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Cosmetic dermatology is the aspect of dermatology that deals with skin conditions which do not cause any significant morbidity or functional disability. These conditions may be left alone without medical consequence or are treated mainly for enhancement of the patient’s appearance. Correct identification and characterization of these conditions are needed for subsequent appropriate treatment. Cosmetic dermatology is a growing and challenging aspect of dermatology with meeting the patient’s expectations being just as important as achieving good and safe treatment outcomes. Better recognition, improved practitioner’s skills, and more effective and safer medical technological advances all contribute to the dermatologist’s ability to enhance the appearance with minimal side effects and reduced downtime.
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Cosmetic dermatological conditions in the Asian skin may be classified into several broad categories:
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Pigmentary changes
Lumps and bumps
Vascular lesions
Decorative tattoos
Scars
Wrinkles and skin laxity
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Pigmentary changes especially hyperpigmentation are a major cosmetic concern of Asian patients (Figures 23–1, 23–2, 23–3, 23–4, 23–5, 23–6, 23–7, 23–8, 23–9, 23–10, 23–11, 23–12, 23–13, 23–14, 23–15, 23–16). The Asian skin (Fitzpatrick skin types IV and V) develops pigmentation both constitutionally and reactively. The common acquired cosmetic pigmentary problems encountered include freckles, solar lentigines, melasma, and Hori’s nevus. Patients with pigmented birthmarks such as café au lait macules and nevus spilus often seek laser removal. Nevus of Ota and Ito are harmatomas of dermal melanocytes that occur almost exclusively in Asians of Chinese/Japanese descent.
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