admin Aesthetics

Microneedling Dermapen Treatment

One of the most requested treatments in medicine are those that lead to eliminating imperfections on the skin of the face to show a luminous and healthy-looking skin. However, as we age, fibroblast cells decrease their production of collagen and elastin, making our skin appear less plump, and wrinkles and fine lines begin to appear.

Dermapen (microneedling treatment) is a minimally invasive treatment that regenerates and rejuvenates the skin with natural results.

What is Microneedling?

The microneedling skin prick, or Dermapen, also known as microneedling, is one of the most innovative rejuvenation therapies available today to treat a variety of skin problems.

The Dermapen is a device with cartridges with microneedles (they can be 9, 12-18- 24-36 – 42 needles and Nanos) that penetrate more or less deeply into the epidermis and dermis (depending on the problem to be treated) at large speed (20,000 rpm).

 

How does it work?

Skin puncture with these microneedles creates micro-injuries in the epidermis (outer layer of the skin) and the dermis (the inner layer of the skin) that stimulate the release of growth factors, thus initiating the healing process: fibroblasts are stimulated and they begin to produce collagen and elastin that will improve the quality and texture of our skin, giving it a smoother and more luminous appearance.

Ultimately, micro-punctures force the skin to repair itself after having suffered minimal physical damage. When we apply them on a pre-existing lesion (aged tissue, wrinkles, enlarged pores, acne scars, stretch marks, …), they will replace it with their own collagen and recent elastin.

This helps correct and blur wrinkles and fine lines, as well as acne marks, stretch marks, and some surgical or burn scars.

In addition, the microchannels allow the direct penetration of the active principles (growth factors, peptides, hyaluronic acid, …) in the areas to be treated.

 

Where can it be applied?

Dermapen routinely treats the face, neck and décolleté areas for skin rejuvenation, but is not limited to just those areas as it can also treat the abdomen, legs, arms and hands.

 

Why Choose Dermapen Skin Puncture Over Surgical Treatments?

-The Dermapen skin puncture gives you a rejuvenated and smoother skin without pain, with a minimum of discomfort and allows you to continue with your work activity (you will only present a redness and a slight swelling of the skin during the first hours after treatment).

-In this therapy, disposable needles are used that eliminate the risk of cross contamination.

-The depth of the needles is adjustable and this allows a personalized treatment to the needs of the patient. By applying, in addition to the adapted topical medical treatments, the active principles penetrate directly where they are needed, optimizing their action and effectiveness.

– the results are natural, the initial appearance of the face is not altered: it is simply allowed to stay younger and more luminous by stimulating its potential.

 

How long does each session last?

They can last between 30 and 60 minutes depending on several factors: the treatment to be performed and the patient’s skin. It is a personalized treatment so it can vary from one patient to another.

 

What treatments can we do and how often should it be repeated?

It will depend on the type of treatment proposed:

  • If it is an INFUSION / “BB GLOW” treatment (where the corneal layer of the epidermis is treated, to give luminosity to the face): the treatment can be repeated every week.
  • If we do a “MEDIUM treatment” (where we treat all the layers of the epidermis – without reaching the dermis – and allow, with the opening of microchannels, the greatest infusion of active principles, it improves the texture and tone / color of the skin) : the treatment can be repeated every 15 days.
  • If we carry out a deep COLLAGEN INDUCTION treatment (to prevent aging, treat wrinkles, spots, stretch marks, scars… ..): it can only be done once a month. This is the time that the skin needs to finish its natural cycle of collagen production: repeating this treatment ahead of time would interrupt that cycle and would be counterproductive.

 

What are the expected effects?

Facial skin looks firmer and smoother, with a more unified, luminous and hydrated tone.

 

Is it also suitable for men?

For sure!

 

Does it have side effects?

After treatment, the skin shows redness as a result of the inflammation caused by the micro-punctures and that can persist between 12 and 48 hours.

 

Who shouldn’t get this treatment?

– pregnant or lactating women.

-people who are taking aspirin or blood thinners.

-presence of active skin infection (acne)

-Patients with skin tumors.

PRICES:

Treatment INFUSION/ “BB GLOW”  “INTERMEDIATE” Treatment COLLAGEN INDUCTION Monthly pack:
Only the corneal layer of the epidermis is treated All layers of the epidermis are treated – without reaching the dermis.

The treatment allows, with the opening of the microchannels, the greatest infusion of active princes

 It is a MEDICAL treatment, which treats the dermis

Stimulate endogenous collagen production.

 1 collagen induction treatment + 2 surface treatments (BB Glow or intermediate)
To give luminosity to the face. Improves texture and skin tone. Prevents aging, wrinkles, blemishes, stretch marks and scars.
The treatment can be repeated every week. The treatment can be repeated every 15 days. It can only be done once a month.
85 euros / session 85 euros / session 95 euros / session 250 euros / month

 

Advice on how micro needling aftercare

-DO NOT EXPOSE TO THE SUN: After undergoing your microneedling procedure, stay out of the sun and do not apply any sunscreen. After the procedure, the skin channels are completely open and only the products indicated by the doctor should be applied.

-DO NOT USE ANY “ACTIVE INGREDIENTS” SKIN PRODUCTS: After the procedure, avoid any skin care products that have active ingredients. These commonly include things like alpha hydroxyl acids, retinol, and other similar agents. The skin will be very sensitive and these products only irritate it more.

-USE COLLAGEN-STIMULATING PEPTIDES (the doctor will indicate them): As the microneedle serves to stimulate the production of collagen, the skin needs higher amounts of collagen than normal to recover optimally. Collagen-stimulating peptides aid in that process, further assisting in the stimulation of collagen production.

-AVOID THE USE OF MAKE-UP AFTER TREATMENT: During the first 24 hours post-treatment, it is important that you let your skin “rest” and recover. The channels of the skin are open and the use of a makeup brush can penetrate the pores, especially if they are very fine, causing further irritation or can even contaminate the skin and, consequently, cause infections. Wait 24-48 hours before applying face makeup.

-You can USE A COOLING MASK to relieve inflammation or redness of the skin, normal after treatment.

-AVOID SWEATING: As you sweat, the pores on your skin will reopen and bacteria on your skin can penetrate it and cause a reaction or infection.

-DINK WATER: since good hydration (before and after treatment) will help your skin heal faster.

Bérénice Ibarra Ottino

admin Aesthetics

Keloid and microneedling

What is a keloid?

Keloids are larger and more pronounced scars than usual, extending beyond the edges of an original wound or incision. They should not be confused with a hypertrophic scar where the tissue remains within the edge of the wound.

Why do they occur?

Their cause is unknown, but they are more common in people with darker pigmentation (especially African-American skin) and can develop after acne blemishes and boils, body perforations, burns, lacerations, and surgical wounds. Therefore, people prone to developing keloids should avoid unnecessary piercings, tattoos, and surgeries.

The presence of infection increases the risk of development, which is believed to result from an alteration in the activity and / or control of fibroblasts (cells responsible for the production of collagen from scars) .It is a complex mechanism in which hormones, genetic factors, and problems with the immune system are involved.

There is also evidence that a family history of keloid plays a role in the development of an individual keloid.

 

What are the symptoms of a keloid?

Keloids can occur anywhere on the body, they tend to be more frequent where there is little underlying fatty tissue (face, neck, ears, chest or shoulders).

It usually begins to develop between three months and up to a year after the original skin damage. So a gummy scar tissue appears beyond the edges of the original damage. It can become tender, painful, itchy, or even give a burning sensation. Over time, the red color changes to brown or turns pale.

Keloid growth over a joint can restrict movement.

What’s the treatment for keloids?

A keloid scar can shrink over time, but it rarely goes away completely. To reduce the occurrence of keloids, a wide variety of treatments can be effective: steroid infiltration, surgery, occlusive dressings, radiation therapy, cryotherapy, laser treatment, interferon treatment, cytotoxic drugs, and microneedles (dermapen).

Of all these modalities, the dermapen is the one that carries the least risk and side effects.

Your doctor will be the most informed on whether it is a valid option for your type of problem, or to propose the most appropriate one.

Bérénice Ibarra Ottino

admin COVID-19, Vaccines

Covid-19 vaccination for foreign residents in Andalucia

If you are a foreigner residing in Andalucia you are eligible for Covid vaccines even if you are not currently registered with the Andalucia Social Security health system. 

You will need to first ensure that you are empadronado or registered as a resident in the town hall for a minimum of 3 months, and obtain a certificate of empadronamiento (which is valid for 3 months). 

If you are a pensioner you will need the document S1 from your home country.

With these documents, and your passport and residence document you can obtain a tarjeta sanitaria or health card from your local ambulatorio (health centre). You will then be included in the vaccination programme and will be contacted (usually by phone) when your appointment is due.

The Junta de Andalucia (the regional government) recommends contacting the consulate of your country of origin for further advice on how to be included in the vaccination programme.

 

I am not a resident in Spain, can I get vaccinated here?

At present non-residents are not being offered vaccination. 

 

How safe is the vaccine?

To date more than 150 million doses of the vaccine have been given worldwide, and side effects have been very closely monitored.

The usual side effects common to most vaccines have been identified. These are generally mild such as a sore arm, tiredness, headache or aching joints for a few days. The very rare occurrence of a serious allergic reaction (anaphylaxis) is also a feature of all vaccines. No long-term complications have been reported.

 

Can I be vaccinated privately?

At present, the vaccines are exclusively controlled by the Andalucian Social Security health system and cannot be obtained elsewhere in Spain. 

During this season’s influenza vaccine program the flu vaccine was initially only available only through the Andalucia Social Security health system and later on was also made available through some private clinics.  

So far we have no information as to whether the same policy may be applied to Covid-19 vaccines. In the light of this it is recommended to have the vaccine through the Social Security health system if you are eligible. Should the situation change you will be alerted via this blog or by email if you are included on our waiting list.

 

Can I choose which vaccine I have?

Vaccines are given according to availability at the time, and you cannot choose. 

 

I have had Covid-19 infection. Do I still need the vaccine?

Most people who have had the infection will probably have some immunity for at least 8-10 months although it is not yet known if it may last longer. There have also been cases of reinfection after having recovered from the illness, so immunity is not guaranteed.

It is very likely that vaccination will provide a better and longer lasting protection than the infection itself and vaccination in these people seems to be equally safe.

The current guidelines in Spain recommend vaccination for those who have had Covid-19 infection (and do not have any contraindications) with the following conditions:

  1. Anyone over 55 yrs should receive the normal vaccination scheme after they have recovered from the Covid infection and at least 14 days from the start of the illness.
  2. Anyone in a high risk group such as health care professionals, carers of vulnerable people etc should receive the normal vaccination scheme after they have recovered from the Covid infection and at least 14 days from the start of the illness. 
  3. Those aged 55 or less (even if they have risk factors) need only 1 dose which should be delayed until 6 months after the diagnosis of the infection.

 

Once vaccinated do I still need to take precautions?

It is not yet known if vaccinated people could still become infected without symptoms and unknowingly pass on that infection to others. 

It is also not known if new variants of the Covid-19 virus could cause illness in those already vaccinated. For these reasons the same precautions should be followed as for those unvaccinated.

 

Does the vaccine protect against the new UK variant of the virus?

Based on the data available so far, the currently used vaccines are effective against this and other strains that are commonly circulating in Europe

 

After I get vaccinated will Covid-19 tests show up positive?

The PCR and antigen tests will not show positive due to the vaccine (but could be positive due to a new infection).

Antibody tests may show positive and indicate a state of immunity. The ELISA  antibody is recommended in this case. Click here for more information about Covid-19 tests

 

I suffer from allergies. Can I have the vaccine?

The only absolute contraindication (must never be given) to the Pfizer, Moderna and AstraZeneca vaccines is a previous history of severe allergic reaction (e.g. anaphylaxis) to a component of that vaccine.

Examples are allergy to; polyethylene glycol (in the Pfizer and Moderna vaccines), and polysorbate (in the AstraZeneca vaccine).

A relative contraindication is giving the vaccine during pregnancy (that is to say the vaccine should be avoided, but in special circumstances may be given). This is not due to any known problems in pregnancy, but rather to a lack of sufficient data to be sure it is safe. Those at high risk of Covid-19 may be offered the vaccine after discussion with their doctor.

It is no contraindication (can be safely given) in the case of;

  1. Allergies to different components of other vaccines which are not present in the Covid-19 vaccine. 
  2. Food, animal, insect, environmental, latex or other allergies.

 

 

 

 

Dr. Anthony Crichton-Smith- GP

 

admin COVID-19

Surviving Covid at home

What to do if you have Covid 19 at home?

Having just been through the experience with all my family, here are my tips on staying safe:

  1. Isolation. Once someone in the family is suspected or diagnosed with Covid that person and all close contacts must isolate. Ideally this means confining an infected person to 1 room with a separate bathroom and leaving meals outside the door for collection. Dirty plates must we washed with care, and any waste put in 2 plastic bags before being disposed of.
  1. Test the rest of the household even if they have no symptoms. PCR test picks up the disease earliest, or an Antigen testing which is cheaper and faster. Check with your doctor which is most suitable according to your circumstances. If you all end up positive, at least you no longer have the chore of 1 or more family members confined to a room.
  1. Prepare. The first few days are often relatively mild, so use this time to order supplies on-line, ask a friend to bring round medication like Paracetamol or Ibuprofen, do any reorganization for work like setting up a home office. Any deliveries of course must be left at the entrance with no contact with the occupants.
  1. Medical equipment. Especially if anybody is at risk because of age or other health problems make sure you have an infra-red thermometer (contactless), and I recommend a blood pressure monitor (upper arm, not wrist) and pulse oximeter. You can buy these from pharmacies or on-line. Don’t rely on phone apps or smart watches, which may not be reliable enough. With these 3 pieces of kit and video access to your doctor you can do a pretty effective monitoring of everybody’s health. 
  1. Day 5 deterioration. It is common for patients to feel worse around day 5 to 7. If you have some meals already prepared/frozen you will be glad not to have to cook.
  1. Symptom relief. 
    1. Paracetamol or Ibuprofen is best for fever and muscle and joint aches and pains.
    2. Cough: Try honey (if over 1 year old) or if distressing, a codeine based cough medication may be helpful, on the advice of your doctor. Avoid sleeping on your back if possible.
    3. Keep well hydrated. It is easy to forget to drink if you are sleeping most of the time. Your urine should be pale in colour. If dark, you may be dehydrated.
  1. Monitor. Those at risk or who deteriorate need close watching. The warning signs that indicate medical advice may be needed are shown in the table below. Green values are reassuringly acceptable.  The more abnormal readings there are, and the closer to the red end, the more serious the situation may be. An isolated abnormal reading can be repeated to see if it persists. Take into account the general trend. If things are getting progressively worse contact your doctor. Don’t delay or think you will wait until the morning because sometimes changes happen fast. It is a good idea to have a written record of your readings to send to him. Another important warning sign is any confusion or reduced level of consciousness.
Hi risk Low risk Hi risk
Breaths/min at rest <9 9-11 12-20 21-24 >24
Oxygen % at rest <92 92-93 94-95 >95
Temp. ºC <35.1 35.1-36 36.1-38.0 38.1-39 39.1-40 >40
Blood pressure (upper reading) <91 91-100 101-110 111-140 141-180 181-220 >220
Heart rate/min. <41 41-50 51-90 91-110 111-130 >130
This table is just for guidance and only applies to patients 16 years or older. It is not a substitute for medical advice
  1. What about antibiotics, Ivermectin, steroids, antivirals…..?
    1. Many patients feel a pressure to do something more active to fight the infection and request all kinds of treatments they may have read about “just in case”. For patients not needing admission to hospital there is at present (Jan 2021) no good evidence to support giving these medications as a preventative or treatment for Covid 19. It is important to be guided by the science and not by wishful thinking based on inadequate evidence.
    2. Vitamin D deficiency has been linked with poorer outcomes in Covid 19 infections. That doesn’t mean that taking extra vitamin D will help you if you are not deficient, but it is a good idea to ensure you have enough. Diet and sunshine are natural sources or supplement if your doctor advises.
  1. Ending isolation. If all goes well you can end your isolation if the following conditions are met (for Spain):
    1. At least 7 days have passed since a positive test or since the last contact with a positive Covid person
    2. AND you have been at least 3 days with no fever without taking any fever-lowering medication (eg. Paracetamol or Ibuprofen).
    3. AND your symptoms have significantly improved.
  1. Retest. If you want to confirm that you are no longer infectious (especially for example if you will be in contact with vulnerable people) ask for an IGG ELISA antibody test. If positive, you have developed antibodies and are not contagious, irrespective of your IGM or PCR result. 

Equally valid is a negative PCR test. But even if the PCR shows positive you may still be in the clear: ask for the cycle threshold  (ct or umbral de ciclos). If above a certain value it means the viral load is too low to be contagious.

 


 

 

 

 

Dr. Anthony Crichton-Smith- GP

admin COVID-19

Covid antigen / flu test combined.

The laboratory at Atlantic Clinic has acquired a new clever piece of kit that will test for Covid antigen and influenza antigen on the same sample, and at the same price as the original Covid antigen test (45 euros, 45 euros on weekend/out of hours).
The results are ready as quickly as 15 minutes (sometimes a little longer when there is a heavy workload).
This is especially useful over the winter months of the flu season when it may be difficult to distinguish between the 2 types of infection.

Book a test

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admin COVID-19

Same-day PCR test

Atlantic Clinic has just acquired the latest PCR equipment which can give a same day result.

 

Our prices for Covid 19 tests have also fallen:

-Same-day PCR: 85 €

–Antigen test (nose swab) 15 mins: 45€

–Antigen test on weekends/ out of hours (nose swab) 15 mins: 45€

–ELISA antibody test (blood sample) same day: 95€

 

Book a test

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To find which test is best for you click here.

To book your appointment, please call 952 81 7425

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admin Vaccines

Vaccinations for children in Spain

What vaccines does your child need? Are they different in Spain from other countries? Should you follow the Spanish schedule or that of your home country? This blog explains all.

The vaccination schedule for children in Andalucia is shown in the table (in green). 

All children are advised to have these vaccines unless there are contraindications.

  • There are optional extra vaccines (in yellow) that are available, but not routinely given within the Spanish social security health system. For example; Meningitis B vaccine (which is part of routine vaccination schedules in other countries such as the UK).
  • Some vaccines (in red) are given under special circumstances.

 

Schedules do vary between different countries. So which should you follow?

If your child is likely to stay in Spain for the foreseeable future I recommend changing to the Spanish schedule. 

If you are planning to return to your home country soon, it may be simpler to follow their schedule.

 

Prices of vaccines are shown approximately as they vary according to the brand that is available.

The fee for the arranging and administering of vaccines by a doctor is 40 euros. 

If you would like to have the height and weight measured and a developmental assessment in addition to the vaccines or to discuss any health concerns, the fee is 70 euros for up to 25 minutes consultation.

Vaccines need to be paid for in advance, as they cannot be returned if unused.

 

This table is for guidance only; there may be particular circumstances for your child that could affect requirements.

 

CHILD VACCINATION 2020 (Andalucia)
Age due Vaccine Comment Price  approx.
0 Hepatitis B 1 Given in hospital  
2 mth Diphtheria 1   € 72-82
Tetanus 1
Pertussis 1
Polio 1
Haemophilus influenza B (HIB) 1
Hepatitis B 2
Pneumococcus 1   € 77
Rotavirus 1 Oral € 70-94
Meningitis B 1   € 107
4 mth Diphtheria 2   € 72-82
Tetanus 2
Pertussis 2
Polio 2
Haemophilus influenza B (HIB) 2
Hepatitis B 3
Pneumococcus 2   € 77
Meningitis C 1   € 36-47
Rotavirus 2 Oral € 70-94
Meningitis B 2   € 106
5 mth Rotavirus 3 Only for Rotateq € 70
6 mth Influenza 1 Yearly for at-risk children € 13-15
Influenza 2 After 1 month if no previous vaccine € 13-15
11 mth Diphtheria 3   € 72-82
Tetanus 3
Pertussis 3
Polio 3
Haemophilus influenza B (HIB) 3
Hepatitis B 4
Pneumococcus 3   € 76
12 mth MMR (measles, mumps, rubella) 1   € 17-18
Meningitis ACWY 1   € 55
Meningitis B 3   € 106
15 mth Varicella (chickenpox) 1   € 46
3 yrs MMR (measles, mumps, rubella) 2   € 17-18
Varicella (chickenpox) 2   € 46
6 yrs Diphtheria 4   € 36
Tetanus 4
Pertussis 4
Polio 4
12 yrs HPV (human papilloma virus) 1 Routinely for girls, optional for boys € 175
HPV (human papilloma virus)  2 6-12 m after 1st dose € 175
Meningitis ACWY 2   € 55
14 yrs Diphtheria 5 Unavailable at time of posting € 9
Tetanus 5
Diphtheria, Tetanus, Pertussis  (Alternative if DT not available) € 24-29
Meningitis ACWY 2 If not received 2 doses previously € 55

 

By Dr. Crichton-Smith ○ GP

admin COVID-19

New Antigen test for Covid-19

This test has just become available in Spain and has several advantages

  1. Rapid: It is as fast as the rapid antibody test, and faster than the PCR test. The results are ready from about 20 minutes of taking the sample.
  2. Early detection: it can detect Covid-19 as early as 2 day after contact with an infected person, or as soon as symptoms appear until 5 days after symptoms start.
  3. Cheaper than the PCR test. It costs 50 (55€ on weekends/out of hours) euros.
  4. Accurate: Sensitivity is 80-94% and Specificity is >97%  (this satisfies the requirements for intenational travel certification).
  5. It is taken by a nose or throat swab.

Disadvantages

  1. The result becomes negative as the infection clears (after 5 days from the start of symptoms). This may be useful to indicate that a patient is no longer infectious, but it cannot indicate a previous infection (antibody tests are better for this). 

So, which test to have?

      1. To detect a previous infection the ELISA antibody test is the most accurate. A cheaper, faster, but less reliable alternative is the rapid antibody test.
      2. When a PCR test is required for travel or employment, or when cost and rapidity is not an issue the PCR is recommended. At present this is the most accurate method for diagnosing a current active infection
      3. When cost and speed are important the Antigen test is recommended. For example a child may be sent home from school, or an employee sent home from work with possible Covid-19 symptoms, or you have had contact with somebody who tested positive. This test can give a positive or negative result within minutes, allowing that person to either isolate or get back to school/work quickly.

Book a test

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admin COVID-19

How to interpret your Covid 19 antibody results

For Rapid antibody tests and ELISA tests the interpretation is the same.

The ELISA test is considered more reliable and also gives a quantitative figure of the amount of antibody (as opposed to a simple positive/negative result with the Rapid test).

There are 4 possible results:

  1. IgM negative, IgG negative.
    1. There is no evidence of current infection or previous infection.
    2. Remember that it takes a minimum of 4 days from the start of symptoms, or 7 days from exposure to the virus before the antibodies show up positive. This means that the antibody test cannot detect an infection in the initial stages.
    3. If there is a suspicion of recent infection in spite of this result a PCR or Antigen test can be done, or repeat the antibody test after a few days.
  1. IgM positive, IgG negative:
    1. This suggests infection in the early stages of the disease.
    2. The patient is infectious
    3. If the result does not coincide with the clinical picture (for example, if there are no symptoms) it could be a false positive. The result can be confirmed with a PCR test or, if the test was a Rapid antibody test, by doing an ELISA test, which is more reliable and uses a different method.
  1. IgM positive, IgG positive:
    1. This suggests infection in the intermediate stage of the disease.
    2. The patient is considered no longer infectious.
  1. IgM negative, IgG positive
    1. There is recovery from the disease and the patient is not infectious
    2. There may be some immunity to Covid-19, although it is not known yet to what extent and how long that immunity may last. Precautions should still be taken.

Book a test

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