and sunglasses and avoiding direct sunlight will reduce the amount of UV damage to the skin. News flash: Smoking is bad, mkay? We are well beyond having to inform people that smoking causes premature aging and will very likely kill you. You already know it. So let’s not beat that horse anymore. However, many people are under the impression that vaping is a good alternative. It isn’t. As with cigarettes, nicotine dries the skin causing premature wrinkles as well as retarding the body’s ability to heal itself. Maintain a low-fat diet high in antioxidants Antioxidants inhibit oxidation which causes damage to skin cells. A diet high in nuts, beans and fresh fruits and vegetables (especially those high in vitamin C) helps prevent oxidation, thus keeping your skin cells healthier. Further, switch from foods high in saturated fat to foods with plant-based healthy fats (avocados, coconut oil, nuts, flax). Foods high in saturated fat are common contributors to acne and the subsequent scarring. Get adequate sleep During sleep the body puts its energy into healing itself. Lack of adequate sleep or disruptive sleep prevents the body from entering this healing stage and cell damage accumulates. "Bone remodeling is the process of bone and fat deteriorating in one area and reaccumulating in another, ultimately changing the structure of the face." Dr. Lani Doser, DNP Step two is treatment. The signs of ageing are no secret to medical professionals. Bone remodeling and UV damage are two of the biggest culprits. As we age bone slowly moves from places we are used to seeing and some is redeposited in new places. Our muscles are no longer able to rely on the support from this bone causing sagging and wrinkles. Injectable fillers are simple and effective way to add volume to these areas of the face. Regular toxin injections such as Botox, Jeuveau, and Dysport can help delay the deep glabellar lines (the 11s between the eyes) and crows feet from forming. In addition, there are many procedures such as microneedling, HiFU and laser therapies that will help encourage new collagen growth creating volume and filling out fine lines and wrinkles. Thanks to new technologies, UV damage can now be seen before it is visible to the naked eye. IPL, LaseMD and ErbYAG can all be effective treatments to address UV damage before it becomes a problem as well as improving the tone and texture of your skin. The bottom line on prejuvination is that signs of ageing become far more difficult to address as time passes. Begin a skincare routine and address aging early with preventative steps and treatment for best results!  Beauty is in the eye of the beholder, as the saying goes. Yet, a new and bizarre beauty trend is testing the validity of that adage. "You should seek a clinician with a similar look as yourself. If they aren’t willing to do it to themselves you shouldn’t let them do it to you.” Dr. Lani Doser, DNP “Devil lips” are trending on social media and the reception has been mixed. Some people find them interesting and intriguing and many others are shocked and disturbed. However, medical professionals are chiming in with warnings about duplicating the curious look. Essentially, having this type of procedure is akin to bending your elbow backwards - Can you? Sure. But you really, really shouldn’t. “The damage inflicted to achieve this look may be irreversible.” Dr. Lani Doser states. “It’s definitely semi-permanent and this look likely cannot be achieved using a reversible filler. I don’t know of a dissolvable filler that can create that type of structure.” Essentially, having this type of procedure is akin bending your elbow backwards - Can you? Sure. But you really, really shouldn’t.
This procedure could cause vessel occlusion, scaring, and infections. Further, changing the border of the lip can permanently distort it. Even with semi-permanent fillers it is unlikely they will wear off symmetrically leaving you with distorted and lumpy lips. Given the high likelihood of permanent damage, the ethics of performing such a procedure must be posited as well. Dr. Doser says "You should seek a clinician with a similar look as yourself. If they aren’t willing to do it to themselves you shouldn’t let them do it to you.”  The following blog post was written by a client of Dr. Doser's and has been reprinted here at her request. “If you squint like that, you’re going to get wrinkles,” my mother would say to me from the time I was in elementary school. The amblyopia and light-sensitive, far-sighted eyes led to the brow-furrowing habit that never abated due to the fact that I like being able to see. Glasses helped me see but didn’t stop the squinting habit – even when I do remember where I left them. "I’m the natural girl – the hippie chick minus the patchouli and comestibles. Keens, no bangs, hair down, casual." I’m the natural girl – the hippie chick minus the patchouli and comestibles. Keens, no bangs, hair down, casual. I’m not a stunner but I mostly feel okay with how I look. Consideration for my appearance has waxed and waned with how I felt about my weight and how much emotional, financial, and logistical bandwidth I had left after homeschooling two girls, having three more babies, running a business with 25 employees, and hosting a weekly home group. "I had noticed that when I took pictures over the last couple years (I am 47 now), I looked old. No position could make the wrinkles disappear." The thought of having medical aesthetic work done never really occurred to me before recently. I had noticed that when I took pictures over the last couple years (I am 47 now), I looked old. No position could make the wrinkles disappear. They exist no matter the cream I use, smile I modify, or facial gymnastic I try to execute for the sake of the camera. People would ask me why I was scowling, and I’d say I’m just squinting because of the light. My mother always said I looked tired. I notice that the eyes of men don’t stay like they used to. These are hard things. I try to face them directly and always with humor, but the sense of being looked over and not feeling as desirable weighs on me. Recently I found out that a couple of my friends, who look fantastic, have been having Botox injections for a couple of years. My first thought was, “That’s so shallow!” That was followed not long after with, “Hey, if they are doing it, maybe I should / could / will think about it.” Notably, these are not shallow women. They work for highly competitive companies in highly competitive industries. They are caring, involved women. I had no idea that they had been having work done except that they don’t look tired. "Would I like the look? Would I still be able to express myself? How would my family and my children feel about it? Was it a slippery slope of vanity and inauthenticity?" My friends’ use allowed me to explore the idea more deeply. I pondered how this would effect me as much emotionally as physically. Would I like the look? Would I still be able to express myself? How would my family and my children feel about it? Was it a slippery slope of vanity and inauthenticity? I finally wrestled with the answers to these questions, which allowed me to choose my next step. I was unhappy with my current look. Judging by my besties, I was going to like the softening of my wrinkles and it would look natural, not artificial. I had not noticed an inability for them to express themselves. I would still be able laugh, smile, inflect, and wink; they certainly did. Legitimately, my family and children would ask the same questions that circled my brain. "As much as I thought a good pantsuit would help me out, I realized that Botox should no longer be considered frivolous or vain. How useful are heels? They serve me no purpose. They are painful and I would rather wear Keens... I am competing in a tech-heavy industry against women half my age. Remaining brilliant but aged, regardless of how okay I was with it, was not going to help me find employment." What finally pushed me over the edge was a need for a job. It is known that beautiful people get hired, earn more money, have more power, have better mentors, get promoted more often, and that even doe-eyed babies look at their faces longer (Bennett, Newsweek, Jul 19, 2010). I will be looking for employment soon armed with a second degree and an additional social media marketing certification. As much as I thought a good pantsuit would help me out, I realized that Botox should no longer be considered frivolous or vain. How useful are heels? They serve me no purpose. They are painful and I would rather wear Keens but they are not appropriate for a professional interview. My same acceptance of heels for work would play into my acceptance of help to create a refreshed and natural exterior. My reality is truly ugly. I am competing in a tech-heavy industry against women half my age. Remaining brilliant but aged, regardless of how okay I was with it, was not going to help me find employment. It was time that I sought treatment, not to become a supermodel, but to keep me viable in a biased, complex, and uncompromising work force.
 "It won’t work" FALSE. Studies show that it can produce results similar to ablative laser resurfacing at a lower cost, less pain, less side effects, and a 1-3 day recovery time. It can be used for wrinkles, thin skin, UV damage, hyperpigmentation, scarring, and loose skin. All forms of skin rejuvenation consist of microinjuries through chemicals, as in peels; heat, as in lasers; and now needles. All of these methods cause new beautiful skin to develop. "It is going to hurt" FALSE. This may be true at other locations but not at SkinWise Rx! Our medical experts will thoroughly cleanse your skin using microdermabrasion to remove dead skin cells and prepare the epidermis. Next, a layer of anesthetic cream is applied to numb the skin and make the therapy comfortable. After about 20 minutes the patient is ready for treatment. "This treatment is ideal if you have serious worries about aging, scarring or discoloration, as there really is a noticeable improvement." Dr. Lani Doser, DNP "I can’t. I am on Retin A"
FALSE. The skin needs to be free of Retin A products for only 12 hrs prior to treatment. Unlike peels you do not have to discontinue your tretinoin or adapalene products for two weeks. You stay off of active skin care products for 3 days after treatment. You can resume your regular skin care after 3 days. "I can’t have lasers, so I can’t microneedle" FALSE. Microneedling works with all skin colors from white to black. You will be quite red post-treatment like a severe sunburn. We will apply Epionce Medical Barrier Cream to help the skin heal. Your skin may have a slight sting when the anesthetic wears off and you can use cold compresses and take Acetaminophen/Tylenol for it. We apply sunscreen at the office. No sun exposure or active skin care products (acids or items that sting or burn) for the next 3 days. "I won’t have immediate results" FALSE... & TRUE. Usually by day three you start to see some skin changes but know this is a cumulative treatment. It is recommended to undergo at least four sessions, once every four weeks, for best visible results. Do not expect immediate results; smooth flawless skin is a slow and gradual evolution. Who should use microneedling? This treatment is ideal if you have serious worries about aging, scarring or discoloration, as there really is a noticeable improvement. We do not recommend microneedling if you have minor skin concerns that could be addressed through less invasive methods like using carefully selected skin care products.  What exactly is a stretch mark?A stretch mark is a type of scar that develops when our skin stretches or shrinks quickly. The abrupt change causes the collagen and elastin, which support our skin, to rupture. As the skin heals, stretch marks may appear. Not everyone develops these narrow bands on their skin. Fluctuating hormone levels seem to play a role. You may also have a higher risk if people in your family get stretch marks.Stretch marks fade with time; however, treatment may make them less noticeable more quickly.
"In-office procedures have proven more effective at reducing the visibility of stretch marks than creams, lotions, and gels." Dr. Doser, DNP 
If you develop stretch marks, you’re most likely to do so during these times:
Applying a corticosteroid to your skin for a long time can also cause stretch marks. If you have Cushing’s disease or Marfan syndrome, you may see stretch marks. When stretch marks first appear, they tend to be red, purple, pink, reddish-brown, or dark brown, depending on your skin color. Early stretch marks may feel slightly raised and can be itchy. In time, the color fades and the narrow bands sink beneath your skin. If you run your finger over a mature stretch mark, you often feel a slight depression.
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 ©SkinwiseRx pt | Bruises can |  ©Skinwise Rx Pt 1hr after treatment. |
Many nonsurgical clinics lack the expertise or equipment to treat bruises, but they can be treated. By using a combination of laser and a heating device, we at Skinwise Rx can decrease the length of time needed to heal from a bruise to about 3-4 days and usually coverable with make up within 1 or 2 days from treatment.
Bruises are a collection of blood from an injury of small blood vessels. Because the skin is unbroken the blood pools and forms small clots that cause discoloration in the skin above the injury. Larger injuries can cause larger pools of blood called contusions. They can be tender and painful and are still flat. A bruise with a lump is a called a hematoma and even more tender and painful.
Bruises come in many colors because of hemoglobin or iron that is in blood. It is usually red at the time of injury. Within 1-2 days it turns purple, blue, or almost black. In 5 to 10 days it turns yellow or green, lightening. Around 10 to 14 days it turns yellow-brown to light brown. It should fade away totally in 2 weeks.
DIY: At home you can use cold compresses and ice packs (15 min on 30 min off) to help contract blood vessels and slow bleeding. Elevate the area above the heart to avoid the amount of blood that pools, help decrease swelling, and the ultimate size of the bruise. In 2 days use a warm compress or heating pad to help the area heal quicker. If with a lot of tenderness, you can take ibuprofen or acetaminophen to reduce the pain. Some use vitamin K cream over the counter, Arnica Montana orally and topically and Bromelain as homeopathic methods. Definitely let your clinician know if you bruise from treatment so they can help you heal faster. You may only need DIY instructions or you may need to come to clinic for treatment.
So while bruises happen, know there are options for treatments. For the patient above, laser and heat treatment around the eye caused moderate swelling the next day. This decreased over the next 2 days. The discoloration was still present but coverable by day 2 with make up. She and I were glad she had options!
Bruises are a collection of blood from an injury of small blood vessels. Because the skin is unbroken the blood pools and forms small clots that cause discoloration in the skin above the injury. Larger injuries can cause larger pools of blood called contusions. They can be tender and painful and are still flat. A bruise with a lump is a called a hematoma and even more tender and painful.
Bruises come in many colors because of hemoglobin or iron that is in blood. It is usually red at the time of injury. Within 1-2 days it turns purple, blue, or almost black. In 5 to 10 days it turns yellow or green, lightening. Around 10 to 14 days it turns yellow-brown to light brown. It should fade away totally in 2 weeks.
DIY: At home you can use cold compresses and ice packs (15 min on 30 min off) to help contract blood vessels and slow bleeding. Elevate the area above the heart to avoid the amount of blood that pools, help decrease swelling, and the ultimate size of the bruise. In 2 days use a warm compress or heating pad to help the area heal quicker. If with a lot of tenderness, you can take ibuprofen or acetaminophen to reduce the pain. Some use vitamin K cream over the counter, Arnica Montana orally and topically and Bromelain as homeopathic methods. Definitely let your clinician know if you bruise from treatment so they can help you heal faster. You may only need DIY instructions or you may need to come to clinic for treatment.
So while bruises happen, know there are options for treatments. For the patient above, laser and heat treatment around the eye caused moderate swelling the next day. This decreased over the next 2 days. The discoloration was still present but coverable by day 2 with make up. She and I were glad she had options!
