MENOPAUSE TODAY: REVIEWING THE SYMPTOMS

A COMPLEX PHYSIOLOGICAL TRANSFORMATION
A Meditorial by: Roberta Kline, MD (OB/GYN)

Women go through many changes during the menopausal process that affect their physical, emotional, and spiritual health. It is often a time of awakening and increased awareness of the need for focusing on their goals and their own self-care. 

The increase in awareness of the role of hormones and options such as hormone replacement therapy has been a great door opener to better care that has benefitted many women. Indeed, estrogen is a ubiquitous hormone that influences almost every aspect of our biology, and many of the diseases we see that increase after menopause are linked to these hormonal changes. But not every woman is a good candidate for or benefits from hormone replacement therapy, nor do all women choose this path.  This then leads them to search for solutions that are aligned with their beliefs and health needs. With so much information (and dis-information) available, it quickly presents its own challenge as each woman tries to sift through what is right for her. In truth, each woman is unique, and how she navigates menopause and life beyond requires an individualized approach.

Cardiovascular disease (including high cholesterol, high blood pressure, and stroke), breast cancer, osteoporosis, osteoarthritis, dementia, diabetes, metabolic syndrome, hypothyroidism, urinary incontinence, sexual wellbeing, and weight gain are among the many health issues that increase after menopause. While the underpinnings for most chronic diseases often exist 10 – 20 years before they appear, menopause can accelerate the disease process.  (See complete feature)

STUDYING HAIR LOSS- AGING RESPONSE OR HEALTH METRIC?

Courtesy of Scalpscan.com / Dr. Robert L. Bard

According to aging societies, Menopause is defined as  "the cessation of a woman's menstrual periods where she can no longer get pregnant".  They go deeper to illustrate its many disruptive and physical discomforts.  But despite its similar effects, menopause is not a disease or disorder but a biological transitional phase in a woman's life.  It is a notable marker in a woman's timeline where their bodies are more prone to a range of disorders and diseases. Randomly, some women experience various symptoms, including hair loss, hot flashes, night sweats and trouble sleeping.  Others get joint and muscle discomfort, pain during sex, forgetfulness, difficultly concentrating, or a combination of these.  We review these physiological changes and explore touch points for addressing them, perhaps better predict them  and someday even find new solutions to redirect such symptoms to reduce the length of their disruptive effects.  In pursuit of understanding the symptoms that comprise Menopause, we shall start with the evident hair loss in women as they enter this phase of life- while offering an overview on this concerning disorder.

According to Dr. Robert Bard (diagnostic imaging specialist, NYC) hair loss is an indicator of one's health. Often significantly linked to a variety of health disorders, losing one's hair in any noticeable or dramatic way warrants possible medical care. Issues such as nutritional deficiencies (vitamin D, protein) and hormonal imbalances (ie. MENOPAUSE, pregnancy or thyroid problems) are common reasons for this. Sudden or dramatic loss of hair has also been associated with trauma, high anxiety or recurring stress. Strong medications including chemotherapy drugs are recognized to have tremendous effect on hair loss, as does chronic diseases such as diabetes.

In 2021, Dr. Bard trademarked SCALPSCAN, a personalized clinical diagnostic program designed to support a comprehensive detection of a patient's personal health- detecting the possible cause for hair loss. This is a sensible strategy to identifying the underlying reason (and there are many) for hair to fall out or disappear. This includes TESTING, MONITORING AND DIAGNOSTIC STRATEGIES that offer an ideal launch pad to a platform of true wellness and disease prevention. "Women's hair loss is aligned with many possible physiological issues and detecting the proper reasons is the key to mitigating those problems... including the hair loss itself.  AGING also comes with many personal changes in the body- and these too need to be addressed for the sake of wellness and longevity." (See: www.scalpscan.com)

Menopause affects all women differently.  A variety of  disruptive symptoms occur due to the body producing less estrogen and progesterone. Women's Health Collaborative member (Educational ambassador for traumatic injuries) Gina Adams expressed her concerns about hair loss and her current physiological changes that are now escalating as she enters this phase. "I see HAIR LOSS as a marker of a bigger problem and one that needs real attention", states Ms. Adams. "life changes like menopause can do additional damage to one's balance... it's good to have solutions like epigenetic testing and nutrigenomics to truly monitor what's going on!"

PART 1: UNDERSTANDING WOMEN'S HAIR LOSS 

Introduction: The Women's Health Collaborative is proud to meet our first Super Nova in women's health advocacy and public education. DIANE PINSON- Hair Transplant Surgery Surgical Tech, Trainer & Educator captured audiences from a powerful video about hair loss. In a matter of days, editors and producers from the WHC editorial team nominated Diane to lead the Clinical Aesthetics Committee and establish "The House of Hair"- an educational series around the  highly charged and complex topic of women's hair loss.

WHAT HAPPENS WHEN WOMEN LOSE HAIR...AND HOW TO FIX IT  Written by: Diane Pinson

Hair loss in women is more common than many realize, and it can be incredibly frustrating. Whether it’s thinning hair, a widening part, or even bald patches, the causes can vary. But don’t worry – understanding the science behind it and knowing what can be done to address it will help you navigate this issue with confidence.

What’s Happening With My Hair?
Genetics is one of the primary factors behind hair loss, particularly in women. While it’s more obvious in men, women also experience hair thinning due to androgenetic alopecia, which is linked to genetics and hormones. If your mother or grandmother had thinning hair, chances are you may be genetically predisposed too.

Hormones are another big player, especially during menopause. As women age, they experience hormonal shifts, like a drop in estrogen and progesterone, which can lead to hair thinning. During menopause, the levels of testosterone (a male hormone) rise relative to other hormones, causing hair follicles to shrink and produce thinner hair. This is one of the reasons why many women in their 40s and 50s notice hair loss.

Additionally, hair loss can also be triggered by stress, poor diet, and environmental factors. High stress levels or an imbalance in essential nutrients (like iron or vitamin D) can weaken hair follicles and lead to shedding. Even things like pollution, harsh weather, or chemicals in hair products can contribute to hair thinning.

How Genetics Play a Role in Hair Loss
For women, genetics can determine how sensitive your hair follicles are to certain hormones, like DHT (dihydrotestosterone), a byproduct of testosterone. Follicles that are genetically sensitive to DHT tend to shrink, making hair finer over time. This process is known as follicular miniaturization, and it’s why hair thins gradually, starting at the crown or part of the head.

Interestingly, women inherit these genetic factors mainly from their mother's side. This means that if your mother or grandmother experienced hair thinning, you may be more likely to experience it too.

How Hormones Affect Hair Loss in Women
Hormonal imbalances are significant contributors to hair loss in women, especially around times of change like pregnancy, postpartum, and menopause. For example, after pregnancy, many women experience postpartum hair loss due to a dip in estrogen levels. During menopause, declining estrogen and progesterone levels leave the body with more testosterone, which can shrink hair follicles and contribute to thinning hair.

To help counteract this, treatments like estrogen therapy or progesterone creams may help rebalance hormones, encouraging hair to grow thicker and healthier again. Additionally, topical treatments like finasteride and dutasteride (which block the hormone DHT) are sometimes used to help stop hair loss and promote hair regrowth, although they are more commonly prescribed to men, they can also work for some women.

The Role of Your Environment and Inflammation
In addition to hormones, environmental factors and inflammation can also play a significant role in hair thinning. Pollution, exposure to harsh chemicals, or even overuse of heat tools can weaken your hair. For example, constant exposure to air pollution can cause inflammation in the scalp, which weakens hair follicles and contributes to hair loss.

To address this, it's essential to take care of your scalp and reduce exposure to environmental toxins. This can include using gentle, natural hair products, wearing protective hairstyles, and avoiding excessive heat treatments. Additionally, anti-inflammatory supplements like omega-3 fatty acids or turmeric may help reduce inflammation and support healthier hair growth.

Good Shampoos for Hair Loss
Shampoos play a critical role in hair health. When choosing a shampoo, it's important to pick products that cleanse and treat the scalp without causing further damage to your hair follicles. Shampoos that de-clog pores and promote healthy circulation to the scalp can be particularly helpful.

Nioxin is one of the most well-known brands designed to support thinning hair. It’s formulated to remove buildup from the scalp and promote follicle health. Nioxin also helps improve the density of hair by nourishing the scalp and strengthening hair follicles.

Other good shampoos for hair loss include:

• Shampoos with biotin: Biotin is a B-vitamin that supports hair strength and helps prevent breakage.
• Caffeine-based shampoos: Caffeine can stimulate hair follicles and promote healthy hair growth.
• Gentle sulfate-free shampoos: Sulfates can strip natural oils from the scalp, making hair more fragile. Opting for sulfate-free shampoos can help retain moisture and reduce irritation.

Ingredients to Avoid in Shampoos
While choosing the right shampoo is important, there are also certain ingredients you should avoid. Many commercial shampoos contain chemicals that can irritate the scalp and contribute to hair thinning. Here’s a list of harmful ingredients to watch out for:

• Sulfates: Found in many shampoos, sulfates (like sodium lauryl sulfate) can strip your hair and scalp of essential oils, leaving it dry and prone to damage.
• Parabens: These preservatives, often used in hair products, can cause scalp irritation and affect hair health over time.
• Alcohol: While alcohol can make products feel light and non-greasy, it can dry out the hair, weakening it and leading to breakage.
• Formaldehyde: A known irritant, formaldehyde is often used in hair-straightening treatments and can cause scalp inflammation.

When shopping for a shampoo, always read the label carefully and try to choose products with natural and soothing ingredients.

Treatments That Can Help
Thankfully, there are plenty of treatments available to help with hair loss in women:

1. Minoxidil (Rogaine) – This over-the-counter topical treatment is proven to help regrow hair by stimulating the hair follicles. It can be effective for women with genetic hair loss and is one of the most common treatments available.
2. Platelet-Rich Plasma (PRP) Therapy – PRP therapy uses your own blood to stimulate hair growth. The blood is processed to concentrate the platelets, which are then injected into the scalp to help rejuvenate the hair follicles.
3. Hair Transplantation – If hair loss is significant, hair transplant surgery may be a good option. This involves taking healthy hair follicles from one area of the scalp and transplanting them into thinning or bald spots.
4. Hormonal Treatments – For women with hormonal hair loss, balancing hormones with estrogen, progesterone, or anti-androgens like spironolactone can help restore balance and prevent hair thinning.
5. Nutrition and Lifestyle Changes – A healthy diet full of vitamins like biotin, iron, zinc, and vitamin D is crucial for maintaining healthy hair. Also, managing stress and avoiding inflammatory foods can go a long way in supporting hair health.

Why Hair Analysis Matters
Another key step in addressing hair loss is understanding what’s happening underneath the surface. ScalpScan, developed by Dr. Robert Bard, is an advanced diagnostic tool that uses high-resolution imaging to analyze your scalp condition. This technology allows doctors to detect issues such as inflammation, scalp infections, or miniaturized hair follicles, which can be contributing to hair thinning. By understanding these underlying factors, doctors can create a more personalized and effective treatment plan for you.

Conclusion: What You Can Do?
Hair loss in women can be frustrating and confusing, but it’s important to know that you’re not alone, and there are treatments that can help. From genetic factors and hormonal imbalances to environmental factors and stress, many things can affect your hair. By addressing these issues with the right treatments—whether it’s medications, lifestyle changes, or advanced hair restoration techniques—you can improve the health of your hair and regain your confidence.

Remember, there’s no one-size-fits-all answer, but with the right approach, you can take steps toward regrowing and maintaining a healthy head of hair.

ABOUT THE AUTHOR

With over 13 years of experience in the hair transplant industry, DIANE PINSON founded  Certified Hair Technicians, a leading industry resource for training and staffing of hair transplant surgeries. Her expertise and extensive knowledge in the industry helped expand her program to include a wide variety of methods including FUE, Strip, PRP, Body Hair, Eyebrows, and Beards. Diane is also an HTS Medical Technician with a background in cosmetology, health care administration, and surgical assistance.  With a long track record of successful procedures and established programs, Diane continues to fulfill a mission to ensure patient and client satisfaction by delivering high-quality, efficient, and competitive services. She trained and staffed hundreds of physicians and technicians across the US and abroad, using the latest devices and techniques in the field. She also offers  private consultation, follow-up, marketing support for her clients, as well as up-to-date medical forms and product recommendations. Diane is highly passionate about sharing her expertise and helping others achieve their goals in the hair transplant industry.

---

SCIENCE NEWS

Understanding Thyroid Health: Key Insights on Hormones, Longevity, and Wellness

Thyroid health plays a critical role in nearly every physiological process of the body, influencing metabolism, brain function, heart health, and more. Yet, despite its significance, the nuances of thyroid function remain elusive for many. As we age, maintaining optimal thyroid function is an essential component of overall well-being, and understanding the balance of thyroid hormones can help prevent future health challenges.  See Dr. Angela Mazza's full report on Thyroid Health @ this season's MenoNews.

Inflammation, DHT, and the Biochemical Cascade of Hair Loss: A Scientific Overview: by Dr. Jordan Plews

Hair loss is a multifactorial condition influenced by genetic, hormonal, and inflammatory factors. Understanding the roles of DHT and inflammation provides insight into the pathogenesis of AGA and informs effective prevention and treatment strategies. Early intervention is crucial, as inflammation and follicular damage can progress unnoticed until significant hair loss has occurred, while genetic factors (such as expression of MMP genes) in some can lead to fibrosis and result in more difficult to treat hair loss. By focusing on inflammation as an early warning sign, treatment target, and significant factor to consider when diagnosing, tracking, and treating hair loss, existing methodologies can be greatly improved. Ongoing research continues to elucidate the complex mechanisms underlying hair loss, paving the way for more targeted and effective therapies. See Dr. Jordan Plews comprehensive overview on MENONEWS and the recent issue on the HOUSE OF HAIR

UNDERSTANDING WOMEN’S HAIR LOSS ("AGAIN WITH HORMONES")

Introduction: The Women's Health Collaborative is proud to meet our first Super Nova in women's health advocacy and public education. DIANE PINSON- Hair Transplant Surgery Surgical Tech, Trainer & Educator captured audiences from a powerful video about hair loss. In a matter of days, editors and producers from the WHC editorial team nominated Diane to lead the Clinical Aesthetics Committee and establish "The House of Hair"- an educational series around the  highly charged and complex topic of women's hair loss.

WHAT HAPPENS WHEN WOMEN LOSE HAIR...AND HOW TO FIX IT  Written by: Diane Pinson

Hair loss in women is more common than many realize, and it can be incredibly frustrating. Whether it’s thinning hair, a widening part, or even bald patches, the causes can vary. But don’t worry – understanding the science behind it and knowing what can be done to address it will help you navigate this issue with confidence.

What’s Happening With My Hair?
Genetics is one of the primary factors behind hair loss, particularly in women. While it’s more obvious in men, women also experience hair thinning due to androgenetic alopecia, which is linked to genetics and hormones. If your mother or grandmother had thinning hair, chances are you may be genetically predisposed too.

Hormones are another big player, especially during menopause. As women age, they experience hormonal shifts, like a drop in estrogen and progesterone, which can lead to hair thinning. During menopause, the levels of testosterone (a male hormone) rise relative to other hormones, causing hair follicles to shrink and produce thinner hair. This is one of the reasons why many women in their 40s and 50s notice hair loss.

Additionally, hair loss can also be triggered by stress, poor diet, and environmental factors. High stress levels or an imbalance in essential nutrients (like iron or vitamin D) can weaken hair follicles and lead to shedding. Even things like pollution, harsh weather, or chemicals in hair products can contribute to hair thinning.

How Genetics Play a Role in Hair Loss
For women, genetics can determine how sensitive your hair follicles are to certain hormones, like DHT (dihydrotestosterone), a byproduct of testosterone. Follicles that are genetically sensitive to DHT tend to shrink, making hair finer over time. This process is known as follicular miniaturization, and it’s why hair thins gradually, starting at the crown or part of the head.

Interestingly, women inherit these genetic factors mainly from their mother's side. This means that if your mother or grandmother experienced hair thinning, you may be more likely to experience it too.

How Hormones Affect Hair Loss in Women
Hormonal imbalances are significant contributors to hair loss in women, especially around times of change like pregnancy, postpartum, and menopause. For example, after pregnancy, many women experience postpartum hair loss due to a dip in estrogen levels. During menopause, declining estrogen and progesterone levels leave the body with more testosterone, which can shrink hair follicles and contribute to thinning hair.

To help counteract this, treatments like estrogen therapy or progesterone creams may help rebalance hormones, encouraging hair to grow thicker and healthier again. Additionally, topical treatments like finasteride and dutasteride (which block the hormone DHT) are sometimes used to help stop hair loss and promote hair regrowth, although they are more commonly prescribed to men, they can also work for some women.

The Role of Your Environment and Inflammation
In addition to hormones, environmental factors and inflammation can also play a significant role in hair thinning. Pollution, exposure to harsh chemicals, or even overuse of heat tools can weaken your hair. For example, constant exposure to air pollution can cause inflammation in the scalp, which weakens hair follicles and contributes to hair loss.

To address this, it's essential to take care of your scalp and reduce exposure to environmental toxins. This can include using gentle, natural hair products, wearing protective hairstyles, and avoiding excessive heat treatments. Additionally, anti-inflammatory supplements like omega-3 fatty acids or turmeric may help reduce inflammation and support healthier hair growth.

Good Shampoos for Hair Loss
Shampoos play a critical role in hair health. When choosing a shampoo, it's important to pick products that cleanse and treat the scalp without causing further damage to your hair follicles. Shampoos that de-clog pores and promote healthy circulation to the scalp can be particularly helpful.

Nioxin is one of the most well-known brands designed to support thinning hair. It’s formulated to remove buildup from the scalp and promote follicle health. Nioxin also helps improve the density of hair by nourishing the scalp and strengthening hair follicles.

Other good shampoos for hair loss include:

• Shampoos with biotin: Biotin is a B-vitamin that supports hair strength and helps prevent breakage.
• Caffeine-based shampoos: Caffeine can stimulate hair follicles and promote healthy hair growth.
• Gentle sulfate-free shampoos: Sulfates can strip natural oils from the scalp, making hair more fragile. Opting for sulfate-free shampoos can help retain moisture and reduce irritation.

Ingredients to Avoid in Shampoos
While choosing the right shampoo is important, there are also certain ingredients you should avoid. Many commercial shampoos contain chemicals that can irritate the scalp and contribute to hair thinning. Here’s a list of harmful ingredients to watch out for:

• Sulfates: Found in many shampoos, sulfates (like sodium lauryl sulfate) can strip your hair and scalp of essential oils, leaving it dry and prone to damage.
• Parabens: These preservatives, often used in hair products, can cause scalp irritation and affect hair health over time.
• Alcohol: While alcohol can make products feel light and non-greasy, it can dry out the hair, weakening it and leading to breakage.
• Formaldehyde: A known irritant, formaldehyde is often used in hair-straightening treatments and can cause scalp inflammation.

When shopping for a shampoo, always read the label carefully and try to choose products with natural and soothing ingredients.

Treatments That Can Help
Thankfully, there are plenty of treatments available to help with hair loss in women:

1. Minoxidil (Rogaine) – This over-the-counter topical treatment is proven to help regrow hair by stimulating the hair follicles. It can be effective for women with genetic hair loss and is one of the most common treatments available.
2. Platelet-Rich Plasma (PRP) Therapy – PRP therapy uses your own blood to stimulate hair growth. The blood is processed to concentrate the platelets, which are then injected into the scalp to help rejuvenate the hair follicles.
3. Hair Transplantation – If hair loss is significant, hair transplant surgery may be a good option. This involves taking healthy hair follicles from one area of the scalp and transplanting them into thinning or bald spots.
4. Hormonal Treatments – For women with hormonal hair loss, balancing hormones with estrogen, progesterone, or anti-androgens like spironolactone can help restore balance and prevent hair thinning.
5. Nutrition and Lifestyle Changes – A healthy diet full of vitamins like biotin, iron, zinc, and vitamin D is crucial for maintaining healthy hair. Also, managing stress and avoiding inflammatory foods can go a long way in supporting hair health.

Why Hair Analysis Matters
Another key step in addressing hair loss is understanding what’s happening underneath the surface. ScalpScan, developed by Dr. Robert Bard, is an advanced diagnostic tool that uses high-resolution imaging to analyze your scalp condition. This technology allows doctors to detect issues such as inflammation, scalp infections, or miniaturized hair follicles, which can be contributing to hair thinning. By understanding these underlying factors, doctors can create a more personalized and effective treatment plan for you.

Conclusion: What You Can Do?
Hair loss in women can be frustrating and confusing, but it’s important to know that you’re not alone, and there are treatments that can help. From genetic factors and hormonal imbalances to environmental factors and stress, many things can affect your hair. By addressing these issues with the right treatments—whether it’s medications, lifestyle changes, or advanced hair restoration techniques—you can improve the health of your hair and regain your confidence.

Remember, there’s no one-size-fits-all answer, but with the right approach, you can take steps toward regrowing and maintaining a healthy head of hair.

ABOUT THE AUTHOR

With over 13 years of experience in the hair transplant industry, DIANE PINSON founded  Certified Hair Technicians, a leading industry resource for training and staffing of hair transplant surgeries. Her expertise and extensive knowledge in the industry helped expand her program to include a wide variety of methods including FUE, Strip, PRP, Body Hair, Eyebrows, and Beards. Diane is also an HTS Medical Technician with a background in cosmetology, health care administration, and surgical assistance.  With a long track record of successful procedures and established programs, Diane continues to fulfill a mission to ensure patient and client satisfaction by delivering high-quality, efficient, and competitive services. She trained and staffed hundreds of physicians and technicians across the US and abroad, using the latest devices and techniques in the field. She also offers  private consultation, follow-up, marketing support for her clients, as well as up-to-date medical forms and product recommendations. Diane is highly passionate about sharing her expertise and helping others achieve their goals in the hair transplant industry.

---

SCIENCE NEWS

Understanding Thyroid Health: Key Insights on Hormones, Longevity, and Wellness

Thyroid health plays a critical role in nearly every physiological process of the body, influencing metabolism, brain function, heart health, and more. Yet, despite its significance, the nuances of thyroid function remain elusive for many. As we age, maintaining optimal thyroid function is an essential component of overall well-being, and understanding the balance of thyroid hormones can help prevent future health challenges.  See Dr. Angela Mazza's full report on Thyroid Health @ this season's MenoNews.

Inflammation, DHT, and the Biochemical Cascade of Hair Loss: A Scientific Overview: by Dr. Jordan Plews

Hair loss is a multifactorial condition influenced by genetic, hormonal, and inflammatory factors. Understanding the roles of DHT and inflammation provides insight into the pathogenesis of AGA and informs effective prevention and treatment strategies. Early intervention is crucial, as inflammation and follicular damage can progress unnoticed until significant hair loss has occurred, while genetic factors (such as expression of MMP genes) in some can lead to fibrosis and result in more difficult to treat hair loss. By focusing on inflammation as an early warning sign, treatment target, and significant factor to consider when diagnosing, tracking, and treating hair loss, existing methodologies can be greatly improved. Ongoing research continues to elucidate the complex mechanisms underlying hair loss, paving the way for more targeted and effective therapies. See Dr. Jordan Plews comprehensive overview on MENONEWS and the recent issue on the HOUSE OF HAIR

EVENT NEWS: THE 26TH ANNUAL DERMATOLOGY SYMPOSIUM IN NYC

Nov 30 – Dec. 3, 2023: The 26th Annual Mount Sinai Winter Symposium took place at The New York Academy of Medicine (NYC). This nationally recognized, live CME event was attended by over 550 participants. It offered a comprehensive program addressing Medical and Surgical Dermatology, which was delivered by 40 sought-after faculty speakers and world-renowned leaders in the treatment of various skin diseases and conditions. Topics included the most current research on the diagnosis and treatment of medical dermatological conditions, such as psoriasis, eczema, alopecia, hidradenitis supportive, actinic keratosis, rosacea, and skin cancer. In addition, cosmetic procedures were performed in front of the audience allowing them to witness the latest techniques in skin rejuvenation.

Dr. Robert Bard, seasoned diagnostic specialist in NYC and a long-time presenter of the Icahn School of Medicine was personally invited to exhibit at the Mt Sinai Winter Symposium series. The 25th Annual event showcasing Advances in Medical and Surgical Dermatology has been a must-attend event to the medical community nationwide where health professionals and medical students traditionally fill the halls of the NY Academy of Medicine each year. In addition, major vendors from some of the largest pharmaceutical brands and other dermatological health solutionists grace the 15,000 sq. ft grand ballroom. This year, Dr. Bard elected a unique and impressive way of presenting to the institution by introducing his recent collaborative ally, Mr. Charles Vorwaller- CEO of Aspen Laser to present about Photobiomodulation therapy as part of Dr. Bard's reserved space. "We have been performance testing Charles' Aspen Laser Apex Model for the better part of 6 months and found the technology to align with the many skin issues (like inflammatory skin disorders) that I found this event to be the ideal opportunity for me to endorse Aspen laser into the dermatological community."

POWER-PACKED CURRICULUM
As educational conferences in medicine goes, this event did not disappoint when it comes to a comprehensive educational resource for Advances in Medical and Surgical Dermatology. "As a recently licensed dermatologist, I was amazed at the variety of CME and NON-CME workshops and presentations", says Abdel Zerzei. "I attended all three days and enjoyed presentations such as: Treatment of Psoriatic Arthritis (Dr. Alice Gottlieb), Tips for Development of a Successful Practice (Dr. Leon H. Kircik) and 'What’s new in Rosacea and Seborrheic Dermatitis' (Dr. Benjamin Ungar)- among others. It was the best educational experience I've had in a very long time!" Surprisingly, Aspen was the only laser company of its class at the event. "I was glad to bring Charles Vorwaller into the society of dermatologists-- he was the perfect educator about near-infrared and so many of the attendees were inspired by his science", continued Dr. Bard.

Among the many honored medical experts and legendary speakers that visited the Aspen Laser booth was Dr. Mark Lebwohl (Image L), top researcher of Itch and Inflammatory Skin Conditions from the Mark Lebwohl Center for Neuroinflammation and Sensation at Mt. Sinai. Dr. Lebwohl is a long-time colleague of Dr. Bard's (R) and recently wrote the foreword to his latest epic textbook project by Springer 'Image Guided Aesthetic Procedures'. "Many of the breakthroughs announced at the symposium were based on work done at Mount Sinai. This annual symposium has been showcasing new developments in dermatology for decades. It is a great source of pride that many of the new treatments are based on our laboratory and clinical research" - stated Dr. Lebwohl.

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DERM-NEWS : TOXINS IN THE SKIN

According to the CDC, DERMAL ABSORPTION happens when a chemical goes through the skin and travels into the body. Many chemicals used in the workplace or even from home (ie. pesticides and organic solvents) can wreak havoc on and under the skin, damage internal organs and also the immune system if they penetrate the skin and enter the bloodstream. Most efforts to address chemical hazards have been focused on breathing, digesting or drinking chemicals rather than what's being absorbed through skin. Because of this, there are far fewer methods and campaigns dedicated to assessing skin exposures to toxins - UNTIL NOW.

With the latest evidence of inflammatory skin disease and foreign bodies under the skin, the medical and aesthetics communities are now facing the many new ways that environmental (toxic) influencers can affect the body through skin contact and absorption. This initiative is achieved thanks to our non-invasive diagnostic imaging advancements including Confocal Microscopy and the 3D Doppler Ultrasound. Dr. Robert Bard, presents this critical health topic as part of his Educational Series on INTRADERMAL IMAGING OF TOXINS in dermatology conferences such as the NIDISKIN Spring Symposium.

(C) 2023 Dr. Robert L. Bard- Inflammatory Skin Disease/NIDI-Weill Cornell event

ELASTOGRAPHY AND QUANTITATIVE IMAGING: CONFIRMING THERAPEUTIC RESPONSE By: Dr. Robert L. Bard 

One  of  the most  comprehensive ways  to  confirm  the  results  of any  treatment  is  by  clinically tracking  the  body's  physiological  response  from  underneath  the  skin.    Diagnostic  imaging captures  measurable  data  about  the  injured  or  inflamed  area,  allowing  both  clinicians  and patients  the  ability  to  identify  therapeutic  progress  in  real  time.    Widely  preferred  scanning  modalities include the Doppler Blood Flow Ultrasound (or sonography) and Elastography, both using high‐frequency sound waves to view inside the body. Like an internal video camera, these high speed scanning innovations capture actual movement of the body's internal organs.  This offers a vast amount of biometric information about the patient’s condition, in comparison to still images of conventional x‐rays. The ultrasound's ability to evaluate abnormalities within the soft tissue in research and clinical trials are widely used in recording evidence‐based biomarkers to trace therapeutic efficacy. 

ELASTOGRAPHY & DOPPLER ULTRASOUND
Elastography  and  Doppler  Ultrasound  are  both  physiologic technologies  which  show  whether  the  cancer  treatment  is working or not.  They provide effective therapeutic markers over a blood test.  

Elastography  measures  hardness  of  tissue  and  tissue  healing through  elasticity.    Hard  scar  formation  or  fatty  changes  is measured  on  the  scale  at  the  top  right.  FAT,  which  is  soft, appears as blue (at 120) whereas the 480 level the scar tissue is harder. We know that scar tissue impedes muscle contractility greater than fatty changes, thus treatment can be appropriately applied to the type of tissue that needs regeneration. 

SCANNING INFLAMMATORY SKIN DISORDERS AND TUMORS WITH ELASTOGRAPHY
Elastic ultrasound technology is an advancement where we can  get real‐time images, this scan shows the tumor from beginning to end as we scan  through it. Notice  that  the blue area is  the softer tissue and the hard tissue (with more aggressive) cancer is  the  red.  In  this  screen, we are able  to have a comparative study of the regular ultrasound (below) and the elastogram on top.   After the use of real‐time elastogram, we can freeze frame a significant image showing the red area of active tumor on the bottom.  Fluid does not have elasticity, it does is not hard and it appears as black. Therefore the two top areas which we saw had low blood flow or no blood flow in the previous  image  have  zero  elastic  qualities‐  meaning  these  areas  that  are  dead  and  inactive.  This  also  means  that elastography is a usable treatment marker to show treatment effect. In other words, when you go from red to black, it means that the black area is a degenerated or dead inactive part of the cancer.  

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CASE STUDY #7: PSORIASIS  / FOOT & ELBOW

FOOT:  laser compare 3-11-23.  Hx: Right foot pain  Sonofluoroscopy of the plantar and hallux tissues was performed in multiple scan planes with 18 and 20 MHz transducer frequencies.  Power and spectral Doppler was performed. Mild tendinitis unchanged.

3D DOPPLER: Normal posterior tibial and pedal arterial Doppler flows. No regional hyperemia. Triphasic waveforms. Peak vel 11cm/s. Hyperemia decreased to the dip joint. 3D shows abnormal dermis decreased from 2.1mm to 15mm.

ELASTOGRAM: Decreased edema psoriatic plaque (light blue) with early fibrosis of talar ligament (yellow). 

PATIENT NARRATIVE“I have been suffering from PSORIASIS since I was 25. Periodically my psoriasis gets inflamed and gets very scaly and very itchy. (When I scratch, which is often it gets worse). I received my first treatment with the (Aspen) Laser back in March, 2023 and I received various treatments afterward. I continue to have this laser treatment on my right foot, which is the worst and on my right elbow.  Lately, the scaling seems much flatter.  I don't know whether it's the laser or some of the other home treatments I'm doing for myself… but it seems to be quite a bit improved”.

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2024 MagLaunch: HEALTHTECH REPORTER For this SKIN HEALTH issue, we caught up with Aspen Laser (photobiomodulation) who exhibited at the 2023 Mt Sinai Symposium. CEO Charles Vorwaller showcased the many advantages of near-infrared laser in cell regeneration and addressing inflammatory skin disorders.  Low-level laser therapy (LLLT) or photobiomodulation (PBM) is a form of medicine that applies low-power lasers or light-emitting diodes (LEDs) to the surface of the body. It is claimed that application of low-power lasers relieves pain or stimulates and enhances cell function. It addresses the underlying cause of all dysfunction in the body (inflammation & disease) and that is cellular health and wellness. Red light is known for its ability to penetrate deeper into the skin- and can be absorbed by cells deep in the body. Today's technology offers Red Light therapy in a variety of devices with different capacities, including the red light bed panels and targeted deep tissue laser therapy systems.   Aspen Laser is recently featured in HealthTechReporter.com.

 

Another recent SKIN feature on HealthTech Reporter is the COMPREHENSIVE PERFORMANCE REPORT OF A TOPICAL SKIN CONDITIONING PRODUCT- Review this anecdotal test drive of the Canon Aplio e550 under a pilot study of an exosome‐based topical product called ELEVAI. Global interest in the advancement of Exosomes continues to raise significant interest in the research community to explore and confirm findings about this technology as has been raised since the advent of stem cell research (early 1980’s). Dr. Robert Bard initiated this “test drive” employing an IMAGE-GUIDED approach to monitor, track and report his findings through the use of advanced ultrasound scanning modalities.

2023 BOOK LAUNCH: "IMAGE GUIDED AESTHETIC PROCEDURES & TREATMENTS"

A MAJOR CAST OF CLINICAL AESTHETICS LEADERS IN ONE COLLABORATIVE TEXT!

Meet BETH HANEY, DNP- one of the recognized industry achievers assembled in this aesthetics collaborative and an honored literary contributor of the recently published IMAGE GUIDED AESTHETICS PROCEDURES textbook by Springer Medical Publishing.  Dr. Haney authored a comprehensive study on (Ch4) "FACIAL REJUVENATION AND NON-SURGICAL PROCEDURES" and also co-wrote a remarkable analysis (Ch6) called "FACIAL DANGER ZONES IN AESETHETICS" with Dr. Michelle Zappas.    Dr. Haney is currently faculty at USC teaching health policy, a former Assistant Clinical Professor at UCI, is a member of the American Association for Nurse Practitioners Health Policy Committee, the Southern California AANP state liaison, and served as Chair of the 2022 and 2023 AANP Health Policy Conference. She founded the Luxe Aesthetic Center in Yorba Linda, CA- a high-profile medspa offering professional aesthetic products and treatments catering to private individuals & celebrity clients. Dr. Haney is currently Mayor Pro-Tem and former Mayor (2020) of Yorba Linda, doctor of nursing practice & a nationally certified family nurse practitioner specializing in cosmetic dermatology treatments, business and leadership, & policy.

IMAGE GUIDED AESETHETIC PROCEDURES: TEXTBOOK LAUNCH

10/21/2023 - After two years in the making, we congratulate Dr. Robert Bard and his alliance of clinical experts for the launch of "IMAGE GUIDED AESTHETIC PROCEDURES & TREATMENTS".  Springer Medical Publishing proudly presents the first installment in clinical aesthetic procedures. This detailed and up-to-date overview of image-guided procedures focuses on the many aesthetic and reconstructive strategies delivered by some of today's renowned leaders in the clinical aesthetics community. They share their valuable expertise and field-based findings throughout this feature-rich textbook. The wide list of audiences for this text (ie. dermatologists, plastic surgeons, aestheticians, general surgeons) will enjoy an insider's look at each treatment program while providing remarkable field-based knowledge for the general non-medical audience seeking the latest information in non-invasive and minimally invasive aesthetic procedures. 

Produced and edited by Dr. Robert L. Bard, (NYC based cancer diagnostic imaging specialist) this collective project showcases the most highly sought-after cosmetic treatments in each priceless chapter- through detailed breakdowns, experiential insights and a generous graphic tour of before and after progress visuals.  Thanks to the additional safety benefits of clinical imaging, our treatment professionals express added confidence in the pre-operative and post-op areas. In addition, many aesthetics procedures noted also brings significant advantages (of accuracy and efficiency) to the actual treatment process from real-time image guidance. 

AUTHOR LIST (alphabetical)
• Arun K. Garg, DMD • Beth Haney, DNP • Cameron Christiansen, BS • Cameron Rokhsar, MD • Cari Green, MD • Elie M. Ferneini, MD • Gabriel Borden • January Howard	• John Catanzaro, MD • Lennard Gettz, EdD • Lio Yu, MD • Lucian Fodor MD • Mairead Moloney • Marc J.Saltzman, MD • Mary Nielsen • Michelle Zappas, DNP	• Noelle Cutter, PhD • Paul Dreschnack, MD • Peter A. Everts PhD • Randall L. Weisel DDS • Richard Kushner, DPM • Robert L. Bard, MD • Samuila Sergiu, MD • Stephen Chagares, MD

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Excerpt from CHAPTER 1: INDUSTRY REVIEW OF THE AESTHETIC INDUSTRY  By: January Howard & Lennard M. Gettz, Ed.D 

Abstract
The history of cosmetics is reviewed with technologies unfolding less invasive options and more functional solutions involving nutraceutical supplementation with natural resources. Minimally invasive options are documented as is the adaptation of therapy to the Covid-19 pandemic. This chapter dives into the positive and negative implications of aesthetic procedures and how minimally invasive tactics could help advance all procedures focusing on the sake of performance, safety, and longevity 

Introduction
Conducting an industry review on the current state of the aesthetic industry would be incomplete without shedding a spotlight on social outlook and how it drives consumer activity trends. All aesthetic procedures are promoted to enhance one's overall look and public appeal and are often theorized to elevate one’s self-appreciation. The public desire to achieve this is what supports this multi-million dollar industry to self-generate constant energy to acquire new market support each year. Fig 1. 

Figure 1: Facial injections may avoid nerve and vascular structures under ultrasound image guidance. 

Historically, the study of human nature has shown consistent evidence of aesthetic personalization throughout every social class as part of natural human desire and need for visually expressing personal pride and individualism. To date, there is an ever-growing list of solutions to enhance and improve a person's image, from PRP injections, microneedling,

chemical peels, Botox, and fillers. These procedures have widely grown in popularity throughout the global community because of their affordable cost to the client/patient, their easy access and their immediate performance and effectiveness. 

The future of minimally invasive modalities has projected a major market growth without any signs of slow-down. Introducing aesthetic procedures to just about ANY practitioner, let it be a dentist, an OB/GYN, a plastic surgeon or a urologist offers a natural add-on, exponentially widening the access of these treatments to the community at large. Where dentists and plastic surgeons clearly have their specialized work intact, aesthetic procedures offer a supplemental income and a lucrative addition to their existing service set. For the practitioner, these procedures are a sensible upgrade by adding fairly recognizable protocols and equipment from prior training. 

Practitioners find the integration and learning curve of adapting aesthetic modalities into their existing practice to be quite comfortable and cost-effective. For example, one can be trained to produce their own dermal filler or bio filler by extracting PRP (which is the client's own biologic) by "cooking" the platelet poor plasma. This is instead of purchasing bio filler from any of the existing manufacturers, offering a savings of anywhere from $300 to $800 per box. 

As the industry concepts of beautification evolved and expanded toward clinical procedures, a sensible upgrade is the implementation of IMAGE GUIDANCE- a valuable tool forged by medical diagnostics. For over 30 years, ultrasound imaging has offered great value in clinical applications and is now adding great directive support to injection situations whereby knowing where the veins and bones truly are could be very helpful as a matter of safety. Whether someone is new to conducting injectable treatments or is a seasoned professional, having the reassurance of visual confirmation lowers the likelihood of hitting a vein or creating an occlusion. Reducing or eliminating risk to the client from pain or the stress of a “land mine” event is a major selling point for imaging devices in pre and post procedures. 

The Modern Age of Clinical Aesthetics
Throughout the 20th century, economic and medical industry reports have traced major activity in cosmetic procedures as part of a global consumer trend of personal enhancement investments. Where elective surgical procedures like breast augmentation, liposuction and rhinoplasty once dominated the aesthetic media, the early 1980's brought forth a new wave of Minimally Invasive procedures which forged an entire industry of cosmetic self-rejuvenation. In 1981, bovine collagen was the first agent approved by the FDA for cosmetic injection. It was developed to induce a youthful appearance (as well as address facial deformities) to target smile lines and improve the presence of facial acne scars. The first regulatory approval gave way for dozens of injectable cosmetic filling agents as well as technologies in pursuit of "anti-aging" or facial enhancement. This minimally invasive treatment trend includes chemical peel, dermal fillers, laser skin resurfacing, hair removal techniques, microdermabrasion and others. [1][2] Fig2.

Figure 2: Optical and thermal energy devices build collagen and firm tissue characteristics 

We can track the history of cosmetic enhancement and aesthetic rejuvenation through the timeline of cosmetic body art as the earliest tribal rituals, to the old testament (840 BC) from the book of Esther to ancient Egypt (1,320 BC)[3]. Since ancient times, the concept of cosmetics, and facial enhancement have been part of personal essence- especially for the elite. Often they were used in religious ceremonies - as seen in ancient Egypt - or as cultural identification. [4] Cosmetic products such as creams, lotions, and talcum powders became more globally accessible to the human zeitgeist, supporting pursuits of cultural acceptance, personal enhancement and beauty. Tracking the aesthetic market in the west, skin care products including skin lotions, powders, creams, bleaches, ointments, and cleansers have historically accounted for a large percentage of the American cosmetics and hygiene industry. The claims and perceived notion of smoother, whiter skin is aligned with better health and beauty has become the impression of beauty since the 1800s. Concealing and removing imperfections like freckles, rashes and pimples are also part of the aesthetic objectives. [5] 

References 

1) Breaking down the most popular noninvasive cosmetic treatments, American Society of Plastic Surgeons , Rod Rohrich, MD, FACS | Dallas, TX Friday, June 16, 2017 - https://www.plasticsurgery.org/news/blog/breaking-down-the-most-popular noninvasive-cosmetic-treatments  2) The history of injectable facial fillers, Theda C Kontis 1, Alexander Rivkin. National Library of Medicine. https://pubmed.ncbi.nlm.nih.gov/19415573/  3) History of cosmetics: https://en.wikipedia.org/wiki/History_of_cosmetics 4) Library of Congress, History of the Beauty Business: https://guides.loc.gov/business-of-beauty/history 5) Cosmetics and Personal Care Products in the Medicine and Science Collections https://americanhistory.si.edu/collections/object-groups/health-hygiene-and-beauty/skin-care 

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