Skin Imaging: Gimmick or Useful?
Salons and med-spas often offer free "skin imaging" to their first-time customers. These skin imaging systems vary somewhat, but the jaw-dropper for the customers is usually the image of their face in ultraviolet, or UV light.
The UV light really makes age spots pop out. And not just visible age spots, but also ones that are below the visible surface of the skin.
Many med-spa customers, horrified by the prospect that these lurking age spots will bloom out at their next sun tan into disfiguring liver spots, will sign up for any treatment or product that will make these terrible time bombs go away.
Gimmick or Useful Diagnostic Tool?
A popular imaging device, the VISIA, was demonstrated on the Oprah Show in December 2008. And it certainly looks impressive as it "images" age spots and oil production below the surface of the skin.
Is skin imaging a gimmick? Are these devices really just sales tools disguised as medical devices? Or are they offering valuable information for consumers of skin care products or anti-aging treatments?
Bottom line, these skin imaging systems are sales tools, not valuable medical devices.
1. No treatment will get rid of all those hidden age spots that show up on the UV photos.
That’s right. You may be horrified by those lurking little time bombs. And you may buy a laser series to make they go away. But no treatment will eliminate all of those age spots below the surface of your skin.
That’s why the UV imaging is essentially a crude scare tactic. It implies that you can get rid of the underlying pigment deposits and that the imaging system can document that precisely.
I had one of my staff call the leading imaging company recently to ask for any studies showing that their imaging system showed a reduction in sub-surface age spots (lentigoes). The representative told my staff member that they had some "images showing a diminishment of sub-surface pigment damage." These images were, the representative said, "private files, and not something we send out." If our office agreed to do a live internet sales presentation, they would show us the images. Hmmmm. So, no studies, and some private images that the company does not release publicly.
In my opinion, showing those age spots in a UV photo is fine. But implying that any treatment will make them go away is absolutely untrue. And the fact is that few salons or spas will offer to give you the UV skin imaging AFTER you’ve had the treatment that you bought to get rid of those spots.
Because if you see the UV photos after your laser treatment, chances are you’ll be disappointed, if not mad. You may well see some diminishment in those age spots. But will the After photo look dramatically different from the Before photo? I don’t think so.
Many scientific studies document the improvement in the visible appearance of your skin from a series of laser/IPL treatments with a medical-grade, customizable laser or IPL. The laser treatments reduce age spots, brown spots, redness, and improve collagen and elastic fibers that in turn improve the visible texture and appearance of your skin.
We don’t need an imaging system to document those improvements, when we have own eyes, many years of patient data, and lots of scientific studies.
2. You never see these skin imaging devices at a good dermatology office, because the medically trained staff at a dermatology office doesn’t need them!
A good cosmetic dermatologist, or one of her nurses or PAs, doesn’t need a fancy skin imaging device to tell them what anti-aging treatments would be good for you. They have studied skin medically, and they treat skin every day. They don’t need a UV photo to assess sun damage, solar lentigoes, and color problems.
It can see where gravity is ever so slightly pulling down on the mid-cheeks and causing some wrinkles around the mouth and jaw line. It can see subtle color variations and can certainly detect pigment deposits.
But the salons and med-spas don’t typically use medically trained staff for their skin care consults. They use lower-paid aestheticians or "skin specialists" who are sales-oriented.
Because a salon or med-spa is focusing all of its business efforts on "converting" that consult into a paying customer. The spa employee doing the consult often gets a commission if they can get that consult to buy a service. So they very much want to sell a treatment.
The imaging systems can be very good sales tools, because they scare the pants off customers. But it still leaves open the question of whether the customer is buying what they need for their particular problem. Which brings me to the third point.
3. Skin imaging devices don’t give women what they really need.
After treating thousands of women for many years now, I am convinced that one of the most important things I do for women is to tell them what they need to do to rejuvenate their faces.
Most women don’t need a pseudo-medical image of their face. They know they have freckles, or wrinkles, or laxity. And they don’t need the size of their pores or their wrinkles compared to a database of other women their age.
What they really need, and want, is for someone they trust to tell them what they need to do to improve their skin.
And no imaging device can do that.
My advice: skip the imaging and find a good cosmetic dermatologist you can trust.
I have compiled a national list of excellent cosmetic dermatologists. And bear in mind that I developed this list on my own. I don’t take fees or payments of any kind to list a doctor here.
Next, see my tips on how to get great laser treatments.
See Dr. Irwin's expert answers to other reader's questions on skin imaging:
Do we review specific products suggested by readers in blog questions? For pigment problems – in which order should you use your products? If you have a medical disease like diabetes or other problems, is it safe to have fillers done? What treatment would be best for wrinkles for me at 65 and my mom at 84? Can I repair damage to the lipid layer of my skin? Hyperpigmentation and Addisons. Can you be your own web doctor for skin issues? Does combining various procedures like Ulthera and Thermage make them more effective?
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