If you were to ask someone what the largest organ of the human body is, you might get some interesting responses. This isn’t something we normally think about, as we tend to take our bodies and their functioning for granted. The answer, at least from an external standpoint, is the skin.
Not only does skin provide a protective barrier for the body, but it is also one of the largest contributors to how one is perceived as a person in the world. This is a fact that Angela Fulton, a certified physician’s assistant and director of aesthetics at Strother Dermatology, is acutely aware of, and it is a motivating force behind her practice.
Early Life
Angela is an increasingly uncommon phenomenon in this area: a native born and bred Washingtonian. She was raised in Carnation and enjoyed all the pleasures of growing up in a rural setting: horses, chickens, 4H Club and more. It was an idyllic and quiet life, made more so by the fact that both her parents and grandparents are deaf. She and her brother would converse and are also fluent in sign language, but so many of the modern amenities that fill our lives, such as ubiquitous television and radio, were not as much of a factor in hers. To this day, she prefers that the radio be off when driving.
“Why not just enjoy the view out the window?” she says.
Education and Training
At the age of 17, Angela attended Lake Washington Technical College and then started working as a medical assistant in cancer care, family medicine and emergency medicine. This inspired her to pursue further training as a physician’s assistant at the University of Washington.
Although she didn’t have a specialty in mind when she entered UW, she soon gravitated toward dermatology, a decision informed by her own experience with acne as a teenager. She sought help from Dr. Cooperrider, a front-runner in aesthetic dermatology and the founder of what is now Strother Dermatology, and it changed her life. She did her preceptorship with Dr. Cooperrider and Dr. Strother and then was hired there after graduation and completing state certification.
Acne as Inspiration
Although she was grateful for the cure she found for her acne, the treatments available now have changed a lot in the last two decades. Angela is diligent about keeping up with the latest developments in aesthetic dermatology.
“In addition to lights and lasers, there are many more modalities such as topical treatments that are easier on your skin, easier to tolerate,” she says. “Many people prefer these to oral medications.”
Following in Dr. Cooperrider’s footsteps, Angela is growing the aesthetic side of the business. While there is some overlap between medical and aesthetic dermatology, aesthetic dermatology is generally concerned with enhancing appearance. That said, if someone has scarring from a surgical procedure, the minimization of it may be no less important to the client than the surgery itself.
Keeping Up Appearances
Personal appearance is important to anyone, and modern aesthetic dermatology can bring about remedies not available in the past. Angela described an example of a non-medical condition but a nonetheless disconcerting one.
“A client this morning told me, ‘People tell me I look angry,’ and she wanted this to change.”
Angela was able to offer suggestions, such as Botox, to help minimize frown lines. Another client had the inability to smile because of facial paralysis, and Angela was able to offer some solutions.
“I can change the way someone feels on the inside by changing the way they look on the outside.”
A Brave New World
The realm of aesthetic dermatology is changing rapidly thanks to developing technologies. Angela discussed several cutting-edge treatments. One area that she is particularly interested in growing is the body-contouring department. Cool laser technology allows for the permanent dissolution of targeted areas of fat as the application freezes it.
Cool laser body sculpting is not an alternative to the tummy tuck or liposuction, but it is good for someone who has tried to lose that last stubborn few pounds and not been able to.
“The ideal candidate,” Angela says, “is someone who is close to their goals, healthy and exercising. We then map it out, and look at the options.”
Kybella
Kybella, a relatively new non-surgical intervention, is used for facial sculpting and the reduction of submental fullness, aka double chins. Kybella is a synthetic deoxycholic acid (bile acid) approved by the FDA in 2015. It is injected into the chin area to reduce fat and may take more than one treatment.
PRP Treatment
Platelet-rich plasma (PRP) is a concentrate of platelet-rich plasma protein derived from a patient’s own blood, centrifuged to remove red blood cells. It has been used by athletes to hasten recovery from soft-tissue damage, but it can also be injected into the scalp to promote hair growth, or it can be injected or infused via microneedling on the face to reduce wrinkles and lines by increasing cell growth and collagen production. For those of you keeping up with the Kardashians, Kim has Instagrammed herself having this procedure.
Sciton Joule
The Sciton Joule sounds like a name straight out of science fiction, but it is actually a laser peel skin treatment tool. Laser treatments increase collagen production, which improves skin thickness and resilience, according to Sciton. This can help with deep wrinkles such as those found around the mouth and eyes, scarring, actinic keratosis and skin texture. It is most commonly used on the face and neck.
On the horizon at Strother Dermatology, Angela says, are muscle stimulation treatments to improve muscle tone. She has demoed several units but is waiting to see what develops in this emerging field.
Preventive Measures
As we ease into the midst of summer, it’s worth asking what can be done to prevent skin sun damage. Angela has some simple but effective advice—if it is put it into practice. When outside, wear sun-protective (SPF) clothing. Wear a broad-brimmed hat. Seek shade when possible. Avoid being outdoors in the prime sun exposure hours between 10 a.m. and 2 p.m. And, lastly, wear sunscreen with an SPF of at least 30.
Angela says most people don’t understand SPF ratings, and they should. According to the American Academy of Dermatology, “High-number SPFs last the same amount of time as low-number SPFs. A high-number SPF does not allow you to spend additional time outdoors without reapplication. Sunscreens should be reapplied approximately every two hours when outdoors, even on cloudy days, and after swimming or sweating.” Chemical sunscreens, such as oxybenzone and avobenzone, work like a sponge to absorb the sun’s rays. Physical sunscreens, such as zinc oxide and titanium dioxide, work like a shield, sitting on the surface of the skin and deflecting the sun’s rays.
When it comes to protecting your skin from the harmful effects of solar radiation, an ounce of prevention is worth a pound of cure.
Oh, and for those who are wondering what the largest internal organ is, it’s the liver.
For more on Strother Dermatology, visit StrotherDermatology.com.