New York dermatologist Orit Markowitz, MD is a leading expert in noninvasive skin cancer therapies, so she’s able to get first access to some of the newest technologies that are changing the way doctors can penetrate, remodel and treat the skin in innovative new ways. At her OptiSkin practice in Manhattan, she utilizes these modalities to not only diagnose and treat skin cancer, but also to provide sun damage rejuvenation, erase tattoos and give her patients tighter, more lifted looking skin. She is the go-to for non-invasive treatments that are trending now. So much so, her motto is “Cutting Edge without the Cutting.”
Here, she shares the top technologies that give her patients the best outcomes.
Heating below the surface of the skin with radio frequency microneedling is a great way to generate collagen, says Dr. Markowitz, but she also likes it because it creates a contraction of the skin. “When you’re trying to accomplish a nonsurgical lift, some of it is also textural, so you have radio frequency that can go as superficial as 0.5 millimeters in depth. You’re creating an injury in the skin that the body now has to go into overdrive to heal itself. You can go as deep as three millimeters if you’re really trying to target excess fatty tissue That’s what causes not just the collagen generation, but also the contraction of skin causes that lift.”
NEW ULTRASOUND TIGHTENING
While you might be familiar with ultrasound therapies of the past, Dr. Markowitz says Sofwave, a new FDA-cleared lifting treatment for the brow, neck and jawline, is next level. “This one has a lot more bells and whistles,” she explains. “It is the only device that delivers heat to the depth of 1.5mm in the mid-dermis, which is where collagen is generated. You can also get a higher amount of heat, so it takes a little less time to treat than other options. Because you’re getting a higher amount of heating, with less discomfort, it’s easier for the patient to undergo.”
THE DO-IT-ALL LASER
The newest of all the PICO lasers, Dr. Markowitz says PicoWay is her go-to laser treatment because it’s faster and more efficient than others before it. “There are new pieces that they’ve just developed, like fusion pieces, where you’re able to combine both the fractionated kind with more superficial treatments, so you’re able to get optimal results. Because it has various wavelengths, you can look at the patient and determine where the pigment is and choose the right wavelength to target so they do not have to keep coming back to be treated with various pieces, you know exactly what you need to target from day one.”
Dr. Markowitz says the PicoWay is the best for correcting significant hyperpigmentation, dark spots, or erasing tattoo ink. “It’s photo acoustic energy, so it’s just sort of acoustic at different depths. So, when you have certain types of scars, hyperpigmentation, melasma or other pigmentary disorders, we’ll also use noninvasive imaging to see where the pigment is and you get a determination of how much of it is, whether it has a vascular component, and then properly target it all at once as opposed to a trial-and-error approach until you get it done.”
The noninvasive imaging Dr. Markowitz is referring to is a new device that looks at the skin in a three-dimensional perspective, making it easier to plan and target other skin treatments.
“We are the only practice in the U.S. with this technology and we’re using it to not only do research to better treat skin cancer, but also to further understand how to manage other diseases like pigment, psoriasis, nail fungus and other skin diseases like eczema.”
For patients undergoing treatments, Dr. Markowitz says it can take months to see how the skin is responding, but with noninvasive imaging, she can start to tell right away whether that patient is going to improve. “When you want to laser a patient, you can see what the depth of pigment is, where are the vessels are, how big they are, and even how to determine what is the most optimal approach and whether the treatment is working under the skin before we see the outcome of the skin.”