Episode #31: Skin 360

In this episode, we’re introducing the Skin 360 treatment series: a six-month program designed to support overall skin quality through a rotating monthly plan using ADVATx, LaseMD, and Exceed microneedling.

Rather than relying on one approach, Skin 360 alternates between these technologies month by month, allowing us to target different aspects of skin appearance, including tone, texture, redness, pores, fine lines, and overall radiance.

We’ll talk through how each treatment works, why spacing and sequencing matter, what patients can expect during the six-month (every 4 weeks) or nine-month (every 6 week) journey, and who may be a good candidate.

As always, treatment plans should be individualized after a consultation, because skin type, goals, medical history, and downtime tolerance all matter.

Thank you for your listenership!

Transcript

Dr. Minni Saluja 0:12

Hi, everyone. Thank you for joining us for another episode of Just Laser It and All Things Cosmetic. I'm here with Kane, as always. Indeed. How are you doing?

Kane Rogers 0:21

I'm great, thank you very much. It's hot, but otherwise I'm good

Dr. Minni Saluja 0:24

to 100 today. That's incredible. Okay. Today, Kane, let's just start right off and talk about something that we're offering in the practice.

Kane Rogers 0:33

Okay, and what is that?

Dr. Minni Saluja 0:35

Okay. And what is that? It is something called Skin360. Oh, I love Skin360.

Kane Rogers 0:38

Skin360.

Dr. Minni Saluja 0:39

It... Why, why do you

Kane Rogers 0:40

I wanna know it's a great program.

Dr. Minni Saluja 0:42

It's a great program. In what way?

Kane Rogers 0:43

Well, you're putting me on the spot, but if I were to describe it in one word is flexibility

Dr. Minni Saluja 0:48

Okay. Okay. So let's go into what Skin360 is. And, you know, I'm gonna start by saying that oftentimes patients will come in for live consults, and they'll sit down and they'll say, "Dr. Saluja, I want my skin to look better." And I kind of sit back and I... We have a mirror that we look at together, and I ask them, "What's bothering you? What would you like to see?" And, and I want them to hone in on things. And oftentimes they'll say, "Well, it's the pigmentation. It's the red ruddiness to my skin. It's the fine lines and wrinkles. It's the pores." So they, they cover over multiple components of the skin they, that they want to see improved. Right. And so the answer is, "Well, how do we do this?" And I sure wish it was one laser that did it all, but as you know, it's not. And the reason is there's different biological targets or different chromophores that our lasers have to target in order to get, to our goal. And so, for example,, if someone has, broken capillaries, then what we need to do is we need to use a laser that targets oxyhemoglobin, so that the, it's absorbed by the hemoglobin in order to clear that away. If someone has pigment, we have to target the melanin in the skin. There's a reason why we start to age in these ways, and you can think about one of the primary reasons, Kane, is UV damage. And what UV damage does when we're outside in the sun day after day, week after week, our cells, you know, we've got melanocytes, we've got keratinocytes, and we've got fibroblasts. In our epidermis, that top layer, our cells, the melanocytes, will absorb this UV. It'll start to produce pigment. And these melanocytes, they interact with about 30 to 40 different keratinocytes, and they take that pigment, they shuttle it to the keratinocytes. The keratinocytes will then use it as a cap above their nucleus, as an umbrella, and then they'll start to slough it away as the keratinocytes come to the surface and slough. So if we get day after day UV damage, what happens is we get dysregulation, and we get pigment that clumps, and we start to see this. So that's one of the things that occurs with, with, uh-

Kane Rogers 3:02

one? That sounded like a lot more than

Dr. Minni Saluja 3:05

there's just so much that goes on underneath the skin that, that is so important to know. But anyway, so how do we do this? Well, this program encompasses three primary modalities that we do on a monthly basis to the skin

Kane Rogers 3:20

Okay. I, can I pause you just for a second? 'Cause I th- I think it's important we say this program. I think it's important to, to help people understand what this program is and how it came about. So just at a very high level, we had, um, you know, a lot of times we have patients come to us from other places and, and, you know, one of the things that they often say is, "I, I'm looking for something different than just injectables." And injectables are great. Fillers, neurotoxins. We do a lot of filler and neurotoxins. That, that certainly has a place. But we

Dr. Minni Saluja 3:53

And I'm gonna also put a plug in for Heather, who's joined our practice, a nurse practitioner who does a lot of fillers in our practice

Kane Rogers 3:59

biostimulators like, like Sculptra and Radiesse. That's, that's certainly, a big part of our practice and, and other places. But we also heavily invest in technology and devices, and a lot of times other places don't. They may have one or two offerings, but we have a lot. And so when patients come to us and they'll often say, "Look, you know, I, I'm, I'm... I don't wanna just chase the concerns that I have with more injectables. I'm starting to now want to address my dermal health, my overall quality of our skin." And so why I use the word flexibility with Skin360 is because we do have a number of different options, and we've packaged them into a program called Skin360 that offers flexibility for the patient to be able to, in consultation with you or their clinician, modulate between different, uh, devices based on the needs of their skin. And we've priced it at a price point that we hope is accessible to many, many people. So we want to help people improve the overall quality of their skin and their dermal health, so a lot of people will start with Skin360. And the other aspect of why it's also flexible is we have patients that maybe come in and do a more aggressive device, and Skin360 is also flexible for them because they will then turn to Skin360 and use it as a maintenance program. So there's a lot of flexibility in terms of which devices are most important for a patient to, to utilize and also how and when to utilize it

Dr. Minni Saluja 5:31

great, Kane. That's, that's exactly right. Well, you know, so when we talk about what's involved with the lasers, there are three main modalities, and we have separate podcast episodes on each of these, but we're just encompassing this together to understand why we're doing it as, this program. So the three devices that we're utilizing are AdvaTX, Lasemd, and Exceed microneedling. And I just wanna go through each one of those. So when someone comes in, this is logistically either a six to nine-month program, 'cause they could either do it every four weeks or every six weeks. So if it's every four weeks, it's six months, nine months every six weeks. So the first, one that you could start with, and I... You can start with any of these, but let's say someone comes in, they have a little vascularity to their face. They're a little ruddy, on their face, and they've got some pigmentation. Of course, we talked about also the textural issues. I might start with an AdvaTX, and that, that has both a 589 nanometer wavelength, which is like a pulsed dye laser, so it targets the hemoglobin, and it also has a 1319, which also begins the process of targeting,, the dermal water to stimulate collagen and elastin, and it also targets the sebaceous glands. So there are studies that show that AdvaTX really can excel even with patients with acne.

Kane Rogers 6:48

Now when you say sebaceous glands, what, w-

Dr. Minni Saluja 6:50

When you say sebaceous glands, what- The oily, the oil, production, glands. And, and the ones that we see that are hyperactive with acne. So you could really get some nice improvements with, the AdvaTX.

Kane Rogers 7:00

So because of the dual wavelength component of it, you can target both your vascularity, your reds, and you can also target collagen stimulation, if I heard you correctly, with the, with the, other wavelength

Dr. Minni Saluja 7:12

Correct. And it takes about... It's a longer procedure. It takes about an hour to perform this procedure. There's no numbing that's required. There really is not much of a downtime at all with this procedure either. So it's relatively easy to do. And by the way, before we get started with these procedures, we like to do,, a skin IQ, an Alma Skin IQ, where patients place their face into a, a device that we take photographs that allow us to use cross-polarized light a It allows us to see the pore size, the vascularity of the skin, et cetera, and then we repeat it at the end as well. But so we s- we like to start with the Adva- TX. Now, after four to six weeks, with numbing, we do a Lase MD. And Lase MD targets dermal water. It's a fractional laser, a 1927 nanometer wavelength that targets the dermal water, and it also creates something called MENDs, micro epidermal necrotic debris, which are areas where the pigment... Think of this as like a little heat highway that's placed into the skin, and the pigment can ride up that hi- heat highway and shed out as well. So it helps brighten the skin, but it also helps with the texture of the skin

Kane Rogers 8:27

Is that something somebody would want if they were trying to address pore size as well?

Dr. Minni Saluja 8:31

Absolutely. Absolutely. And, and again, with the 1319, that also addresses

Kane Rogers 8:36

the Lase MD is a thulium

Dr. Minni Saluja 8:38

Correct. It's a 1927 nanometer. Correct. Very popular, wavelength right now. You see it in different devices. We have the LaseMD Ultra. And so that one requires... It's a little bit of a downtime. You have- You're red for about a day. Some patients say barely a day, some patients say a twen- full 24 hours. But then you'll be gritty. The skin will feel gritty for about five to seven days until it sheds. You could wear makeup the next day, but you'll have that grittiness to the skin

Kane Rogers 9:06

So Lace MD, you need to numb, you have a little bit of, of recovery or downtime. The AviTX, which you just spoke about, no need to numb and relatively little to no

Dr. Minni Saluja 9:16

Correct. Correct. So one's targeting the reds and, and I also like IPL in the wintertime, but when we're talking about this program, this is targeting the reds and the browns, the AdvaTX. The Lase MD is going a little bit more for the texture and the wrinkles. And then finally, if you wanna get a little bit deeper into the skin, you can do the Exceed microneedling. And remember, these microneedling devices lay down about 600 to 900 insertions per second. It's not just a stamp, stamp, it's not just a stamp, stamp, stamp, but you can... And you can go deeper into the skin. Typically, about 1.5 millimeters is used, but you can go to two millimeters if there's an area of acne lesion, or you can go to one millimeter or 0.8 millimeters. So there's different, variability that you can select from for the depth and what you're trying to treat. And so when you combine that together, each month you're coming in and you're turning on those fibroblasts, you're correcting the coloration of the skin, you really get some nice improvement. And that's the first three months. AdvaTX, Lase MD, microneedling. I like for patients to go through each one of those in the first three months. But the second three months, they can select whichever one they wanna use. Let's say some- a patient is more vascular. They might say, "Hey, Dr. Saluja, I want Blair to do all the next three AdvaTX," or, "I wanna do two AdvaTX and a Lase MD," because again, everybody is different. So this program, back to what you said you liked about it, it targets the flexibility of the, of the patient and their biological concerns.

Kane Rogers 10:53

Right. So it's, it's really customizing based on their, the needs of their skin. We can customize what treatment we're gonna do. So s- if somebody... I understand that you wanna do, you know, the first three to kind of go through the, go through all three, but if there's really a need, we could, do AdvaTX the first three if there was really a need

Dr. Minni Saluja 11:13

For sure. Absolutely

Kane Rogers 11:15

the flexibility to modulate based on consultation with you or Blair or somebody else, on what their skin needs, and you can modulate that, every time you come in for a procedure

Dr. Minni Saluja 11:25

That's right. And you know, this was really born from one of the patients that Blair had done and I had seen her, back again for some, Botox. And I was like, "Wow, your skin looks amazing." And Blair's... And I told Blair later on, I said, "Oh my gosh, this patient's skin looked amazing." She said, "She has committed to a treatment every six weeks for the past two years." And I tell you, her skin looked amazing. So it was almost like this was born from... SKIN360 existed even before SKIN360

Kane Rogers 11:55

Before we were calling it that, yeah

Dr. Minni Saluja 11:57

right. And it really made it an exceptional difference,

Kane Rogers 12:00

So really, and a- again, just high level with Skin360, you have three different treatment options to choose from. You get up to six different procedures done, and that will probably be over the course of about six to nine months, depending on, on the frequency of the treatments

Dr. Minni Saluja 12:17

Now, this is not a program if someone wants to do one every three months, then you're not a Skin360 patient. This is every four to six weeks that the procedures are done. And it's not just for the face. It can also be done for the neck. So there's two different areas that

Kane Rogers 12:29

There's a Skin360 face and a Skin360 neck.

Dr. Minni Saluja 12:33

Correct. Correct

Kane Rogers 12:34

And then, and then also if you do like say a, Fotona 4D non-surgical facelift procedure and they complete that, we've also seen patients saying, "Hey, now I wanna maintain this," and Skin360 is a great maintenance program as well

Dr. Minni Saluja 12:49

Absolutely. And we'll talk the next time about T-Runner. Okay. About the robotic

Kane Rogers 12:55

teasing out there. So g- g- can you give a little more, like what is it? Like high level, like what is a

Dr. Minni Saluja 13:01

teasing out there. I am, I am, but I- Can you give a little more, like what is it? High level, like what is it? It is a robotic scanner that lays down these pulses, Kane, and you can treat body parts with it, you can treat necks with it. It's really pretty amazing. But I- Okay but

Kane Rogers 13:10

the latest and greatest in the new technology that we have. Okay

Dr. Minni Saluja 13:13

Correct. All right. That's it for today. Pretty, easy. There, again, there are separate episodes to each one of these, in our podcast. There's an Ava TX. Lasem D is six. Avdva TX I think is, oh gosh, number 17 or 18. And then, Exceed MicroNeedling is number 14. Don't quote me on those, but you can see, you can flip through the, the catalog and see

Kane Rogers 13:34

All right, great. Thank you, and, thanks for listening, and we're all anxiously awaiting for the T-Runner now. Perfect. All right. I'll talk to you later. Bye.