Dr. Adriana Ribé
Behind The Woman
About your career and the people who inspired you:
It has been a long but extremely gratifying journey. I became a doctor by ”accident” since I wanted to be a lawyer. Once I finished my medical school, I was very interested in research, (especially molecular biology) and I decided to specialize in Pathology in Barcelona, Spain. It is through pathology that I came to Dermatology. I joined as a visiting fellow, the Dermatopathology department of the New York Presbyterian Hospital (Cornell University) in New York where I spent 4 years and became a Dermato-pathologist. Moving back to Spain, I worked as a Dermato-pathologist and started performing lasers treatments in Aesthetic Medicine. Laser Therapy became a real passion.
In Spain, as you know, the lock down was very strict. As such, my patients have been home for 2 months with little to no medical skin care. I noticed after 2 months that their skin was dull, dehydrated and wrinkled. The second noticeable skin change to be associated with the confinement period, is the worsening of the Melasma of most of my patients. This might be associated with less skin protection against solar radiations ( especially UVA that do still pass through windows), some increased exposure to Blue light ( increased screens time) and excess heat associated with more home cooking. Overall, the skin has changed because its daily environment has significantly changed but also because patients have modified their skincare routine, their eating and exercising habits.
What impact is the COVID-19 pandemic having on your patients’ behaviors & expectations?
People have had more time to look into information and the overall situation has boosted their critical sense when it comes to their Health and by association the health of their skin. They are coming back to the practice with more questions about skincare ingredients for example and/or have specific questions about some treatment options. As a matter of fact, they are more determined than ever to undergo treatments that provide instant gratification. The fact that they have seen their own face on computer screen so often and in such a close-up way, has made them realize that their skin was sometimes not optimal. For example, the flaccidity of the neck is clearly a newly expressed patient need that is completely driven by the vision of their own image on the screen.
Are there any skin complications associated with wearing a mask?
People having to wear a mask all day long, may experience oilier skin, clogged pores or an exacerbation of an underlying skin condition such as: Seborrheic Dermatitis, Eczema or Rosacea. Some people get even allergic to the fabric of the mask and/or the metal band on the nose. They need to be told how to care for their skin while wearing a mask.
What are the ways to prevent face-masks skin problems?
It is all about CLEANSING. Better to use a mild, fragrance-free cleanser to thoroughly remove skin impurities that accumulate during the course of day and prefer a light exfoliating cleanser providing an “ asymptomatic” peeling of the skin to protect and strengthen the skin barrier.
Has your Medical Aesthetic practice change post-COVID-19?
I have definitely seen some significant changes in the types of treatments patients are ready to do and that they were not ready to consider before. They have had more time to document themselves. They have not spent that much money on travelling or going out so they have saved some money. They want to “fix” what they have noticed on their skin that is now bothering them. More than ever, they want quick results that will be visible on their next Zoom meeting….
What is the role of LASER therapies in all of this? Tell me more about this passion you have for LASER?
I like technology in general and I like gadgets. LASER therapies are operator related. In the end, it is a tool that you have at your disposal but which requires a lot of precision. This is what I like about LASER. If you master the technology, you can achieve many many things through laser. Laser Therapy is an Art.
What is newest trend in LASER therapy?
Combining picosecond technology device with the fractional handpiece for Collagen Remodeling.
Picosecond pulse duration lasers ( PS) have altered the field of dermatology. PS were initially used in tattoo removal. They are firing in a very, very short time to break the ink in the skin. We realized over time and practice that they were also breaking scars and activating collagen remodulation. So recently, they have been demonstrated to be effective in the treatment of pigmentary disorders, acne scarring and photodamage2. As a result, a new fractional handpiece has been developed for this device for anti-aging & acne scars treatment. What is magic about this treatment is that you are able to achieve high quality remodulation without damaging the skin, no downtime, no redness and this is what everybody wants.
Are there still some role for ADJUNCTIVE SKINCARE in LASER TREATMENT?
Absolutely and more than ever. Skincare is actually part of the treatment. It is a combination. Skincare has more than a maintenance and/or adjunctive role, it is a booster of the treatment. When you perform LASER treatment, you create tiny, tiny holes in the skin so that if you apply a skincare product on top of the treatment, you are going to deliver the skincare active ingredients much deeper into the skin and have a much better targeted action.
Regardless of the Aesthetic Treatment being performed, all patients are recommended to use a healing cream (post treatment), some sunblock AND some Antioxidants. Sun protection is now a given but not yet the importance of prevention against pollution particles and other external factors through the use of Antioxidants. Antioxidants are essential to protect and strengthen the skin barrier function.
What does the future look like ?
The future is about BODY. We are completely Face centric but we need to consider very seriously options to reduce Body Flaccidity. This is obviously a super challenging field as it is much more difficult to get visible results on the body. If you tighten the face skin by three millimeters, this is a lot and visible but if you tighten the body skin by 3 millimeters, this is almost nothing. We need to get better devices but we also need to start educating our patients . We need their cooperation when it comes to the BODY. We will never be able to do it on our own. Aesthetic Treatment will need to be part of a Holistic program including exercising and appropriate diet. We are now moving into EARLY TREATMENT/PREVENTION. People are no longer waiting to notice deep wrinkles before coming to me, they come at a much younger age. This is great because it is in the 30s that early body treatment should start being performed.
Anything you wish to add?
In the end, we should keep learning, studying and being ethical. I think that in our field, we should remember these values to be good professionals.
What is your definition of Healthy Skin?
Healthy Skin looks fresh, glowing and has an even tone. To me, Healthy Skin is beautiful skin, a skin with wrinkles in harmony with skin age.
2. Torbeck RL et al. Evolution of the Picosecond Laser. A review of Literature. Dermatol Surg, 2019 Feb,45(2):183-194