Photofacial Sale 20% off in September

Photofacial Treatments 20% off 

Schedule your FREE consultation today: info@courienter or 692-6838.

Sale ends September 30, 2017

About Skin Revitalization/Photofacial Treatments 

Uneven skin tone is a common aesthetic problem we all notice as we age especially if we have an active lifestyle out in the sun. After years of unprotected sun exposure you will notice brown spots, freckles, sun spots. You may also notice unwanted vessels around your nose or rosacea on your cheeks. These common concerns can now be removed and you can reveal your glowing complexion with skin revitalization.

Skin revitalization is ideal for reducing the appearance of pigment on your face, chest or hands including age spots, sun damage, freckles or birthmarks. It is also the perfect solution for unwanted vessels on your face including spider veins, broken vessels or rosacea (redness/flushing of the cheeks). In just a few quick treatment sessions you will see a reduction in the appearance of brown spots and vessels leaving you with a more even skin tone and beautiful looking skin.

How It Works

 Icon™ utilizes optimized pulsed light technology which, unlike lasers, uses many wavelengths of light with special filters that deliver the best wavelengths to treat specific aesthetic conditions. As the handpiece glides over the area being treated, specialized pulses of light are delivered into your skin and target brown spots, sun- damage and vessels without causing harm to the surrounding skin. Once these targets absorb the energy they are destroyed and will slowly disappear through your body’s natural healing process. You will see your brown spots turn darker in color and flake off over the next few weeks. You may also see an immediate improvement in your vessels with a continued clearance over the next few weeks.

What To Expect On The Day Of Treatment

Before the optimized pulsed light handpiece is used, a gel is applied to your skin where you will receive treatment. You will also be provided eye shields to protect yourself from the light during treatment. The treatment will begin with the provider guiding the Icon™ handpiece over the treatment area. You will feel cooling while the handpiece is gliding over the treatment area to provide a comfortable session. You may also feel a slight rubber-band like snapping when the energy is being delivered into your skin which disappears almost immediately however, a warm sensation after the treatment is common. Depending on the size of the area, treatments can take just minutes.

After the treatment, the gel will be removed and a cooling gel may be applied to your skin. Bandages and ointments are not necessary due to the nature of the treatments being so minimally invasive. For a few days after your treatment, you may feel like you have a mild sunburn but can resume your normal day to day activities immediately following treatment.

If you are a laser skin revitalization patient, please be aware of the following:

  • Remove all make-up and lotions prior to the treatment.
  • At least 4 weeks prior to your appointment, discontinue unprotected sun exposure, tanning beds and tanning creams on the areas receiving treatment.

Frequently Asked Questions

What type of pigment can be treated?

 Icon™ is designed to treat age spots, sun damage and freckles on the face, neck, chest, arms, hands, legs and feet.

What type of vessels can be treated?

Icon™ is designed to treat spider veins and broken vessels on the face, neck, and some other areas of the body.

Am I a good candidate for skin revitalization?

Icon™ can be safely used on most skin types. During your consultation, we will determine if you are a good candidate for the procedure based on a variety of factors.

What type of result can I expect?

You can expect to see a decrease in the appearance of brown spots, sun damage and vessels for a more even skin tone. You will see a continued improvement over the first 6 weeks after your treatment.

How long does the treatment take?

Depending on the size of the area and the condition being treated, the sessions could range anywhere from 5-30 minutes.

What does the treatment feel like?

 Most people feel only a slight “snap” like a rubber band followed by warmth of your skin. You will also feel cooling on your skin as the handpiece glides over the treatment area to help in providing a comfortable session.

How many treatments will I need?

 Depending on the condition being treated, 1-3 treatment sessions are recommended for desired results.

How far apart are treatment sessions?

 Treatment sessions should be scheduled 3-4 weeks apart.

How much does the treatment cost?

 Treatment costs vary depending on the size of the area to be treated.  Schedule your FREE consultation with one of our providers today: 692-6838.

How does it work?

 Specialized pulsed of optimized light are used to target brown spots, sun damage and vessels without harming the surrounding skin. These imperfections absorb the energy delivered to your skin causing them to slowly disappear through your body’s natural healing process.

How quickly will I recover?

 You can resume regular daily activities immediately following treatment.

Are there any side effects?

 Immediately after the treatment, it is common to feel a mild sunburn-like sensation around the treatment site, which typically lasts 2-24 hours. Redness and/or swelling may accompany this and usually resolves in 2-3 days. We will discuss any other possible side effects and the necessary post-treatment care with you during the consultation

Schedule your FREE consultation today: or call 692-6838.




Abnormal Bleeding and Steroid Use By Dana Humes Goff, APN, CNM, DNP


If you’ve ever suffered from an inflammation in a joint or tendon, your healthcare provider may have prescribed a cortisone injection or a prescription of oral prednisone. These steroid preparations are commonly prescribed and can greatly relieve the symptoms of a painful joint, tendonitis, arthritis, or other bodily discomforts.

Unfortunately, for some women the use of steroids may result in abnormal uterine bleeding. Abnormal uterine bleeding (AUB) is defined as a change in menstrual frequency, duration, and/or volume, as well as bleeding between periods. In postmenopausal women, AUB is defined as bleeding 12 months or more after the cessation of periods.

The use of steroids interferes with the normal regulation of hormones by the hypothalamus, pituitary gland and the ovaries. When this relationship is disrupted, an imbalance of estrogen and progesterone occurs and too much estrogen remains in circulation. This can cause a thickening of the uterine lining, which results in AUB. An episode of AUB can be alarming for women and it warrants an evaluation by your gynecologist to determine the cause.

A comprehensive history is important when evaluating someone with AUB because the presentation can be complicated due to many causal factors. Since the incidence of AUB after steroid use is only 2.5%, and, since bleeding post steroid use many not present right away, it is often not considered a probable cause of abnormal bleeding.

Your gynecologist will perform the testing necessary to exclude a more serious diagnosis of AUB. Lab tests, an ultrasound, and a procedure to test the uterine lining are often recommended. While these procedures may seem unnecessary if your bleeding to due to steroid use, the diagnosis of post-steroid induced AUB is often made retrospectively after all other possible causes have been ruled out.

It is important that you are aware of the potential side effects of all medications you are on, including steroids. Women should be advised of AUB as a potential adverse effect after steroid administration and healthcare providers should be aware of this association when evaluating abnormal uterine bleeding.

Stronger together,




Top Questions Answered: HPV Vaccination By Renee Alwan Percell, MMS, PA-C


In 2006, a vaccination was made available that prevents cancer. It’s remarkable when you think about it like that. Wouldn’t you want to prevent cancer? This vaccination was the Quadraivalent HPV Vaccination that protects young adults against HPV Types 6, 11, 16, and 18. In 2014 the vaccination was updated to the 9-Valent HPV Vaccination that protects against 9 genotypes of the virus.

So what is HPV? HPV is a virus that is transmitted through sexual contact. Most HPV infections go away by themselves within 2 years. But sometimes the HPV infection will last longer and can cause certain cancers and other diseases. HPV is a virus that can cause cancer of the cervix, vagina, vulva, penis, throat and tongue. It is also a cause of genital warts. One in four people have HPV but it often doesn’t have any symptoms. Since there are no obvious signs of infection, it is easily spread and may only take one sexual encounter to become infected.

Does this vaccine really work? According to the CDC, clinical trials show that the vaccine provides close to 100% protection against cervical pre-cancers and genital warts. There has been a 64% reduction in HPV type infections among teen girls since the vaccine came out in 2006. The 9-Valent Vaccine has been shown to reduce cervical, vulvar, and vaginal cancer as well as penile cancers and warts at a greater than 99% rate.

Is the HPV vaccination safe? The United Sates currently has the safest, most effective vaccine supply in history. The CDC and FDA closely monitor any associated side effects/adverse events through the Vaccine Adverse Event Reporting System. All of the HPV vaccinations went through safety testing and clinical trials. There have been more than 60 million doses of HPV vaccine distributed since 2006 and there is no data to suggest that there are any severe adverse reactions linked to the vaccination. There are potential side effects but they are minimal and the same as many other vaccinations. The most common side effects are redness, swelling around the area and soreness that is temporary and will pass on their own without any treatment. Brief fainting can happen after any medical procedure including vaccinations. Your provider administering the vaccine may recommend staying 15 minutes after administration to prevent fainting.

Who should get the HPV vaccination? The recommendation is for girls and boys at the age of 11-12 as part of the adolescent immunization platform to help reduce the incidences of HPV infection. This group is more likely to complete the vaccination series versus an older teen thereby giving the child full protection against HPV. The vaccination is most effective in those who have not been sexually active, although the vaccination is recommended regardless of prior exposure to HPV. It can be started at age 9 and through age 26. It is recommended to have two doses at least six months apart.

What are you going to do? I’ve been asked by many fellow mothers about this vaccination. My children are younger so I hadn’t thought about it from a mother’s perspective until now. When I see statics like: 50% of new HPV infections occur in 15-24 year olds, my conclusion is that I will vaccinate my boys and daughter at the recommended age. The evidence based medicine is solid and supports the recommendation.


Renee Alwan Percell, MMS, PA-C



Understanding the Pap Smear By Dr. Kaleb Jacobs, DO, OB/GYN

No other cancer screening test has seen the success of the pap smear.

Sir John Williams, in the late 1800s first described what would eventually be known as carcinoma in situ (CIS) of the cervix, or abnormal cervical cells that remain in the place where they first formed. Some refer to CIS as precancer. Identifying cancer early when treatment options can prolong the length and quality of a person’s life is the cornerstone of preventive medicine.

In the early 1900s, several scientists discovered that changes inside cervical cells could be seen before cervical cancer was recognized. Pathologists in this early part of the century relied on microscopic examination of tissue biopsies, which meant there was a visible abnormality on the cervix which could be seen by the naked eye. This unfortunately translated to being “too late” for many women, because cancer had taken hold already.

In the 1940s, as the cervical smear was being developed, scientists learned that changes inside cervical cells could be seen several years before cancerous growths, visible by the naked eye, had developed. This process of viewing cervical cells under a microscope is termed cytology. The discovery that individual cells from the cervix have features which may be used to diagnose carcinoma (cancer) is attributed to the “father of cytology,” Dr. George N. Papanicolaou. His landmark publication in 1941 marked the beginning of cervical cancer screening with cytology and the test that bears his name, “the pap smear.”

The finding of abnormal cervical cells on a pap smear, which have the potential to grow into cervical cancer, was a breakthrough in preventative care for women. As a result, the pap smear over the last 40 to 50 years has decreased the incidence of cervical cancer by 75%.

Overtime, cervical cytology (the pap smear) as a means of screening for pre cervical cancer has changed. Most notably and recently, with the addition of testing for human papillomavirus (HPV). It is recognized that an infection with HPV is required for the development of most cervical cancers. It is also established that most women with HPV will NOT go on to develop cervical cancer. A woman’s healthy immune system and other personal risk factors, contribute to her ability to “clear” this virus, thus decreasing her risk for the development of cervical cancer.

Through extensive research and collaboration, two prominent societies, the American Society for Colposcopy and Cervical Pathology (ASCCP) and the American College of Obstetricians and Gynecologist (ACOG), have made recommendations for cervical cancer screening with the pap smear.

The most recent guidelines were published by the ASCCP in 2012 which changed the frequency of screening for women and placed a larger emphasis of combined screening with HPV testing. These changes were made to balance the benefit of screening with the risk of over (and sometimes unnecessarily) treating women for abnormal pap smears.

The nuances of the screening recommendations are many, but there are several steps you as a patient can take to maximize your health:

  • Annual Well Woman Exams with your gynecologist
  • Get pap smears per your gynecologist’s recommendations
  • Do NOT smoke or use other tobacco products – tobacco promotes the abnormal cells which can develop into cancer
  • Get yourself vaccinated or your children (girls and boys) vaccinated for HPV per the CDC recommendations

Last minute facts:

  • About 60% of women diagnosed with cervical cancer have NOT been screened in the past 5 years or longer
  • The lifetime risk of acquiring a genital HPV infection is about 80%
  • HPV-16 and HPV-18 (both covered by all of the HPV vaccines on the market) are present in upwards of 70-80% of cervical cancers

There is a myriad of information available about cervical cancer, screening, and HPV. If you would like more information please reach out to us on the portal.


Dr. Kaleb Jacobs







Precious Steps By Dr. Michele Couri, MD, FACOG, ABIHM

I recently read a very interesting article that discussed the optimal amount of “steps” that we should walk in a day to improve our health. Most of us are familiar with the “10,000 steps everyday” recommendation. This recommendation arose from a Japanese team of researchers who back in 2000 found that walking 10,000 steps everyday can improve blood pressure readings in men with hypertension. Subsequent research has shown that the 10K step habit reduces risks of cardiovascular disease, benefits mental health, assists in weight loss and improves body composition.

However, a couple of new studies suggest that actually getting 15,000 steps or more per day may be a better daily goal. These studies from the reputable medical journals Lancet and International Journal of Obesity both link getting a greater amount of daily steps in to significantly reduced risks of cardiovascular disease. The study in Lancet looked at an isolated group of people who live in the Bolivian Amazon. These people spend roughly five to six hours a day on their feet, engaging in physical activity. This translates to approximately 15,500 to 17,000 steps per day for women and men respectively. Based on coronary calcium scores that measure coronary artery disease, their hearts were on average 28 years younger than American’s.

The other study looked at 111 postal workers in the UK. They all wore fitness trackers, and those that took 15,000 steps or more each day had almost no risk for cardiovascular disease. Reversely, every extra hour that a postal worker spent sitting during a typical workday was associated with an additional 0.8 inches of waistline and a heart disease risk of 0.2% greater.

Now, realistically, we are all aware of how much time it truly does take to achieve 15,000 steps in a day. It can equate to 3.5 hours per day, and most of us do not have that kind of spare time. My advice to you is get at least 5,000 steps a day and ideally 7,500 or more. Just move more. Get out of your chair and move often throughout the day. Do not sit in one spot longer than one hour without getting up and walking for a few minutes.

One activity that I absolutely love and would encourage anyone to try is hiking. Three of my friends and I hike four to five times a week, both after work and on the weekends.   There are some amazing hiking trails in the Peoria area and now that we are moving into fall, the colorful scenery will be a perfect backdrop for this excellent form of exercise. I have found hiking to not only be a great way to get cardiovascular exercise, it also quickly racks up my step count and clears my mind, reducing stress and anxiety. Some of our favorite local hiking trails are Forest Park Nature Center, Grandview’s Pimiteoui, Robinson Park and Detweiller Park. We also enjoy Farmdale in East Peoria. I have included several pictures from our hikes this summer, and I hope the natural beauty in these pictures inspires you to get out in nature to hike and take those precious steps.

To Your Health,

Dr. Couri