Frequentley Asked Questions
A. Retinoids are derived from vitamin A and come in various strengths and go by the names retinol, retinoic acid, tretinoin, Retin A, and Tazorac, to name a few. Retinoids stimulate your skin to make new collagen while exfoliating your skin so the older layers are shed evenly instead of sticking to the surface, which makes the skin look dull. The regular use of retinoids will soften and smooth the texture of the skin.
The ultraviolet rays from the sun damage the skin and lead to wrinkling and age spots. Use a broad spectrum sunscreen with a SPF of 30 or higher every day, even on cloudy days.
A. Retinol-containing products are a good choice for all age groups and have been proven to be one of the best products for anti-aging. Regular use will stimulate your skin to make new collagen, smoothing existing fine lines while slowing down the appearance of new ones. The overall texture and tone of the skin will be softer, fresher, and more even. When you start to use a retinoid cream for the first time you will probably have some skin peeling or flaking, which is your skin exfoliating and is not a sign of allergy or intolerance to the cream. If you are very dry, try using the cream every other night for a couple of weeks and then use it every night. You can also apply your moisturizer on top of the retinoid, and it will not decrease the effectiveness of the treatment. Continue using the retinoid cream and your skin should adjust to it and stop feeling dry after 2 to 3 weeks. There are different strengths of retinoids, and you may start with a mild one increasing over time to stronger treatments.
A. You want to fade the spots that you can see now and also limit the number that appear in the future. To treat the brown spots you currently have, Intense Pulsed Light treatments are very effective. Most people have 2-4 treatments spaced 3-4 weeks apart, and see significant improvement in brown spots and freckles after each treatment.
These brown spots appear due to skin damage from sun exposure that is cumulative over time. Regular use of creams containing retinoids, and certain other products such as antioxidants, can help to treat the sun damage and slow down the appearance of new spots. You should also be diligent about applying sunscreen daily. Look for a broad-spectrum sunscreen with SPF of 30 or higher, and apply it every day regardless of the season.
A. Fraxel is a resurfacing and retexturizing laser treatment. Fraxel improves fine lines and wrinkles, scarring, general textural irregularities, and pigment abnormalities such as age spots, sunspots, and melasma. Traditional resurfacing lasers remove the entire skin surface and require meticulous wound care and a lengthy recovery period. There is also a risk of permanent scarring or discoloration. However, with Fraxel re:store® there is minimal downtime and very low risk of negative side effects.
Fraxel re:store® is a non-ablative laser, which means that it does not destroy the skin tissue. The re:store® laser treats thousands of microscopic columns of skin, stimulating the skin's natural healing processes to create new collagen, smoothing and repairing the skin. Think of your skin like a digital photo, made of thousands of pixels. Each Fraxel re:store® session improves the picture pixel by pixel, giving you smoother, more even, and healthier skin.
A. After your Fraxel re:store® treatment the treated area will be red and swollen for 2-3 days. Swelling can be minimized by applying ice packs for the first 24 hours and keeping your head elevated. The only aftercare required is to apply a moisturizing healing cream several times during the day, to keep the skin hydrated and encourage the healing process. You may feel a little itchy, but there should not be any pain or discomfort at any time after treatment. When the swelling and redness subsides you will have some skin flaking or peeling, similar to very dry skin, windburn, or sunburn. However, because you will be applying the healing cream so often, you may not notice any skin peeling.
Some people, usually those with darker skin tones, may notice that the skin looks a little darker before it begins to peel. The intensity of your reaction may also depend on the strength of your treatment.
If you have a history of acne you may have a flare of your acne after treatment. Sometimes people who do not usually have a problem with acne notice the appearance of acne-like bumps. This is temporary and easily treated with mild anti-acne medication.
A. Botox treats wrinkles that are caused by repetitive muscle movements, for example the lines between the eyebrows that appear when we frown. Botox is injected into the muscle that makes the wrinkle, relaxing the muscle so it cannot make the line. That allows the skin to smooth out and the line goes away. However, sometimes the line is so deep that it doesn't go away right away. It may take several months of maintaining muscle relaxation for the skin to become smooth, or you may need to have a small amount of filler (for example, Juvederm, Restylane) injected into the line.
Botox only works on lines that are caused by muscle movement, so it is used primarily for the forehead, between the eyebrows, and the crows feet around the eyes. It will not work on lines and wrinkles that are caused by skin sagging or loss of volume. That is why Botox is often used in conjunction with fillers. There isn't only one cause for wrinkles and the signs of aging, and therefore there isn't only one treatment.
A. Botox is a very effective method to treat excessive underarm sweating. The treatment takes only a few minutes and lasts for up to 6 months.
A. Milia are tiny cysts that look like white bumps or whiteheads. It is important to not try to pop them because even though they look like they are on the surface, they are deep enough that you will only cause irritation and make them worse. Milia may form due to the use of thick creams, rubbing the skin (especially in people who have itchy allergy eyes), and even for no identifiable reason. There are several ways to treat them and I often use a combination approach. I may start with a topical retinoid cream which over several weeks will exfoliate the skin and "open up" the milia. This may be enough to treat the smallest ones. Regular use of a retinoid will also reduce the formation of new milia. Larger milia usually need to be opened with a pinpoint-fine needle in order to remove them. Your skin tone helps determine the best method of treatment. Patients with darker skin tones have a higher risk of discoloration, so I am very conservative and very careful in their treatment.
A. Thermage is a non-surgical skin tightening treatment that provides subtle skin tightening and contouring. It absolutely works, but it isn't surgery so no one should expect the same results as with surgery. People choose Thermage because they want skin tightening without the risks of surgery, without the downtime, and without anyone knowing they have had anything done. They also choose Thermage as a maintenance or preventative treatment, to postpone or prevent the need for surgery, or to maintain their surgical results.
Thermage is a non-invasive procedure that uses radiofrequency energy to heat the deeper layers of your skin, stimulating your body's natural collagen renewal. It results in the tightening of existing collagen and the formation of new collagen. The result is a natural look with no downtime or scarring. People won't think you've had surgery, they will think you were on vacation.
A. This is different for each patient; some are able to use Tylenol or Advil after you leave the hospital, and others require pain medication as needed for 2-3 weeks. A general rule is that you should try to decrease your use of these medications as time passes.
A. Almost anyone can get Thermage. Thermage tightens your skin by heating the deeper layers of skin, tightening existing collagen and stimulating the production of new collagen. Because Thermage works with your body's natural processes, people will see the best results if their skin has less sun damage and they do not smoke. Age is also a factor, because the older we get the less responsive our collagen is. Thermage can be performed almost anywhere on the face or body where you have loose skin, but you cannot get Thermage in the same area that also has a tattoo. Many people choose Thermage because they get skin tightening without scars or downtime, and not all people or all body areas are appropriate for surgery. We often rely on Thermage to maintain our current look, delay or prevent the need for surgery, or maintain someone's surgical results over time.
A. Skin cancer is the most common type of cancer in the US. It affects men and women of all ages and skin colors, and will affect 20% of the population at some point during their lifetime. There are three common types of skin cancer: basal cell carcinoma, squamous cell carcinoma, and melanoma.
The most common type of skin cancer is basal cell carcinoma (BCC). BCC are almost always due to sun exposure; infrequently they can form due to certain types of burns, scars, or skin diseases. BCC is rarely life-threatening but it can grow and damage surrounding tissue, leading to considerable destruction and disfigurement. Squamous cell carcinoma (SCC) is the second most common type of skin cancer. SCC is also caused by exposure to ultraviolet light, from both the sun and tanning beds. SCCs grow and destroy the skin and, while uncommon, if left untreated some can get large and deep enough to spread to other parts of the body. Both BCC and SCC have a more than 95% cure rate if treated early.
The most serious form of skin cancer is melanoma. It is the least common of the three types, but the incidence is increasing. If caught and treated early, melanoma can be cured. However, if it is not caught in time it can spread to other organs and can be fatal. Melanoma often, but not always, occurs on sun-exposed skin. There are both environmental (sun exposure) and genetic factors involved in the development of melanoma, so it is important to practice safe sun habits and check your skin regularly. The risk of developing melanoma is higher if you have fair skin and eyes, many moles on your skin, or a family history of melanoma.
A. When the skin gets dry, which can happen year-round, it can get itchy and flaky. Microscopic cracks form, making your skin more vulnerable to irritation and inflammation. Keep your skin hydrated with the regular use of moisturizing creams. This will help repair those microscopic cracks and make your skin softer and smoother. A cream containing glycolic acid or lactic acid can be very helpful. These alpha-hydroxy acids help the skin hold onto water while shedding the flaky dry surface layers. If you are getting red, itchy patches of skin you may need a prescription for a hydrocortisone cream to treat the inflammation. Also, be sure to use gentle skin cleansers and fragrance free laundry detergents. Soap and fragrances can be irritating to sensitive skin.