Frequently Asked Skin Care Questions

Questions about one of our skin care treatments? Read our FAQ’s below

How do I know if I need Retin A? What does it do?

Retin A or Tretinoin 0.05% and 0.1% Cream are both FDA indicated for anti-aging, while 0.025% Tretinoin is indicated for acne.  However, the higher strengths will work well for both acne and anti-aging.  If I have a patient who has sensitive skin, I will start them on 0.025% Tretinoin and gradually increase the strength depending on their tolerability.  The trick is to not over-treat.  A small pea size is adequate to get the job done and application is important.  You should dot that small pea size around the perimeter of the face, and then work toward the center.  This way, you don’t get the bulk of the medication in the region that moves the most – the mouth area.  If nightly application is too aggressive (you are continually irritated), apply it Mon-Wed-Fri followed by your moisturizer.

Does Fractional Laser work on scars?  Will it reduce pores and dark circles?

When patients come in for Fractional Laser treatment, I always talk to them about expectations… In other words, “What is it that bothers you and what would you like to see as an end result” or “The benefit of lasering your full face is…”.  That way you and I will be approaching your treatment in a holistic manner.  Scar therapy is tricky and may take several treatments to reduce the appearance.  They will not necessarily be “gone”.  Numbing cream can distort the skin, so pictures should have been taken ahead of time so the scars (if you are only doing spot treatment) can be easily delineated.  Yes, fractional laser can refine large pores and make them less noticeable, but the laser by itself will not keep your skin refined.  You will need to use a program (medical) designed to make a physiological change in your tissue long term to support your laser investment.  Dark circles, depending on whether they are from vascularity or pigment may need a different approach.  If vascular, you need an ongoing treatment (home) that will help your body absorb the leaking blood molecules rather than them sitting under the fragile eye skin looking red-blue.  The laser may help reduce pigment under the eyes, but you will likely also need to use a hydroquinone prescription to assist the process.  In my office we typically treat the full face, concentrating on the areas of concern – scars, wrinkles, fine lines, pores etc.  This decreases the chance of pigmentary differences between the treated and non-treated areas.  I hope this helps!

I am 41 and I have oily skin with acne.  I clean it often, but still break out!

Most patients who experience acne and oily skin believe that it is related to cleansing the skin.  In reality, if you over cleanse the skin, it strips the barrier of the natural oils that protect your skin.  It also signals the skin to produce more oil, so it’s a catch-22.  At 41, your acne is more than likely related to hormonal changes.  I would recommend seeing a skincare specialist who can help identify what is going on with your skin and help formulate a plan to balance out your oil production while treating the acne.  The key is to get it under control.  In our office, the skin is evaluated with the Visia Compexion Analysis which identifies bacterial count (or no bacteria) which then helps us determine what course of action to take.  The skin is cleansed, then extractions are carefully done followed by an appropriate chemical peel to treat the acne (as well as aging).  Finally, a hydrator, SPF and Oxygenetix (breathable) Foundation are applied. Typically when a patient leaves the clinic, they comment that they look better after treatment than when they arrived!

I am currently using Ziana for my acne.  How can I even out skintone, acne redness and white patches?

You need to be using a good regimen along with the Ziana.  Are you spot treating with the Ziana or using it full face?  If spot treating, you are more likely to end up with lighter spots in those treated areas.  Ziana is meant to be used full face and will improve the overall appearance of your skin, skin tone etc.  A peel regimen will improve not only the appearance of your skin, but start the anti-aging process, making your skin stronger.  Although you could have a deeper peel for a quick fix, a series of lighter peels has been proven to improve the overall appearance and health of the skin.  A very nice program we do in our office is the DermaCeutic Peel which comes with its own homecare system.  Check it out and good luck!

Reverse the signs of aging from tanning with Retin-A, Jessners Chemical Peel for younger skin… literally!

Lucky for you, oily skin does help ward off those pesky lines and wrinkles!  I always tell my patients that 70% of their improvement and maintenance is what you do on a daily basis.  Retin A .05 and .1 are FDA approved for anti-aging.  Retin A thickens and strenghens the dermal layer, restructuring it.  When you are in your 20’s, it takes 28 days for your skin cells to turn over.  By the time you are 50, it takes 45 days, so the skin looks duller from the standpoint that those cells are not plump, round and light reflecting as you get older.  Retin A will help your skin regain that luminosity while it is making it stronger.   Chemical Peels are fabulous for keeping it that way and most of my patients come in every 4-6 weeks for those treatments.  The new Enerpeels by Glytone work exceptionally well.  The type of peel is dependent on the condition being treated. The bulk of the peel penetrates to the lower levels of the skin where it is needed, with less pooling at the surface.  Therefore, most patients have little to no outward side effect such as excessive peeling and flaking.

I would like to have a laser treatment for hair growth, but am afraid of dark spots and scars. I have light skin and dark hair. Who may be exposed to such damages or side effects? Thanks for your answer ahead of treatment.

The good news is that with light skin and dark hair, you are a perfect candidate for for Hair Removal, as the laser’s target is color; the darker the hair and lighter the skin, the better. With lighter skin, the laser doesn’t have to compete with color in the skin.  Having said that, the clinician should always evaluate your ethnic background when consulting with you, to determine if there is any potential to pigment, i.e. do you have American Indian in your background?  If there is a potential for pigmentaiton, the settings should be adjusted for that potential, which means the treatment is still effective, but it may take a few more treatments.  Safety is always first, followed by efficacy.  Ask questions about the laser as well.  The laser we use in our clinic, Lumenis LightSheer Duet, is FDA cleared to treat the darkest skin-type as well as tanned skin.  If your clinician sees that there might be a potential for pigmentation (especially on the face), a prescription called Hydroquinone is dispensed in order to suppress excess melanin production.  Infrequently, hyperpigmentation or hypopigmentation can occur, but is usually transitory.

Will IPL or FotoFacial work for broken vessels on the face?

IPL or FotoFacial works extremely well on redness or broken vessels over a period of time.  The light breaks down the vessel and it may looked resolved after treatment, but blood will partially fill those vessels up again, so staying on a regimen of 3 weeks between treatment (X 3-5 treatments) will greatly diminish the appearance of redness.  I always tell my patients that they will then need maintenance treatments (usually single treatment) a couple of times a year to maintain those results.  SPF on a daily basis will help prevent further damage.

What is PDT, PhotoDynamic Therapy?  (Blu-U for age spots, pre-cancerous spots, Actinic Keratosis, Acne)

PhotoDynamic Therapy is a combination of Blu-U and Levulan PDT, a 2-part treatment, unique because it uses a light activated drug therapy to destroy AKs. How does it work?  For pre-cancerous lesions, called Actinic Keratosis (AK), Levulan Kerastick Topical Solution is applied to the AK. The solution is then absorbed by the AK cells where it is converted to a chemical that makes the cells extremely sensitive to light. When the AK cells are exposed to the BLU-U Blue Light Illuminator, a reaction occurs which destroys the AK cells. We often combine lights; Intense Pulsed Light (IPL) and Blu-U which takes the treatment to the next level for photo rejuvenation.  The purpose is to treat the tissue at different depths to increase efficacy.  Great Treatment for age spots, Aks, but also for Acne!  With Acne, the Levulan Kerastick Topical Solution is applied to the area with acne; full face, back etc. The solution is then absorbed into the follicle where it is converted to a chemical that makes the p-acne bacteria, the leading cause of acne, extremely sensitive to light. When the p-acne bacteria is exposed to the BLU-U Blue Light Illuminator, a reaction occurs which destroys the p-acne bacteria.

Can IPL burn your skin?

Every laser can be dangerous.  However, they are only as dangerous as the provider performing the treatment!  In other words, aesthetic lasers are designed to treat various skin types safely, from light to dark (depending on the technology), fragile skin to thick skin, 18 to 80 years of age…  so there are many settings available – from conservative to aggressive.  The provider must have an in-depth awareness (thru proper training and experience) of what can be accomplished, taking all of these factors into consideration.  It is far better to treat multiple times than to push the envelope and leave someone with scars or marks for life.  Do your research – ask for referrals.  Ask your doctor or clinician to help set your expectations.  Are you a good candidate for the treatment?  Is there pre-care and post care set up to prevent adverse effects?  Don’t have a treatment from a facility simply because the treatment is “cheap”.  These are extremely sophisticated technologies that employ an educated and knowledgeable approach to treatment!

Should IPL/FotoFacial for pigmentation be done on the arms?  I had it done and have scabs in the area that was treated.

Although IPL can be done successfully on the arms, that area can be tricky.  The best way to approach treating pigmentation on the arms, shoulders is to 1) pretreat with a glycolic lotion,  2) have your clinician perform 2-3 chemical peels in the area to reduce excess pigment and break it up.  Then a series of IPL can be done carefully (using a longer wavelength) and meticulously to finish up the process.  This technique will result in an even, favorable result.  Also, I’m not sure if you were intimating that there were scabs after the treatment, but this is not the desired end point.  My suggestion is to use SPF to the excess, let that skin heal fully, at least 4 weeks, then have your doctor or his/her clinician treat as recommended above to even out the skin.  We often have patients come to us to “fix” a problem and have seen this result; it will take some time, but I am confident if done correctly, you should not have an undesireable outcome.

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