Blog with Dr. IrwinCategory >> 0 Why do some areas of the face seem to require more Botox?Posted in Crows Feet, Botox, 2010 on Dec 21, 2010 | Permalink HI Dr. I, I wonder if you can tell me why certain areas such as the eyes (one in particular) would require so much Botox relative to the rest of the areas/face? What would you consider "a lot" of botox (units) for the crows feet on one side? I'm 40 years old and I have been getting botox for about a year. I have tried different doctors (just 2)but the results have been similar? Thank you for your time.
This is a good question but it's a little hard to answer without seeing you. Let's take crows feet, for example. I have some women in their 30-40s who have very active muscles here and... more What do you recommend for hollow areas under the eyes?Posted in Restylane, Eyelid Treatments, 2010 on Dec 21, 2010 | Permalink Hi Dr. Irwin, what type of treatment do you recommend for the hollow area underneath the eyes? I'm 28 and tired of people telling me I look sick or tired, but due to some weight loss, the area underneath my eyes has lost volume. Any suggestions? Thank you!
At age 28, you definately do not need surgery under eye hollows. Look for a truly expert injector in your area and depending on where you live this may take some time. When you call,... more
Hi Dr. Irwin-
I believe I either have hormonal or cystic acne along my jawline and neck? I also have scarring in this area due to the acne. Do you have any recommendations for products to use?
Thanks so much!
Sincerely,
Amy
Dear Amy - Most of the "over the counter," drugstore type products and acne care systems like Proactive, have either benzoyl peroxide, salicylic acid, alpha hydroxy acids or retinol in... more
Help! I'm having problems with irritation from Renova/tretinoin.Posted in RenovaRetinoids, Renova Retinoids and Vitamin A Creams, 2010 on Dec 18, 2010 | Permalink I used Renova for six years and Tretinoin for a year. Tretinoin worked fine for a year then it started irritating my skin a lot (despite using it on top of a moisturizer), excessive peeling of the skin, cuts, scratches etc. Why am i not able to tolerate the product, is it an allergic reaction? If i am allergic to Tretinoin will i be allergic to all its cousins. Should i go back to Renova or can you recommend a gentler version? If i cant go back to tretinoin or its cousins, what other products do you recommend for wrinkle correction.
So here are some things to think about. When you started getting irritation from the tretinoin, had you been given a different strength (like a 0.05% versus a 0.025%) or a different... more I have very old hands! They have age spots, wrinkled and thin skin, and show very large blood vessels. What can I do to get a fresh start with them? I take great care to eliminate sun damage to any exposed skin, consistently, every day, no matter what. So I would like to reset my hands to a much much earlier time and I WILL ensure that they never get sun exposure again.
I sometimes joke with my patients that hands and neck are now the "holy grail" of skin because it's tough to really improve these areas. Progress on "deaging" hands is being made... more Bumps on my son's face - what to do?Posted in Lumps bumps moles, 2010 on Dec 09, 2010 | Permalink My son is 11 soon to be 12. About 4 months ago he developed a patch of bumps on his face that at first I thought was just acne developing because of his age. The bumps are hard, small and white and can not be popped. I took him to his regular doctor and she said that they were a type of wart that would go away in a few months. Since then a couple of them have been scraped off during rough play and bled when they did. Just in the last 2 weeks he has developed more on other areas of his body. About a dozen on his back, a handful on his chest and 1 or 2 on his leg. Any ideas? Any suggestions for treatment?
Please go back to your dermatologist to get more options for this. These sound like a very, very common problem in children called molluscum contagiosum (caused by a virus like... more
I'm allergic to the DHA in self-tanning products. What now?Posted in Skin Care Products, Self Tanning, 2010 on Dec 09, 2010 | Permalink I am allergic to dihydroxyacetone the active ingredient in most self tanning products. The only alternative I'm aware of is erythrulose but I cant find a self tanner which only uses erythrulose as the active ingredient. Can you provide any suggestions.
I really do not know of any ingredient that works as well as the DHA (dihydroxyacetone) does. One of my patients tried eating so many carrots that she turned a slightly orangy color but I... more
What can I do about excess skin on the abdomen after children?Posted in Thermage and Radiofrequency Devices, Thermage, Body Treatments, 2010 on Dec 09, 2010 | Permalink Hello, I am curious as to the best recommended treatment for excess skin on the abdomen after childbirth. I was 115 then became pregnant and gained 45 lbs. My youngest is now 8 and I would really like to be comfortable in my own skin again but cringe at the thought of tummy tucks. Thank you.
In my opinion, plastic surgery is still the best option for this problem. If you have just a tiny bit of excess, you could consider body Thermage but I really don't see much result from... more
Help! I'm confused about my products.Posted in Skin Care Products, Skin Care, Acne, 2010 on Dec 04, 2010 | Permalink Hi, I recently went to my aesthetician (referred by my dermatologist), and she recommended that I start a new routine. AM- Wash, Moisturize, Sunscreen. PM- Exfoliate, Tone (Toner includes only water, latic acid, citrix acid, aloe vera), moisturize, and use Ziana as needed. My question is, is this too much exfoliation? Would it counterproductive to use Ziana and the Toner at the same time? Also, shouldn't there be an antioxidant somewhere? I only use Ziana on a spare basis, should I use a Retinol on a more consistent basis for anti-aging?
I think many, MANY women are confused about products. So let's work through this logically. Let's think am and pm. I'm assuming you have some acne because you were prescribed Ziana,... more Why we love Paula Begoun!Posted in Skin Care Products, Skin Care, 2010 on Dec 04, 2010 | Permalink I love Paula's Choice skin care. Her radio show is how I found you. I trust you because she trusts you. Why don't you recommend her product or is it a conflict because she is your patient?
I do love Paula too and I think she provides an incredibly invaluable service to the beauty community with her objective voice and her excellent brain. And another plus, she's really funny... more That Dr. Oz episode with Radiesse for jowls.Posted in Restylane, Radiesse, JuvedermRestylane, Juvederm and Restylane, Jowlsjawline, Jowls and Jawline, 2010 on Dec 04, 2010 | Permalink Dr. Oz had a cosmetic dermotologist on yesterday addressing the issue of jowls- uck! She treated a woman on the show with RADIESSE- instant results and lasts up to 1 1/2 years. Was really quite amazing and was wondering what your thoughts are on this. Thank-you Dr. Irwin! Connie
This episode was a few weeks ago but I thought it was interesting. I generally don't like Radiesse in the cheeks because I think it looks too stiff and a little wooden when the face is... more Complications after a TCA eyelid peel. What should I do?Posted in Peels, Eyelid Treatments, 2010 on Nov 28, 2010 | Permalink Hello,
I had a tca peel done one month ago on my lower eyelids. one month later they are red/brown. my doctor prescribed hydroquinone 4%. i woke up this morning and they look very red on the area where the peel was performed. should I keep using the hydroquinone cream and will the
redness lessen over time. thank you.
You bring up several good points. With TCA peels or almost any procedure, there is the procedure itself and then there's what comes afterwards. When there's a complication, sometimes... more Does running make your face sag more?Posted in Jowlsjawline, Jowls and Jawline, 2010 on Nov 28, 2010 | Permalink Does running make your face sag more?
No, fortunately not! Sagging is due to the gradual loss of volume in the face when fat pads, skin thickness (the dermis), and bone thin over time, combined with damage (mostly from sun) to... more
I am 46, what is best way to treat the loose, slightly crepey skin up and down the neck?Posted in Necks, Lasers, 2010 on Nov 28, 2010 | Permalink | View Comments (1) I am 46, what is best way to treat the loose, slightly crepey skin up and down the neck?
In my opinion, the best way to treat this skin non surgically is the fractionated/pixilated CO2 laser. Think 1-3 treatments with 2-6 months in between treatments. Full results are... more How many skin types do we have?Posted in Skin Care Products, Skin Care, 2010 on Nov 28, 2010 | Permalink How many skin types do we have?
I had to think about this question for awhile because it depends on who you ask. Looking at it one way, Dermatologists are taught to think skin types I-VI which refers only to the amount... more Is a fractionated CO2 laser safe on darker skin types to treat acne scarring?Posted in Lasers, Carbon Dioxide Lasers, African american skin, Acne Scars, 2010 on Nov 28, 2010 | Permalink Hi Dr Irwin
I was just browsing your website doign research on Fractionated CO2 lasers. I see it mentiond that it can be adjusted on more darker skin types to be safe. Can you elaborate if this is a viable and safe option for treatment of acne scars (ice pick/rolling types) on darker skin types? I see various websites listing CO2 as not safe on darker skin types though so i am curious if you can shed some more light on how it works on darker skin types and what are potential complications and recovery times especially for acne scars
Thank you for asking this. The answer is yes with some restrictions. First, you must go to an expert who has a lot of experience because the right settings really matter. They need to... more
I have rosacea and its not too bad but I want to stop it if I can. Is there a product to help me?
Please, please, please see your dermatologist or primary care doctor. Over the counter products do not usually work well for rosacea no matter what the marketing says. Prescription... more
What is the difference between Thermage and Sculptra?Posted in Thermage and Radiofrequency Devices, Thermage, Sculptra, 2010 on Nov 28, 2010 | Permalink Hello I am a 44 year old female, who's considering a thermage or scupltra treatment to tighten around the jawline. What is the difference of the two and which one would you recommend?
Here are the two links that should help you (Sculptra) (Thermage). Sculptra is an injectable liquid that adds volume and lift by slowlng building your own collagen. Thermage is a... more
Is the Accent system a good way to tighten skin under the chin?Posted in Thermage and Radiofrequency Devices, Thermage, Radiofrequency systems, 2010 on Nov 20, 2010 | Permalink Dr Irwin I want to try to tighten the skin under my chin. My dermotologist center says accent lazer is the best way to go with a series a 6 treatments over 6 months. What do you think. is accent the best way to go?
The Accent system is a radiofrequency (read sound waves) based system that uses as it's marketing point that it uses 2 types of waves in the same system. In my opinion, there really is no... more Can I use my TNS retinol product/Renova on top of my TNS Esstential Serum?Posted in Skin Care Products, Skin Care, RenovaRetinoids, Renova Retinoids and Vitamin A Creams, 2010 on Nov 20, 2010 | Permalink Can I use my TNS retinol product/Renova on top of my TNS Esstential Serum?
There have been no studies on it but I have used TNS Retinol over TNS Essential Serum for several years. Dr.... more
What do you think of Jan Marini products? I use the Jan Marini skin care regimen.Posted in Skin Care Products, Skin Care, 2010 on Nov 20, 2010 | Permalink What do you think of Jan Marini products? I use the Jan Marini skin care regimen. In addition, what do you think of the daily antioxidant sunscreen. I really like that product because it seems to soak in right away.
I should look at that line again. I did a few years ago but things can change. You bring up a good point though which is that I really don't believe in using a specific line of... more
What do you think of Dot therapy for skin tightening on the face and neck?Posted in Lasers, Carbon Dioxide Lasers, 2010 on Nov 20, 2010 | Permalink What do you think of Dot therapy for skin tightening on the face and neck?
I've been working with this laser for about 7 months now fairly intensively and I am very impressed. It's actually exceeded my expectations and those of you who read me frequently know I... more I am a huge fan of yours! If I lived in Seattle, I would choose you for my doctor. I love your website. My question is about my 17 yr. old son. He has a big problem with sweating under his arms no matter what deodorant he uses. He sweats through his shirts and is very self conscious about it. What else could we do? Is this a common problem for this age? I remember I was like that in high school as well. I think a lot of it is just being nervous in school. Any advice you have, would be greatly appreciated. I'm concerned about the really strong deodorants, whether they are really safe or not. Thank you in advance.
Thank you for the nice compliment. So there are 3 things for this problem. First, the antiperspirants (I'm going to assume you meant that since deodorants mask the odor only), which... more Is this hydroquinone product okay to use around the eyes?Posted in Pigment problems, Eyelid Treatments, 2010 on Nov 20, 2010 | Permalink I have a question regarding Hydroquinone. I asked my dermatologist about the dark circles under my eyes and also a few brown spots I had. He recommended 8% hydroquinone in 0.01% retisol, to be used twice a day. I am finding that it seems to make my skin more sensitive and I have been getting these red itchy spots. Will this pass or is this product maybe too strong. Any recommendations for these problems that may be better than this. I am 54 years old.
Thanks
In my opinion, this compounded 8% cream with retinol is WAY too strong to use around the eyes. I'm surprised you are not completely red, itchy and puffy. You must have very tough... more
Is there a good makeup for dry, sensitive skin?Posted in Skin Care Products, Skin Care, 2010 on Nov 14, 2010 | Permalink What makeup do you recommend for dry, sensitive, rosacea skin? When I use mineral makeup, I feel and look dry, not glowy. I am in my late 40's, and want to find something that won't make me feel tight, and look natural. Thanks!
I have a couple of ideas for you. Have you tried the Laura Mercier tinted moisturizer, SPF 20? It's lovely, goes on well with a natural look and has a little SPF in it. Another... more
Is thermage relatively safe now? I am interested in getting this procedure done but I don't want to risk facial fat loss.Posted in Thermage and Radiofrequency Devices, Thermage, 2010 on Nov 14, 2010 | Permalink Is thermage relatively safe now? I am interested in getting this procedure done but I don't want to risk facial fat loss. If so, can you recommend a good thermage doctor in the bay area? Thank
It's very safe. The reports of fat loss were with the first generation of Thermage tips and had nothing to do with the technology. Back then, there were individual doctors who were using... more
What is the difference between the "DOT" and Thermage?Posted in Thermage and Radiofrequency Devices, Thermage, Carbon Dioxide Lasers, 2010 on Nov 10, 2010 | Permalink --------------------------------------------------------------
Dr. Irwin,
I am 59 years old and am considering DOT therapy. However, I do not know a single person who has actually had this proceedure. Can you explain the difference between Dot and Thermage?
Thanks so much for your time...Brenda
Dear Brenda - There is a big difference because Thermage uses radiofrequency (a sound wave) and has a gentle skin tightening effect. There is no recovery time from it in general because... more What do you think of Obagi cosmetics?Posted in Skin Care Products, Skin Care, RenovaRetinoids, Renova Retinoids and Vitamin A Creams, Pigment problems, Cosmeceuticals, Brown Spots, 2010 on Nov 09, 2010 | Permalink What do you think of Obagi cosmetics?
I think I'll just tell you the pros and cons in my mind because it's a little complicated. Obagi was one of the first doctors who tried to base skin care more on science, and for that I... more What can I do about chronic eczema that's now involving my face too?Posted in Skin Care Products, Skin Care, Moisturizers, Dry Skin, 2010 on Nov 09, 2010 | Permalink I'm 28 years-old and have battled eczema since birth, mostly on my hands, the crook of my elbows, and behind my knees. Within the past few years, the eczema has appeared on my face, neck, and ears. I've been using a hydrocortisone cream, which helps a lot, but I'm worried about the long-term consequences of using such a product several times a day, especially on my face. Is there a cortisone-free product (OTC or Rx) that will do the job? Also, I'm wondering if my shampoo could be causing/exacerbating my facial eczema. I've heard sodium lauryl sulfates are rather sketchy. Is there a SLS-free shampoo you recommend? Thanks!!!
You didn't tell me if you've been seeing a dermatologist? Please, please, please get thee to one right away if you haven't. And yes, over time, the chronic steriod use (even... more What can I do about chronic eczema that's now involving my face too?Posted in Skin Care Products, Skin Care, Moisturizers, Dry Skin, 2010 on Nov 09, 2010 | Permalink I'm 28 years-old and have battled eczema since birth, mostly on my hands, the crook of my elbows, and behind my knees. Within the past few years, the eczema has appeared on my face, neck, and ears. I've been using a hydrocortisone cream, which helps a lot, but I'm worried about the long-term consequences of using such a product several times a day, especially on my face. Is there a cortisone-free product (OTC or Rx) that will do the job? Also, I'm wondering if my shampoo could be causing/exacerbating my facial eczema. I've heard sodium lauryl sulfates are rather sketchy. Is there a SLS-free shampoo you recommend? Thanks!!!
You didn't tell me if you've been seeing a dermatologist? Please, please, please get thee to one right away if you haven't. And yes, over time, the chronic steriod use (even... more What do you think of Obagi cosmetics?Posted in Skin Care Products, Skin Care, RenovaRetinoids, Renova Retinoids and Vitamin A Creams, Pigment problems, Cosmeceuticals, Brown Spots, 2010 on Nov 09, 2010 | Permalink What do you think of Obagi cosmetics?
I think I'll just tell you the pros and cons in my mind because it's a little complicated. Obagi was one of the first doctors who tried to base skin care more on science, and for that I... more What can I do about chronic eczema that's now involving my face too?Posted in Skin Care Products, Skin Care, Moisturizers, Dry Skin, 2010 on Nov 09, 2010 | Permalink I'm 28 years-old and have battled eczema since birth, mostly on my hands, the crook of my elbows, and behind my knees. Within the past few years, the eczema has appeared on my face, neck, and ears. I've been using a hydrocortisone cream, which helps a lot, but I'm worried about the long-term consequences of using such a product several times a day, especially on my face. Is there a cortisone-free product (OTC or Rx) that will do the job? Also, I'm wondering if my shampoo could be causing/exacerbating my facial eczema. I've heard sodium lauryl sulfates are rather sketchy. Is there a SLS-free shampoo you recommend? Thanks!!!
You didn't tell me if you've been seeing a dermatologist? Please, please, please get thee to one right away if you haven't. And yes, over time, the chronic steriod use (even... more Problems with hair removal and brown spots with light olive skin.Posted in Sun Protection, Pigment problems, Melasma, Hair Removal, Hair, Brown Spots, 2010 on Oct 22, 2010 | Permalink Dr Irwin, Thanks for sharing your expertise! My qs is about hair removal and lentigoes.
Which specific laser do you recommend for facial hair removal for type 2/type 3 skin? (light olive with dark hair)? What is your opinion on LightSheer v/s Alexandrite v/s ELOS (by Syneron)? I have had 7 treatments of ELOS but the hair still comes back (though not any more within the 6 week interval, more like 12 weeks). Is it true a traditional laser will get faster results than ELOS?
The clinic also used ELOS on another setting on my lentigoes but after 2 x crusting and improvement, it didnt reduce the pigment any further. Of course i use sunblock daily (la roche posay meroxyl sx 50+ and clinique spf 15 powder on top of that - based on your recommendation for layering- thank you!), but despite this, this summer the spots all came back, with vengeance- there is now more general melasma under the eye area on both cheeks which looks like it will become one giant patch. I'm 42, and don't take any medication or hormones.
In my opinion, the Elos Syneron system is not the best for hair removal. Best choices for you with light olive skin would be the LightSheer or any of the Nd:Yag based systems. If the hair... more Why would Botox wear off quickly suddenly?Posted in Botox Mistakes, Botox, 2010 on Oct 21, 2010 | Permalink Dear Dr.I, Why would botox wear off in a month? I have done botox on my forehead and crows feet in the past and it lasts 3-5 months. I just had the squint lines (between the eyebrows and I realize my lines are back???? Why would it last such little time? Thank you
I'm glad you asked this because there are several different reasons. I'm assuming you went to your usual doctor and that they are mixing the Botox the same way each time. If the... more Pregnancy and cosmetic procedures - what is advised!Posted in Pregnancy, Botox Mistakes, Botox, 2010 on Oct 21, 2010 | Permalink Hi Dr.I- I have sun spots that I manage with IPL treatments and the hydroquinone 4% and I love Botox for my crows feet. I just found out I am pregnant-8 weeks (completely unexpected) and I just had an IPL and botox prior to finding out. How damaging can that be? I love your site and appreciate your time. Thank you.
Okay ......... let's take these one by one. The IPL is just light on the surface of the skin. and I have never any reports of pregnancy related problems. We do not treat pregnant... more What do you think about sublative rejuvenation? It claims to promote collagen growth.Posted in Radiofrequency systems, Lasers, 2010 on Oct 17, 2010 | Permalink | View Comments (1) What do you think about sublative rejuvenation? It claims to promote collagen growth.
I'm glad you asked about this because there are a couple of good issues that you raise. The first is about collagen growth. All laser and radiofrequency (sound wave) technologies... more Is using Retin A too much for the skin after Fraxel?Posted in Skin Care Products, RenovaRetinoids, Renova Retinoids and Vitamin A Creams, Fraxel laser, 2010 on Oct 17, 2010 | Permalink I have had several successful Fraxel ( Restore) treatments and now have a light treatment once a year for maintance. I hear that Retin A is wonderful for the skin. My question is.. Is Retin A too much after Fraxel? I am 57 and have good skin. I wanted to know if the kind of Fraxel treatments that I have is enough for my skin? Thanks
No, it's not too much. It would be a great way to help maintain the benefits you got. Just be sure you are really sun protecting. I often advise stopping it a week or two before a sunny... more How much sunscreen is enough on the face?Posted in Sunscreen, Sun Protection, Sun Damage, Skin Care Products, Skin Care, 2010 on Oct 17, 2010 | Permalink How much sunscreen do I need to apply to my face to get the full SPF?
I read that you need 1/2 teaspoon. I measured it and tried to put it on but it was difficult to put that much on my face. Is this the correct amount and if I don't put that much on am I not getting that much protection? Does it differ with chemical versus physical sunscreen?
I know what you mean - it's a lot. But I think common sense can apply here and these are guidelines really. If I were outdoors, midday in Hawaii and surfing, I would apply all that and... more Do I travel to other places?Posted in Finding a Good Doctor, 2010 on Oct 17, 2010 | Permalink Some MD's travel to different places to offer their services. Is there any chance of coming to Califorinia? I would love to make an appointment with you. Are the md's that you recommend on your site ones that you highly recommend as an alternative to yourself?
Dear Maggie - Thank you for the compliment and you are kind to ask. Until my 3 high school age children go to college, I'm really staying in Seattle. You can understand why! I DO... more Are there good home glycolic peels?Posted in Skin Care Products, Skin Care, Peels, 2010 on Oct 17, 2010 | Permalink I have loved every product recommendation you have given on your Website and it your book. I am wondering if you recommend any at-home glycolic acid peels to use?
Thanks for all your expert advice!
The home peels have to be made to be so gentle that I really don't think they do much except as a nice refresher before a party, for example. You're probably better off just using a good... more A recommendation for a good Vitamin C serum?Posted in Vitamins for Skin, Vitamin C, Skin Care Products, Skin Care, Antioxidants, 2010 on Oct 17, 2010 | Permalink I was wondering if you could recommend a good Vitamin C serum that I could purchase in Canada. Can I use a moisturizer with the C serum.
I use Retin A at night and was considering using a c serum and moisturizer in the morning. I am 54 years old.
Thanks
The SkinCeuticals (try the Phloretin CF or the AOX 10 or AOX 20, the C&E Ferrulic is probably the best but a little more irritating) and Cellex-C serums are excellent. They can be a little... more Is Lac Hydrin 12% good for moisturing and also exfoliating?Posted in Skin Care Products, Skin Care, Exfoliation and Scrubs, Exfoliating, Dry Skin, Body Treatments, 2010 on Oct 17, 2010 | Permalink Is Lac Hydrin 12% good for moisturizing and also exfoliating? Can it be used daily on the face?
Thank You, Francie McPherson
Francie - you are completely cracking me up here!!!! (Francie is my absolutely wonderful mother-in-law!). You can always just call me! But to answer the question - Yes - LacHydrin 12%... more Can brown spots be something serious?Posted in Skin Cancer, Pigment problems, Eyelid Treatments, Brown Spots, 2010 on Oct 11, 2010 | Permalink I was told by my family physician to use "Mother of Pearl" cream to help with a brown spot I have on the side of my eye since it is getting larger. After reading your tips on brown spots, I am making an appointment with a dermatologist to make sure it is nothing serious.
Thank you for writing this. You did exactly the right thing!! There are brown spots that can be melanomas or lentigo maligna or "pre melanomas" - also called dysplastic nevi. I... more
Is it okay to have Thermage with metal in my body?Posted in Thermage and Radiofrequency Devices, Thermage, 2010 on Oct 11, 2010 | Permalink I had disk replace surgery and have titanium screws and braces to hold them in place. I would like to know if this would interfer with Thermage on my face?
Yes - it is fine to have a Thermage treatment. Just let your doctor know too. I have double checked with the company on this and my patients have had no problems. Dr.... more
Chloasma/melasma - are lasers safe especially on darker skin types?Posted in Peels, Melasma, IPL, Fraxel laser, Carbon Dioxide Lasers, Brown Spots, 2010 on Oct 11, 2010 | Permalink Hello Dr Irwin,
I have very lage dark brown spots on each cheek which appeared in 1999. They have been diagnosed as chloasma. I consulted three dermatologists between 2000 and 2005, two of whom advised me that laser or peeling techniques were not recommended for Asian skin types , I have Indo-European origins. Therefore I have only used depigmenting creams which had no effect and in fact the spots have increased in size in recent years.
My question is: have laser techniques advanced since 2005 and are there any now which would provide a good result on my skin type?
Thank you So first, I'm assuming you've had these spots looked at in the past year by a dermatologist to make sure they are not skin cancer! Then, this is a tough question and not all dermatologists... more Botox, Fillers and FaceliftPosted in Sculptra, JuvedermRestylane, Juvederm and Restylane, Finding a Good Doctor, Botox, 2010 on Oct 09, 2010 | Permalink Should one wait until your Botox has relaxed and all fillers out when you decide to have a facelift, so that the doctor can tell how much skin to lift?
I think it makes sense to let the more temporary fillers like Juvederm/Restylane/Perlane - all the hyaluronic acid fillers - wear off so you can get the optimum result from the surgery. ... more I had a IPL done which caused severe swelling for about 5 days! She did not use gel prior but did afterwards. The tissue still seems a bit hard and I ended up with sags of fluid under the eye. When I call my doctor they put me on a steriod. Is this normal?
There are a lot of different IPLs on the market now so I can't claim to have looked at them all but....... most systems use gel on the skin between the crystal and the skin. It's hard to... more Can skin on the neck be tightened non surgically?Posted in Necks, Lasers, Carbon Dioxide Lasers, 2010 on Oct 09, 2010 | Permalink Is there anything sort of a face lift to tighten the skin on the neck. I had a neck lift (muscle too) 5 years ago and there is still loose skin on one side. Surgeon said a face lift will fix it but I do not need a face lift.
Even a year ago, I probably would have said "no, don't waste your money." But the newer fractionated CO2 lasers look promising, although the data is early and sparse. It can often... more HI Dr. I, I was wondering what you recommend for overall volume for my face? I lost about 20 pounds 3 years ago, along with turning 40. I have high cheek bones but my eyes and mouth area make me look gaunt and older. I have used fillers for the smile lines and that does help but I need an overall plumping. From your sight I know a laser would be the next thing to do, but which one would give the most volume? I have a month off coming up incase downtime is required but I am interested to get your opinion since I follow your sight closely ;) Thanks for your help.
I think this is a common misconception - that a laser can create volume - so thanks for asking this! Lasers are best used on the face for color problems (too red, brown spots), or
What can I do about melasma?Posted in Pigment problems, Melasma, Brown Spots, Blotchiness, 2010 on Oct 03, 2010 | Permalink | View Comments (1) Dr. Irwin,
I was diagnosed by a dermatologist a few years ago with melasma. I have also had slight acne and with my pregnancy 2 years ago my melasma was really dark. I am 35 years old and the melasma and acne started in my late late 20's. I have had numerous laser treatments (ip-Fraxel) and they helped some and broke up some spots but I still have really dark spots all over my face. It is uneven all over and very oily. I'm searching for a good glycolic peel but have not decided on anything. Do you have any recommendations on what to try now or what type of peel to use.
I used the Obagi for months and still use some of the products but the hydroquinone didn't seem to make a difference.
Help
DWebb
I still think that melasma is the toughest problem to treat because there is no cure for it - just good control. You will absolutely need the help of a dermatologist who's interested in... more Problems with Sculptra.Posted in Sculptra, Finding a Good Doctor, 2010 on Oct 03, 2010 | Permalink | View Comments (1) DR Irwin I lost weight I was reccommended sculptra by a doctor I trusted she didnt tell me about side affects she injected sculptra under my eyes I have lumps nodules its been 12months volume is too much under eyes and temples its not depleting the doctor who disfigued me has no duty of care she doesnt want to deal with it how long before this goes back to my normal self I had erbium laser for nodules didnt help. the doctor who did this dr angela richardson in kenmore brisbane clinic called cozmetics. I hope you can give me advise
I'll be back to you on this. I'm working with the company, Sanofi Aventis, to try to find a resource for you. Dr.... more
Would Radiesse be a good alternative to Restylane?Posted in Restylane, Radiesse, JuvedermRestylane, Juvederm and Restylane, Fillers, 2010 on Oct 03, 2010 | Permalink I want to get a dermal filler in my marionette lines. I was considering Radiesse for this area. Do you agree? If not what would you recommend for this area. I had Restylene last year and it caused horrible swelling. I am afraid to use that product again.
In your situation, Radiesse is a reasonable option. Just make sure your doctor is experienced and a board certified dermatologist or plastic surgeon. It's not a guarantee, but it helps. A... more Which laser is best in my situation?Posted in Lasers, Carbon Dioxide Lasers, 2010 on Oct 03, 2010 | Permalink I am a 61 yr old female with fairly decent skin. I would like to get rid of lines on my cheeks and other fine lines on my face. I get Botox several times a year and I am using all of your recommended products. I do not have brown spots or acne.
What lasar would be appropriate for me?
At 61, you'll get the most result with a fractionated carbon dioxide laser like the DEKA DOT or the Lumenis Active/Deep Fx. Please see our section section on Finding a Good... more
A follow up on a problem with an IPL treatment!Posted in Pigment problems, Peels, IPL, Brown Spots, 2010 on Oct 03, 2010 | Permalink Dear Dr I, I took your advise and went back to the doctor who did my IPL and left me with brown/black marks on my face for 10 days!!!! I still have dark spots on my face a month later and he says it's just a matter of time and he will do a peel once a week to speed up the process. I didn't like that answer and went for a second opinion. The 2nd doc said to wait about a month and do a lime light treatment. I got a 3rd opinion who recommended to do another IPL treatment with a lower setting to break up the pigmentation he says is stuck right below the surface. Needless to say, I still value your opinion over a computer than these other people. I know it's hard without seeing me but any suggestions you have I will use to help make a better decision. I'm hispanic, 37 yrs old and had good skin with the exception of some sun spots that led me to the horrible IPL treatment. I still have the sun spots plus alot more brown blotches:( Thanks for your time.
I'm impressed because this is a really tough situation and you're doing such a great job being proactive about it. Kudos to you! I'm guessing, hoping that they all went over the basics... more Is it okay to have Thermage with a metal plate in my shoulder?Posted in Thermage and Radiofrequency Devices, Thermage, 2010 on Sep 26, 2010 | Permalink Dear Dr. Irwin,
I've read and really like both of your books (your Best Face and Surgery-Free Makeover). I'd like to try Thermage based on your recommendation in your book. However, I have a metal plate in my left shoulder which was put in about 5 years ago when I had a surgery to fix my broken collar bone. Is it safe for me to do Thermage or other similar type of radio frequency treatments for sagging skin? The metal plate was about 5 cm long,0.8 cm high and 0.5 cm wide. Thank you very much.
Forgive me if I answered this already. I just may have not erased it. :) Yes - it's okay!! Dr.... more
Can having filler along labial nasal lines cause shadows and furrows elsewhere?Posted in JuvedermRestylane, Juvederm and Restylane, Fillers, 2010 on Sep 26, 2010 | Permalink Can having filler along labial nasal lines cause shadows and furrows elsewhere? I had two syringes of Juvederm, on either side of my mouth and now appear to have a hollow the other side of the filler and also the bags under my eyes look slightly worse. Should I have more filler to counteract the hollows or will this just transfer the furrow to somewhere else? I am a 47 year old with fair skin which tends to be dry. I also have Botox to counteract corrugation on my forehead and crows feet and Botox for bunny lines down the side of my nose.
Without seeing you, it's really hard to comment. This can happen sometimes depending on your original facial contours. It's fixable and preventable the next time. Please go back to your... more
I'm having difficulty finding a good cosmetic dermatologist where I live.Posted in Skin Care, MedSpa, Lasers, IPL, Fraxel laser, Finding a Good Doctor, 2010 on Sep 26, 2010 | Permalink I am trying to find a cosmetic dermatologist in Vancouver, BC. I have discovered in my research that most of the clinics have technicians doing the laser procedures rather than the dermatologist. In addition, many of the anti-aging clinics are headed by medical doctors that have "a special interest in cosmetic procedures." Is this the norm?
Thanks,Lisa
Okay so good questions! I'll try to clarify. Many good dermatologists or plastic surgeons will delegate procedures. I don't have a problem with this as long as the laser provider has a... more Can this Botox mistake be corrected?Posted in Botox Mistakes, Botox, 2010 on Sep 26, 2010 | Permalink I found your site searching for solutions to Botox mistakes, I had injections in the chin area which gave me a lopsided smile. It is not apparent if not smiling but has caused me not to smile anymore. When should this effect wear off and is there anything that can be done to fix this? I went to a plastic surgeon and trusted he knew how to do this, I initially went for the forehead area but he talked me into the chin to help raise the corners of the mouth and fix a dimpled chin. I'm worried thinking this is permanent, it has been 10 days since the injections. Please let me know if there is help, i would fly to your office if you can correct this. Thank you!
I wish I had a magic wand for you, could just wave it and this would go away fast. But first let me reassure you. This is NOT permanent! It will go away but it could take anywhere... more I have to have V-Beam treatments for the broken blood vessels I get on my face from Rosacea. So my question is, does the V-Beam help build collagen? Thanks for any info.
The short answer is no. The reason is that it is a "true" laser which has only 1 wavelength. The IPLs remove blood vessels, remove brown spots AND build collagen because they light... more
Is it safe to use Thermage to tighten the eyelids since the skin is thin?Posted in Thermage and Radiofrequency Devices, Thermage, Eyelid Treatments, 2010 on Sep 26, 2010 | Permalink Is it safe to use Thermage to tighten the eyelids since the skin is thin?
Yes. Thermage has a special FDA approved eyelid tip which is tiny and perfectly suited to delicate eyelid skin. In our office, just to be extra careful, we put in small "intraocular" eye... more
Can I apply Latisse with a different brush?Posted in Latisse, Eyelashes and Eyebrows, Eyelash Growth, 2010 on Sep 26, 2010 | Permalink Hello there!!
Loving your blog from Bozeman, Montana!!
Question: Do I need to use the applicator brushes that come with the Latisse, or could I really apply the product with a new, clean, fine tip brush?
Yes. I will never, never understand why Allergan released Latisse with those ridiculous brushes. All the patent infringing products prior to Latisse, had nice, tiny brushes. Just... more
At 37, would an eyelid Thermage be the best for my eye area?Posted in Thermage and Radiofrequency Devices, Thermage, Fraxel laser, Eyelid Treatments, 2010 on Sep 21, 2010 | Permalink HI Dr. I- I am 37 and really considering thermage for the eyes. I would like to tighten the area. I currently do Botox for the crows feet and bunny lines. They really make a nice difference but I am not completly satisfied. I think I am losing the volume under my eyes and around my mouth. I have high cheek bones which helps but I really notice the change :( I follow your skincare regimine and I have good skin overall but it's become significantly thinner and combined with my other issues I am wondering what you would recommend? Thank in advanced for your time.
At 37, it depends on what's bothering you the most. Eyelid Thermage tends to be best if there is a just little "hooding" or slightly lax skin. Eyelid Fraxel tends to be better if the... more
What is the best treatment for vertical lines over the lips?Posted in Lips, Fraxel laser, Fillers, Carbon Dioxide Lasers, 2010 on Sep 17, 2010 | Permalink What is the best treatment for vertical lines over the lips?
I wish there was one "slam/dunk" treatment for vertical upper lip lines. They can be 80-90% corrected but it takes a little time, money and patience. There really is no one treatment... more Is there a non-surgical way to shorten the distance between nose and mouth?Posted in Lips, JuvedermRestylane, Juvederm and Restylane, Fillers, Carbon Dioxide Lasers, 2010 on Sep 17, 2010 | Permalink Dr. Irwin, as I've aged, the distance from my nose to lip has lengthened and my lips have also flattened. Is there a non-surgical way to shorten the appearance between nose and mouth, and to make my upper lip go up and out so they're not so flat looking?
The answer to this is yes ........but depending on the exact anatomy. You didn't tell me how old you are. If you're 80, it will be much harder than if you are 50. The bony structure of... more Hi Dr. I...Like many of us on your site...how I wish you were in my state! I am a light (olive) hispanic and had an IPL done for spots and I am mortified!!! The first 7 days the areas treated were brown/purple and now on my 12th day the scabs have fallen off and the area is pink and very scaly/white blistery type skin. The pink has started to darken again to a light brown. The doctor (who I did research prior to the procedure) says its healing and I need to give it time!!! My question to you is will my skin return to normal from your experience ? I had great skin with some sun spots I has hoping to lighten and I am so afraid that I damaged my skin permenantly.
Did your dermatologist see you after the IPL treatment or was this done over the phone? If the doctor has not seen you, please call and just nicely insist that they do. It may be just... more What are the best laser options for light/olive/Hispanic skin with minor discolorations and a few broken capillaries?Posted in Lasers, IPL, Fraxel laser, 2010 on Sep 14, 2010 | Permalink Dear Dr. Irwin,
What are the best laser options for light/olive/Hispanic skin with minor discolorations and a few broken capillaries?
You are wise to be a bit careful! If you can do it in the winter and not be tan at all, you might do well with an IPL (photorejuvenation). BUT......... you must go to an expert... more
Do I need to worry about moistuizer being contaminated with bacteria?Posted in Skin Care Products, Skin Care, 2010 on Sep 14, 2010 | Permalink Hi Dr. Irwin. I am a huge fan of yours and have purchased both of your books and followed your recommendations. I have heard, though, that it is better to use a moisturizer from a tube as opposed to a jar to cut back on bacteria and preserve ingredients. Do you have any suggestions for good hydrating moisturizers that come in a tube?
Thanks so much.
Wendy
For better or for worse, most moisturizers have multiple antibacterial preservatives in them. So, I hear your concern but it's really almost never an issue unless you're living in the... more
Why don't you use sculptra in the lips?Posted in Sculptra, Lips, Fillers, 2010 on Sep 11, 2010 | Permalink Why don't you use sculptra in the lips. I would like to have my lips made a bit fuller but really don't want to spend 400 every 6 months.
Sculptra becomes bumpy in or around the lips where the muscles around the lips are strong. The same can be true around the eyes. Lumpy lips is not a good look! Dr.... more
For a 44 yo female, what would be the best laser to tighten after weight loss?Posted in Thermage and Radiofrequency Devices, Thermage, Lasers, Carbon Dioxide Lasers, 2010 on Sep 11, 2010 | Permalink Hi Dr. I,
Your website is fantastic! Thank you for taking time out of your very busy life and answering our questions. I am a Vietnamese 44 y/o female, and have lost 20 lbs. over the past 4 mo. I have very good skin with no wrinkles, or discoloration. My facial skin is now lax on the cheek and neck. what is the safest and best laser treatment for this? There are so many types out there?
Thank you! The answer to this really depends on how much extra skin you really have. If you have a lot, surgery could be the best answer. But at 44, Thermage could be a great option for... more
I had a neck lift 5 years ago, bands tightened too. One side still has some loose skin under my chin, (he did not pull it tight enough on my bad side) the surgeons response was I will fix it when you get a face lift. Well I am 50 and still do not need one. what can I do to tighten this small piece of skin under my chin on one side. I am tired of waiting and looking at it.
It sounds to me like you're talking about a platysmal band(s) which are the vertical bands running from the chin down onto the neck???? If so, consider having your dermatologist inject a... more
Is it okay to do Thermage if I have a steel plate in my shoulder?Posted in Thermage and Radiofrequency Devices, Thermage, 2010 on Sep 11, 2010 | Permalink Is it okay to do Thermage if I have a steel plate in my shoulder? Yes, it's not a problem to have Thermage with your steel plate in your shoulder. And, I doubled checked with the company on this one also. Dr.... more
In which order should I use my products??Posted in Skin Care Products, Skin Care, RenovaRetinoids, Renova Retinoids and Vitamin A Creams, 2010 on Sep 11, 2010 | Permalink Dr Irwin, I have ordered as per your skin care test- Topix Replenix Cream, Cellex-C Sea silk Moisturiser, Skin Medica Retinol Complex and TNS Recovery Complex, please help me as I have no idea in which order I should put them on my skin. Thank you for your time.
Okay - I know this is confusing and I wish I could figure out a way on the site to make it less confusing. We're working on it. So here goes. Is it okay to use tretinoin/Retin A, etc if I live in a sunny climate and am driving a lot?Posted in Sunscreen, Sun Protection, Sun Damage, Skin Care Products, Skin Care, RenovaRetinoids, Renova Retinoids and Vitamin A Creams, 2010 on Sep 06, 2010 | Permalink Hi Dr Irwin,You are a very kind person to answer questions on your blog because I'm sure you are a very busy person. I can't personally visit your country to make an appointment with you but I do buy products through your links so I hope that helps. My question is regarding tretenion. I live in a very hot dry climate and I am exposed to the sunlight many days that shines into my vehicle as my job involves driving. I want to use tretenion but I read that you don't use it in summer. Could I be doing more damage to my skin by using it considering my climate with my particular job. I am very diligent with sunscreen and I reapply every few hours.
Thank you! Sorry it took me so long to get to your question since it's a good one. Car window glass does not block all UV rays as you pointed out. Window glass usually blocks UVB but... more Do you perform needling/subcision on skin that has been scarred from acne?Posted in Lasers, Acne Scars, Acne, 2010 on Sep 06, 2010 | Permalink Do you perform needling/subcision on skin that has been scarred from acne?
Yes. Like all treatments for acne scarring no single type of treatment will take care of all the scarring. We often use subcision occasionally alone but more often in combination with... more
What can I do about melasma? It just doesn't go away with products.Posted in Skin Care Products, Skin Care, Melasma, Brown Spots, 2010 on Sep 06, 2010 | Permalink Hi Dr. Irwin:
I have medium color skin (latin), with some melasma spots on forehead. A Dermatologist and a Cosmetic surgeon had recommended to stay away from deep laser. I used many products, hydroquinone, BHA, AHA. Renova, and plenty of sun block with 17% zinc oxide. I don't see any changes. What else can I do?
Thanks for your help.
Myrna
If I could have one dermatology wish granted by a good fairy, I would wish for a true cure for melasma!!! It is such a painful problem for many women (and some men)! And, in some... more What is the difference between the CPT and NXT Thermage machines? Do you recommend one over the other.Posted in Thermage and Radiofrequency Devices, Thermage, 2010 on Sep 06, 2010 | Permalink Hi Dr Irwin,
What is the difference between the CPT and NXT Thermage machines? Do you recommend one over the other.
In my opinion, there is really very little advantage to you as a patient. The results of the treatment are the same. The CPT system is a a little faster (benefits the doctor) and it has a... more
Do you do Botox in armpits for excessive sweating? How much is they typical cost?
We do offer Botox injections for armpit sweating and our patients love it! I would only recommend it though if your sweating is really interfering with your life. For example, if you... more Good dermatologists and plastic surgeons?Posted in Finding a Good Doctor, 2010 on Sep 06, 2010 | Permalink Dr. Irwin-
Could you please recommend a cosmetic dermatologist and/or plastic surgeon in Dallas, TX. We have so many that it is overwhelming to review. You and Paula Begoun recommend asking someone who looks good for their source - Hello - if the work is done well how would you know? And it would be a bit rude to ask them.
Your website is very good! Its been a huge help.
Thank you Dallas, TX
See my regional guide to good dermatologists, there are a few great doctors in Texas. Also, here are some more tips on finding an expert cosmetic dermatologist. Dr.... more
Which treatment should I have next?Posted in Thermage and Radiofrequency Devices, Thermage, Sun Damage, Skin Care, Sculptra, Lasers, Fraxel laser, 2010 on Sep 06, 2010 | Permalink Hi Dr. Irwin,
In what order would one consider the following treatments in your clinic:
*Thermage
*Fraxel or recommended laser tx.
*Sculptra
I'm 51 and have had Botox, Restylane, and some Laser treatments over the past 4 years with good results. I'm considering these other treatments down the line, so to speak!!
Thanks!!
Your question brings up two good issues: customization and maintenance. First, the answer to your question really depends on your particular skin. I think it would be bad medicine to... more What about the filler Selphyl. Is it the best filler?Posted in Selphyl, Sculptra, Fillers, 2010 on Sep 06, 2010 | Permalink What about the filler Selphyl. Is it the best filler? How long do the effects last and is there downtime?
I'm not recommending Selphyl at this time. There are two issues with any new filler: safety and how well does it work? I think it's pretty clear that Selphyl is safe as long as blood... more Is SkinMedica TNS Recovery safe?Posted in Sun Damage, Skin Care Products, Skin Care, 2010 on Sep 06, 2010 | Permalink On your recommendation I bought the Skin Medica TNS Recovery product. Since then I've read with some concern suggestions that Human Growth Hormones might have nasty side effects. Should I be worried? I loved the product, by the way and have reordered, but I'm thinking maybe I should be very sparing, or use it intermittently until further research is done.
Thanks, Jane
Jane - TNS does NOT have human growth hormone in it!!!!! The cell growth factors (from skin cells in the lab) and human growth hormone are completely different things. Please don't... more
Can I get good results with the Fraxel without the downtime?Posted in Lasers, Fraxel laser, 2010 on Aug 20, 2010 | Permalink I recently had two profraxional laser treatments done and am seeing some improvements in tone and texture, however the downtime was extreme. For 6 days I had red blood marks all over my face. I would like to continue my treatments but am not able to take time off. What kind of results should I expect with Fraxel? And is there a reason profraxional should be recommended over Fraxel?
Thanks,
Dave
There are now A LOT of copy cat laser systems in existence who use the words fractional or some like that in their titles or their marketing. Everyone please pay a lot of attention to... more In what order should I apply my products?Posted in Skin Care Products, Skin Care, RenovaRetinoids, Renova Retinoids and Vitamin A Creams, 2010 on Aug 20, 2010 | Permalink I am currently using Skincueticals C+AHA and Suncscreen in morning and at night using Tazorac 1% cream. I would like to use TNS essential cream, since you spoke so highly of it. When would I use it during the day?
In your situation, it would be fine to put the TNS Recovery Complex under your Tazorac at night. Just use a gentle cleanser, put the TNS on, wait a few minutes and then apply the... more
I don't like my Juvederm. Can I get rid of it?Posted in JuvedermRestylane, Juvederm and Restylane, Fillers, 2010 on Aug 20, 2010 | Permalink I do not like the look of the nasolabial lines after the Juvederm application because they are hard and changed my smile. How can I get rid of it?
Yes, you can! Please call your doctor. There is an enzyme (hyaluronidase) that can be injected into the Juvederm (or Restylane) to dissolve it pretty much instantly. It works on all the... more
I've had 4 Botox appointments with the same doctor and the problem still isn't solved?Posted in Finding a Good Doctor, Botox Mistakes, Botox, 2010 on Aug 17, 2010 | Permalink Hi Dr. I- I had Botox on the bunny lines and under the eyes. I have been back four times for the follow up because my left side hasn't really changed at all. One side/right side is great-smooth and wrinkel free after the 2nd treatment. The doctor said I had strong muscles on the left side and thought #4 would do the trick. It's been 7 days since that treatment and it looks the same. Is that normal? I plan to make another appointment but why would one side require so much more than the other side????
Since I don't know what you looked like before and I don't know exactly what was done, I can't really comment. But as a general rule, it doesn't make sense to me that one side is... more
Why am I irritated with Refissa/tretinoin and what can I do?Posted in Skin Care Products, Skin Care, RenovaRetinoids, Renova Retinoids and Vitamin A Creams, 2010 on Aug 17, 2010 | Permalink Hi Dr. I,
Thanks so much for taking time out of your busy day to answer all of our questions. I am a 44y/o vietnamese female and have been using Refissa for the past 4 months. I try to use it twice a week, a pea size amount, but it causes more and more irritation each time. I tried to cut the strength by using a moisturizer ahead of time, but it does not help at all. Does using Renova 0.02% cream better and does it help with blotchy sun spots?
There are so many Retin A type products out that it's confusing isn't it? All these products have the same active ingredient - tretinoin. Tretinoin is prescription and comes in many forms... more Is the zinc content more important than the SPF in a sunscreen?Posted in Sunscreens, Sunscreen, 2010 on Aug 17, 2010 | Permalink I have melasma and noticed that you recommended a couple of sunscreens with high zinc in them. Is this more important that a high spf? Thanks...Jennifer
Glad you asked to clarify this! The short answer is yes! As long as the sunscreen has at least an SPF 30 and is appropriate for the situation - i.e. water resistent when you're in... more
Should I use Renova during the summer?Posted in Sun Protection, Sun Damage, RenovaRetinoids, Renova Retinoids and Vitamin A Creams, 2010 on Aug 13, 2010 | Permalink Dr Irwin
Should i be using renova during the summer?
If you have an indoor job and really aren't outside much in the summer, it's fine to keep using it. If you are outdoors frequently, I usually recommend stopping or cutting back on use for... more I am 28 female and have had trouble with acne around the area above the lips and chin area. It seems to "flare" up during the menstruation cycle each month. I've tried different products but some I can't use because it dries my skin. Is this something that can be helped if I see a dermatologist?
Yes, yes, and yes!!! A good dermatologist should be able to help you with this. Sometimes, the problem is the hormone spikes that occur in women around the time of our periods. ... more
Hi doctor
I have 2 scars on my lips from 10 years ago. The scars occured after removing warts electrically. One on my upper left side lip and the other on the right side bottom lips and they are all hypertrophic. I had consulted with a plastic surgeon and he said that fraxel laser could help to makr the scars shrink
I am so afraid because the lips are so sensitive .
Does fraxel cauuse any more hypopigmentation or hyperpigmentation in my case? And does it work well to blur the scars edges because they are so reaised which get me embarassed
Hmmmm. I'd really like you to get an opinion from a dermtologist too. Do you have a good one in your area? Ideally, one who does the full range of medical, surgical and cosmetic... more Are there other products as good as Latisse but cheaper?Posted in Eyelashes and Eyebrows, Eyelash Growth, 2010 on Aug 13, 2010 | Permalink Hi Dr. Irwin
I am thinking about using the eyelash product Latisse but I have heard alot of good things about another eyelash product called Rapidlash. It is a lot cheaper and people seem to be getting good results. Before I make my decision I wanted to get your advice.
Thanks
This is kind of long story so I won't go into all the details here. The short version is that there were and still are several companies who are infringing on Allergan's patent by putting... more
Dear Dr. Irwin,
What do you think of the procedure where they use your own blood and derive part of it to use as a filler via injection?
Selphyl is the name of the method.
Thanks you,
Sharon Newton
Albany, Oregon
The marketing machine for this product is beginning to rev up! I can tell because I've been getting a number of questions about it. It's buyer beware. My opinion is that it's way... more I have had bad experiences with several fillers. What can I use around my mouth?Posted in Sculptra, Restylane, Lips, JuvedermRestylane, Juvederm and Restylane, Jowlsjawline, Jowls and Jawline, Fillers, Chin Lines, Cheeks, 2010 on Aug 13, 2010 | Permalink I have marionette lines around my mouth. It is due to volume loss in my chin. I had a bad experience with Restylane, (massive swelling after the procedure that scared me into a visit to the ER). Would Artefill be a more permanent option? I also had fat put into this area but it only lasted about 3 months. Could a laser tighten the skin in this area to get rid of it. It is not to bad I am 50.
I wish I could say your situation is unusual but I've heard many similar stories! Let's start at the beginning and think through this. I want you to go back to the mirror because most of... more Is there anyone in VirginiaPosted in Skin Care, MedSpa, Lasers, Finding a Good Doctor, Fillers, Botox, 2010 on Aug 10, 2010 | Permalink Dr. Irwin,
I have been a regular visitor to your website since hearing you on Paula Beguon's radio show. I feel like I can't go wrong having the both of you in my corner. I'd really like to pursue getting dermal fillers. However, you have not included any Virginia cosmetic dermatologists on your 'trusted' listing. I did take a virtual tour of the Washington D.C. 'trusted' facility because I reside in Northern Virginia. What makes me hesitant about the D.C. facility is that they list so many things they specialize in. I've read almost every blog you've responded to and what stays with me the most is your insistence that it all goes back to the injector and his/her skill. I don't see how anyone can be skilled in so many procedures?
Any suggestions? Linda
Thank you!!! As you all know, I am revising the regional guide but it's SLOOOOW because I feel like I need to check possible additions with several different sources. In Virginia, I'm... more How do I treat leg veins?
Sclerotherapy, done well, is still the most effective treatment for leg veins and spider veins. It is also the most cost effective. If you truly have large, bulging varicose veins,... more
What can I do about scars on the lips?Posted in Scars, Fraxel laser, 2010 on Aug 05, 2010 | Permalink Hi doctor
First of all, please doctor I hope you answer me via my e-mail because I don't want my problem to be seen publicly, I sent my first message to you without telling you that (the e-mail thing) by mistake.
I have 2 scars on my lips since 10 years ago. The scars occured after removing warts electrically. One on my upper left side lip and the other on the right side bottom lips and they are all hypertrophic. I had consulted with a plastic surgeon and he said that fraxel laser could help to makr the scars shrink
I am so afraid because the lips are so sensitive .
Does fraxel cauuse any ,more hypopigmentation or hyperpigmentation in my case? and does it work well to blur the scars edges because they are so reaised which get me embarassed
I will be so grateful to see your openion .
regards,
Confidentiality is important! We would never publish your email address or a last name. Unfortunately, I really can't answer emails individually. Hopefully this will help. When you... more Does the use of Botox or dermal fillers have any potential to slow down the deepening of existing wrinkles?Posted in Wrinkles, Fillers, Botox, 2010 on Aug 05, 2010 | Permalink Does the use of botox or dermal fillers have any potential to slow down the deepening of existing wrinkles?
Yes!!! If the wrinkle is being caused by an over active corrugator muscle (the "frown" muscle), then relaxing the muscle with Botox will not only make the lines improve but also... more
Can I make a scrub for myself in the kitchen?Posted in Skin Care Products, Skin Care, Scrubs, Exfoliation and Scrubs, 2010 on Aug 05, 2010 | Permalink Hi Dr. Irwin,
I recently read that sugar mixed in olive oil can be used as a mechanical scrub on the face. Is this true? Thanks for all your help.
Yes - it actually works but don't keep it around. Use it within an hour or two of when you mix it so it doesn't become contaminated with bacteria. You can do the same thing with salt and... more
What treatment is most effective for sagging skin in the neck area?
Okay - so I need a little more information here. Are you talking about a pooch or fullness right under the chin which is usually a fat pad (submental)? Are you talking about those... more
Are growth factors like TNS Recovery Complex safe to use?Posted in Skin Care Products, Skin Care, Eyelid Treatments, Cosmeceuticals, 2010 on Jul 31, 2010 | Permalink I know there have been concerns (at least in theory) about abnormal cell growth from topically applied human growth factors. You recommend TNS Recovery Complex and I would love to be reassured that there is little danger from using it since I'd love to try it.
I think you'll feel comforted by knowing how they are made. Since our own cells make these factors, they are completely natural. To make a long story short, a certified young cell line... more
Can I use tretinoin cream with hydroxy acids or ascorbic acid serum if I can tolerate it?Posted in Vitamins for Skin, Vitamin C, Skin Care Products, Skin Care, RenovaRetinoids, Renova Retinoids and Vitamin A Creams, Premature Aging, Cosmeceuticals, Cell growth factors, Aging Skin, 2010 on Jul 31, 2010 | Permalink Can I use tretinoin cream with hydroxy acids or ascorbic acid serum if I can tolerate it?
I heard that these ingredients inactivate each other when used together at the same time.
I've never seen any studies on this. One way to get around the issue would be to use the hydroxy acid alternating with the tretinoin at night and the Vitamin C serum every morning. Also,... more
What results have you seen using Thermage on thighs?Posted in Thermage and Radiofrequency Devices, Thermage, Body Treatments, 2010 on Jul 29, 2010 | Permalink What results have you seen using Thermage on thighs?
Not many. We haven't been recommending it to our patients because the first 3-4 patients we did (with the new reengineered tips) had very disappointing results. Theramge skin... more
Last June I had a Sculptra injection in my right cheek area. In about 3 months I developed a line of noticeable nodules. My doctor said to apply heat and massage the area. This did not help. I returned to his office and he injected a solution of steroids into the nodules. In about a week and a half, the entire section of the Sculptra became enlarged, swollen, and painful. He then treated me for an infection with oral antibiotics. He wants to do another injection of steroids, but I am becoming concerned because the area has hardened and the nodules are increasing. Can you suggest an alternative process?
This is difficult because I really don't know what happened. You didn't mention if the Sculptra was massaged well by the doctor at the time of the injections and then by you once or... more
Do you have a recommendatin for a dermatologist in the east bay area of san francisco; someone who works like you do.
Thanks
Please see the regional resource guide on SkinTour. There are some great dermatologists in the Bay Area. I'm working on updates and should have new resources on the site soon! Dr.... more
If I have sarcoid, is it safe to have botox injections for wrinkles? I can't find anything on here about that. Thank you so much.
I do not know of any data prohibiting Botox Cosmetic use with sarcoid. Having said that though, we are all individuals and our reactions to products can be very individual. I would... more
Is it possible to scar with the Fraxel Restore laser?Posted in Scars, Fraxel laser, 2010 on Jul 27, 2010 | Permalink Dr Irwin- I have been on the internet reading some reviews regarding Fraxel Restore. I wasn't aware that you can actually scar from this treatment. I never considered Repair because I thought that would be of a possible side effect of the more aggressive treatment. Have you seen this happening to patients before. I have had several treatments of Restore and once a year I have a very mild one when I go back to maintain. My skin looks great.
On the face, assuming the treatment is done correctly, it would be extremely unusual to develop scarring from Fraxel treatments. I'm also assuming you are not prone to keloids! You've... more Botox: per area or per unit cost? I've read in California MD's charge per area. Other parts of the country per unit. Please comment.
Thank you.
Please look back in the July posts! I did a fairly detailed explanation of the different ways offices do this. I can't remember the exact date but it was in the past couple of weeks.... more Could these bumps on my forehead be molluscum?Posted in Lumps bumps moles, Growths, 2010 on Jul 22, 2010 | Permalink | View Comments (1) Situation:
My forehead has had some 'odd' looking bumps for years now. I regularly go to the derm for 'vanity' purposes; Botox, fillers. The problem is I can't ask about skin problems without paying for his opinion & diagnosis when I'm getting my cosmetic work. My insurance doesn't cover this particular derm that I've gone to for years & years.
I went to the website: skinsight.com. This site, you may be familiar with, has pictures of various skin disorders. My forehead resembles Molluscum Contagiosum. The sight says it generally goes away on it's own or can hang around for a long time - that's my situation.
Question:
Do you have a recommendation on getting rid of this with a topical oinment or what? I don't want ot have a in-office procedure, again because my derm doesn't subscribe to my insurance carrier.
Thank you in advance.
I really think you should go to a dermatologist who is covered on your plan if you don't want to pay out of pocket for medical care. An accurate diagnosis is key and you will save yourself... more
Can I have a Thermage and Fraxel treatment on the same day?Posted in Thermage and Radiofrequency Devices, Thermage, Fraxel laser, 2010 on Jul 22, 2010 | Permalink | View Comments (1) Can I have a Thermage and Fraxel treatment on the same day? If not what is the recommended wait time between the two treatments?
I know that there are excellent offices who do this but it's a lot to take on in one day. The Thermage should be done first, in my opinion. I would recommend waiting at least 2-3 days... more
Dr. Irwin , I am a fifty eight year old woman that has had aortic valve replacement and am on blood thinners. I want to have filler injections for the lines that go from my mouth to my chin. I am very self conscience of these lines and so much want to have this taken care of . My question is can this be possible since I need to be on the blood thinners?
I'm going to assume for this answer that you're on coumadin/warfarin. It's very safe to use a filler like Juvederm or Restylane while you are on coumadin BUT you will very likely... more Is there any type of laser procedure that will lighten dark undereye circles?Posted in Lasers, Eyelid Treatments, Carbon Dioxide Lasers, 2010 on Jul 19, 2010 | Permalink Is there any type of laser procedure that will lighten dark undereye circles?
Lasers don't always work for this but a series of 2-3 fractionated CO2 (like the DEKA DOT or Lumenis Active/Deep Fx) laser treatments would be your best choice. Be sure to go to an... more
I'm concerned about possible side effects of photorejuvenation - what should I watch out for?Posted in Lasers, IPL, Brown Spots, Blotchiness, 2010 on Jul 08, 2010 | Permalink Dr. Irwin: Your website has been extremely helpful - thank you! I have been thinking about Photorejuvenation for brown spots on my face. I have them on my upper lip & a few on my cheeks. Just as you said in the video - "many people are scared of lasers" well I am one of those people. I have read a great deal online & have discussed the treatment with a local doctor, but still have concerns. First, I have read about the "striping" that can occur after - how common is this; what % of people would you say this happens to; how long does this effect last; what's done to correct it? Is there typically any crusting of the brown spots after a treatment, if so what % of people experience this? Finally, what % of people actually see results from the treatment, if done properly? I guess, my fear is making the "problem" worse because of the "striping" & is the cost worth it?
I looked at your recommendations for local doctors - do you know of anyone in the Cleveland, Ohio area? Thanks so much....
These are all good questions. My concern is that when you saw your local doctor these questions weren't answered. I would recommend getting a second opinion from another office and... more Should I stay with tretinoin gel or switch to the cream?Posted in RenovaRetinoids, Renova Retinoids and Vitamin A Creams, 2010 on Jul 08, 2010 | Permalink Hello, Dr.Irwin:
I have oily skin recovering from acne and my dermatologist recently prescribed me Tretinoin Gel 0.025%, in which alcohol (denatured with tert-butyl alcohol & brucine sulfate) is listed as the 4th ingredient out of 4 ingredients. I'm a bit concern about the alcohol content because I am a bit sensitive to alcohol. I would feel a burning sensation whenever I applied anything with a large amount of alcohol to my face. With this gel, there's a strong alchoholic smell to it and I felt a slight stinging sensation over certain areas of my face when I'm applying it, but not my whole face. And the sting disappears within seconds. I know Paula says alcohol can be damaging to skin and tretinoin may also cause the sting. I'm not quite certain whether I stick with the gel or ask my dermatologist to prescribe me a cream instead. Any sort of answer would be very much appreciated! Thank you for your time.
Definately switch to the cream!! Gels almost always have a higher alcohol content than creams. Dr.... more
How can my friends and I figure out unit pricing for Botox?Posted in Botox Mistakes, Botox, 2010 on Jul 08, 2010 | Permalink | View Comments (1) Botox pricing:
Having a discussion with friends on the cost of botox. My MD charges by the area. On the realself.com, many derms, plastic surgeons comment. Some say they charge by area, some or most by unit.
What do you think? Is unit pricing more transparent and accurate or by area?
Thank you.
Okay - so this is where I really disagree with the vast majority of doctors who inject Botox, many of whom do an excellent job. I don't do either - at my office we charge by volume... more Why do you recommend eye creams?Posted in Eyelid Treatments, Eye Creams, 2010 on Jul 05, 2010 | Permalink I've read that you recommend eye creams? This seems to be a contradictory subject as many derms do not recommend eyecreams. For example Dr. Ellen Marmur says in her book "Simple Skin Beauty" they are redundant.
Why do some derms recommend and others not?
Good question and I have three reasons that I do recommend them: 1. The skin on and around the eyelids (neck skin is similar) is very thin compared to the rest of the face and has almost... more Can fillers be used to contour the nose?Posted in JuvedermRestylane, Juvederm and Restylane, Fillers, 2010 on Jul 05, 2010 | Permalink Can fillers such as restylane be used on the nose to fill out imperfections? Thanks for any information. Bonnie
The answer to this is absolutely yes! In fact, there are several dermatologists and plastic surgeons who have made this a special interest and published papers on these techniques. Is there any way to reduce the swelling after an IPL laser treatment?Posted in IPL, Brown Spots, 2010 on Jul 05, 2010 | Permalink Hi I just had a treatment for brown spots using IPL laser and had very severe swelling any tips to reduce the swelling, thanks.
Here are some things to try for swelling after an IPL treatmemt:
I think I still have marks from Botox six weeks ago, what should I do?Posted in Botox Mistakes, Botox, 2010 on Jun 29, 2010 | Permalink I had botox approx six weeks ago, I had an injection between the eye area and still see the prick from the needle, there is also one side of my face at the corner of my left eye toward the ridge of my nose that has a bump that almost feels like cartilidge, could that happen as a result of botox and if so what do I do? I really need help and would appreciate your response.
Please, please, please call your doctor who did the Botox injections!! I can't emphasize enough the importance of following up with him/her. The doctor who did the procedure is the... more
Is there any help for crepey skin on the back of the arms?Posted in Carbon Dioxide Lasers, Body Treatments, Body Thermage, 2010 on Jun 29, 2010 | Permalink What to do about crepey skin on side and back of arms - have been exercising - no help
A few years ago, I would have said no and told you to please not waste your money with offices making false promises. But ........... now there's beginning to be some very interesting... more What causes pads under the eyes?Posted in Thermage and Radiofrequency Devices, Thermage, Sun Damage, Skin Care Products, Eyelid Treatments, Eye Creams, 2010 on Jun 29, 2010 | Permalink HI Dr. I have a question about the pads that form under the eyes. I am 37 and at times my eyes look puffy underneath. I wouldn't say the its are very prominent or lasting but I am becoming more aware of that area and now I am wondering how the "pads" form in that area?? Is it something that just appear one day or is it a gradual process and if so is there anything to keep them from forming??? I have good skin, I have a good skincare regime (influenced by you of course. I use the sunscreen and moisturizers,etc my eye area is really changing. Thank you in advanced for your time!!!
Under eye pads or puffiness are complicated because there are several different causes and sometimes they coexist together. So....... causes can be: 1. The skin on the eyelids loses... more Do I need to reapply my sunscreen at the end of the day at my office?Posted in Sunscreen, Sun Protection, 2010 on Jun 25, 2010 | Permalink Love your site, I’ve learned so much – Thanks!! I have a question on sunscreen. My morning routine includes using a separate sunscreen, currently the Skinceuticals Sheer Physical UV Defense 50. Throughout the day I blot my face w/ tissue to control oil. When I leave work around 5, is my skin still protected or does the sunscreen lose potency by sitting in an office all day?
Thanks!
You're welcome!! Sunscreens do degrade on the skin over time slowly with exposure to light, blotting or wiping the skin, exposure to our natural skin oils, etc. I've never seen a study... more
Is Heliocare helpful for added sun protection?Posted in Sunscreens, Sunscreen, Sunburn, Sun Protection, Sun Damage, 2010 on Jun 25, 2010 | Permalink Several dermatologists have recommended Heliocare for added sun protection. What is your opinion on Heliocare? Thanks for all you do! Bonnie
This is a tough one because since Heliocare is sold as a supplement, it is not regulated by the FDA. That means that side effects from it's use may go undetected for some time. I cannot... more How can I get rid of sun spots if I work outside???Posted in Sun Protection, Sun Damage, Skin Care Products, Brown Spots, Blotchiness, 2010 on Jun 21, 2010 | Permalink Dr. I, Your site is Fabulous!!!! You are so helpful...thank you. I am outside (work) during the day. I have sun spots that I am trying to manage. I use the sunscreens (zinclear and colorscience)to protect and I do IPLs in hope of lightening and minimizing the spots. I have been using the obagi blender and retina A once a week. I use it on my last day of work because then I have the tree days out of the sun. Is this enough to make a difference or should I just not use it till the winter. I want to do away with these spots all together!!!! They bother me. I have olive skin and I am 39. Thank you for your help!!
Thank you! I'm having so much fun doing this. You're doing a good basic job I can tell. Here are some thoughts for fine tuning more. Do you have a hat with a good brim?? Hats are... more If I'm 68, would Juvederm help my chin area?Posted in JuvedermRestylane, Juvederm and Restylane, Fillers, 2010 on Jun 21, 2010 | Permalink I am a 68 year old woman considering Juvederm XC. I have deep wrinkles around the chin area. Would it be feasible to have treatment?
Yes - Juvederm will work for deep wrinkles around your chin, but you would almost certainly need 2-3 syringes to lay down a good base. Follow up treatments would probably require less. ... more
When can I go back to tretinoin after having a rash on my face?Posted in Skin Care Products, RenovaRetinoids, Renova Retinoids and Vitamin A Creams, 2010 on Jun 21, 2010 | Permalink I was on tretinoin for the last 7 years, after I came back from India where the temperature was 100 deg, I went for a facial laser session and after a few days my face became red and consulted a dermatologist after 15 days. Until then I was using tretinoin everyday without knowing i had burnt. The doctor prescribed me desonide for a week and after that she told me that I could go back to TRETINOIN. But this time the cream made my skin break, I could see peeling of skin here and there, which is not the normal reaction, why is this happening? Now my face is on rest and how long can I stay off of tretinoin (0.05%) without losing results? Can I ever go back to the product? Please advise. I love the product.
This is good question. Generally, what I tell my patients is that it takes the skin almost a full month to repair itself after an injury like a serious rash, sunburn, a bad reaction to a... more
Does Differin gel have the same benefits as Renova, etc.?Posted in Skin Care Products, Skin Care, RenovaRetinoids, Renova Retinoids and Vitamin A Creams, Oily skin, 2010 on Jun 16, 2010 | Permalink Does Differin gel have the same benefits as Renova, Retin-A, Tazorac, and Retinol? I seem to tolerate it better than the Retin-A micro gel I used in the past, but would like to know if it is helping build collagen. I am 47 and do not have active acne, just oily skin.
Lisa in Naples, FL
Pretty much! They are very close since they all are in the same class of medications called retinoids which are vitamin A cousins. The Differin is a good choice for you if you have oily... more
Can Accutane be prescribed for Rosacea if the papules(Bumps/Pimples) are not present?
I have the constant redness and broken blood vessels. Thanks for any info! Bonnie
I think it would be safe to say that Accutane is rarely used now for rosacea because the FDA guidelines for it's use are very strict and it's use is monitored so closely through the... more Can Sculptra be used to treat hollowing around the eyes?
The company that makes it, Sanofi Aventis, does not recommend it's use around the eye area at this time because visible Sculptra bumps are more likely to occur there. They occur more... more
Are there any creams that can improve the appearance of hollow cheeks?Posted in Skin Care Products, Cheeks, 2010 on Jun 12, 2010 | Permalink Dr Irwin are there any skin cream rather than an injectable that might improve appearance of hollows under cheeks - thanks
I wish there were but there really are not. You could try consulting a good makeup artist who could teach you how minimize the appearance of the shadow that a hollow creates. But
Differences between Sculptra and Restylane?Posted in Sculptra, Restylane, 2010 on Jun 12, 2010 | Permalink Dear Dr. I
I was wondering if you can briefly give me the differences (excluding cost and how long it lasts) between Sculptra and Restylane. I have had Restylane shots in the past for the smile lines and around my mouth. I am in my late 30's. Thank you for your helpful site!!!
This is tough because there are a lot of differences. Can you write back and be more specific with your questions? I just updated the Sculptra article on SkinTour and the new updated... more
I've been hearing scary things about the long term side effects of Accutane. Do you agree?
No, I really don't. There's no question that Accutane is a serious medication and the FDA guidelines must be followed absolutely to the letter. If they are, side effects and risks are... more
What products are safe in pregnancy?Posted in Skin Care Products, Skin Care, Pregnancy, 2010 on Jun 11, 2010 | Permalink Hi – I’m trying to get pregnant. I stopped using my Retin A/Renova/tretinoin cream, but what about Vitamin C serums. Is that ok? What product should I discontinue or not use and what can I replace them with? Thanks!
When you're pregnant or actively trying, it's best to stick with tried and true natural ingredients. So Vitamin C serums are fine because Vitamin C is known to be safe in pregnancy in... more
Is the new Thermage vibrating tip really helpful?Posted in Thermage and Radiofrequency Devices, Thermage, 2010 on Jun 11, 2010 | Permalink Thermage has a new tip now for helping lessen the pain level. I was told that now the doctors can turn up the radio F. and it will work better. My question is.. I thought that was the problem with fat melting a many years ago.. the high heat level. The doctors seem anxious to turn the levels higher now. What is your opinion about the higher level?
There is absolutely no data from the Thermage company, or anyone else, that says this tip gives better results. In my opinion, it's a marketing gimick. The vibration does allow slightly... more
Are ingredients in these products compatible?Posted in Skin Care Products, Skin Care, Product safety, 2010 on Jun 09, 2010 | Permalink Dear Dr. Irwin,
I hope you can help with the following.
Is Topix replenic CF cream (and serum) compatible with Aveeno ageless vitality
night cream, Nia24 skin strengthening complex, skinceuticals CE ferulic and
prevage MD? (As in no components are deactivated)
I hope you can shed some light on the often compex world of skincare.
Thank you in advance,
The bottom line on this one is there are so many different ingredients in all these products that no one on this earth knows whether these are all truly compatible. A good rule of thumb... more Is my fat pad damaged?Posted in Jowlsjawline, Jowls and Jawline, 2010 on Jun 09, 2010 | Permalink How can you tell if your fat pad has been damaged?
Okay - you might have to help me a little on this one. Which fat pad are we talking about? Since we have them all over us and most of us would love to get rid of a few on our bodies, I'm... more
Would fractionated carbon dioxide laser be helpful for me with acne scars?Posted in Scars, Fraxel laser, Carbon Dioxide Lasers, Acne Scars, 2010 on Jun 03, 2010 | Permalink
Re: Fractionated Carbon Dioxide Laser
I was most interested in your article on this laser. I have acne-related scars including depressions in my skin. Also, I had some hypertrophic scars excised, which resulted in deeper depressions. To date I have done 5 treatments of Fraxel at ever increasing strengths. I have just had 2 treatments 3 weeks apart at Fraxel's highest level (i.e. level 12). Yet I STILL have the aforementioned scars. They have faded a bit, but they're still there and quite noticeable. Do you think the Fractionated Carbon Dioxide Laser would be a good option for me. If the answer is yes, do you know of a dermatologist located in NYC who has the necessary expertise w/ this laser? Thanks for your help, Simone
It's a bit difficult without being able to see you or knowing your age. But, yes, usually the fractionated CO2 is more effective than the Fraxel Restore for acne scarring. If you are 30... more Why didn't my brown spots light up after my IPL treatment the way they usually do?Posted in Pigment problems, Lasers, IPL, Brown Spots, 2010 on Jun 01, 2010 | Permalink Hi Dr. Irwin
I just had an IPL treatment for my brown spots at a new clinic. This was my 4th treatment over the span of 2 years. I didn't feel the "zapping" that I did in my previous treatments and my brown spots have not gotten darker like past times- immediately after the treatments. I was expecting the pinkness on my cheeks,the slight scabbing for a few days and then the spots disappear or are much lighter. This experience was very different. Do you think it can have the same results if I didn't experience any of my expected/usual things? I know the settings must have been different and probably the machine. I hope I didn't waste money trying to find a new place closer to home. I know time will tell ...I was just wondering if there is somewhat of standard experience for the IPLs? Thank You
Excellent question! There are many different companies making IPLs now and they are not all created equally. The ones sold to salons and medispas tend to be less powerful and therefore... more What can I do about problems with irritation from tretinoin?Posted in Pigment problems, Hair Removal, Hair, Finding a Good Doctor, 2010 on Jun 01, 2010 | Permalink I was in India for a vacation till end of march and two weeks later went to a hair removing laser clinic, and started developing red patches on my skin and continued applying tretinoin on top of that, then the Dr gave me desonide to apply for a week and started on tretinoin again, my skin started peeling (more irritation, could see some pink skin underneath), then stopped tretinoin, how long can i stay without it, i have been on it for 7 years and it was going very well (0.05%). Can i ever go back to it?
I think I have this straight. You were using the tretinoin without problems until the India vacation, the laser hair removal (assuming on the face?), and then the desonide. It takes the... more Will self-tanner make my melasma worse?Posted in Skin Care Products, Self Tanning, Melasma, 2010 on May 28, 2010 | Permalink I am 32 and suffered from melasma from my pregnancies. Now I am so fanatical about sunscreen that I want to use a self-tanner to compensate for being so pale. Can I use self-tanner on my face, or will that make the melasma flare up? Thanks.
The good news is no! All the self tanners so far contain the same active ingredient (DHA) and they do not affect the pigment making cells (melanocytes) one way or the other. They just... more
My 26 yr old daughter has been taking Spirolactone 100mgs for acne for almost two years and it has been a miracle for her skin. She had tried everything with no results,so this has been great. She glows now. My question for you is..is this safe long term like and how long should she wait after getting off before becoming pregnant? Thanks for your answer.
These are all good questions and you are a very nice mom for caring so much about your daughter, but she really needs to ask her doctor these questions herself! Have her make an... more
Is it likely that Restylane will show through thin skin?Posted in Restylane, JuvedermRestylane, Juvederm and Restylane, 2010 on May 23, 2010 | Permalink Hi Dr. Irwin,
Can you tell me if Restylane will show through (either in lumps or color) in someone with really thin skin? Thank you so much for this website and all the information you provide!!
Bonnie
If it's placed correctly, it really shouldn't. We treat many thin skinned at our office with this product and Juvederm. If it's placed too superficially in the dermis (the layer of skin... more
Are there any non surgical treatments for stretchmarks on the abdomen that work?Posted in Stretch marks, Fraxel laser, Carbon Dioxide Lasers, 2010 on May 23, 2010 | Permalink Hello Dr. Irwin...
Thankfully my question isn't about treatments for my face. However I figured you may still be very well able to answer it. My skin problem is all over my abdomen. (stretchmarks) My stomach is for the most part-flat, so I really wouldn't need a "Tummy -tuck" but is there anything I can do besides surgery to remove these unsightly marks?
Signed,
Hopeful
Well - first of all, let me tell you what doesn't work so you won't waste your money! Don't bother with body Thermage for stretchmarks. It's even questionable in my mind whether body... more
After weight loss, is Thermage a reasonable choice to help tighten and lift lax skin?Posted in Thermage and Radiofrequency Devices, Thermage, 2010 on May 23, 2010 | Permalink hi there, first off, love this site, its so informative and hands on!As a 25 yr old who has yo-yo dieted for the better part of my life, | am noticing that it has really taken a toll on my face in regards to skin laxity and even sagging the cheeks (i have a very full/flat face with little cheek definition to begin with) and have noticed it has begun to droop downwards, creating nosolabial folds and jowls:( I have received filler to alleviate some of this, with some success, and have been further recommended to do thermage to tighten and lift my skin back up. My issue, being from Toronto, is thermage is pricy here (3500-5000) and I'd like to hear your input as to whether you feel this will benefit me or if I'm too young for it. Thanks!
Thank you!! Since you are twenty-five, I think it would be a good choice. Everyone is an individual but generally younger patients see more results (I'm guessing it's because there's more... more Dr Irwin:
I love you web site. It has answered many of my questions. Regarding Sculptra, it is suggested that a person with rheumatoid arthritis should not use Sculptra. Why not?
Thank you for your help.
DLW
Thank you! The two doctors who have done the most treatments in the world are Dr. Danny Vleggar in Switzerland and Dr. Bauer in Italy. In their series of greater than 10,000 treatments,... more
Should I use both Retin A and the Neostrata glycolic together?Posted in Skin Care Products, Skin Care, RenovaRetinoids, Renova Retinoids and Vitamin A Creams, Acne, 2010 on May 18, 2010 | Permalink It was recommended to me to use Retin A at night followed by NeoStrata Level 1 or 2. I was wondering whether it was necessary to use both a Vitamin A and glycolic product and if I should be using them together?
You didn't tell me your age or whether or not you have acne. But unless you have very tough, oily skin, I wouldn't recommend that combination to start out with. Why don't you try the... more What are these red and brown spots on my legs?Posted in Brown Spots, Blotchiness, 2010 on May 18, 2010 | Permalink Dear Dr. Irwin,
I am 54 years old and in menopause. The past 4 years I have brown spots on both legs below the knee. I get more and more usually starting as red botches and then turning brown, in all sizes. What can I do?
Grateful for your help.
Regards
Ruth Sternberg
Gothenburg, Sweden
Dear Ruth: Do you have a dermatologist nearby? I think it would be good for you to see one. What you're describing sounds like something called Schamberg's disease but it's absolutely... more Help! I have awful bags under my eyes after a Restylane treatment.Posted in Restylane, JuvedermRestylane, Juvederm and Restylane, 2010 on May 18, 2010 | Permalink | View Comments (1) DPlease help! I just had Restalyne for the first time 55 hours ago to help with the deep, dark circles under my eye. The well known doctor injected Restalyne under the muscle, using a threaded needle to inject the Restalyne into the corners or as near corners as possible. I have bruising on my left eye only, its ok, I can cover w/makeup.
However, both eyes have tear drop shape pouches on the top of my checks under the eye. It looks terrible as they stick out, swollen. Will this go away what should I do? It is Sunday, had this done on Friday afternoon. I saw your site and wished you were in the NYC area. Please help and can you recommend a good doctore in NYC or New Have, CT? Please.
Thank you so much.
Louise
Dear Louise: I wish I could answer every question you, my wonderful readers, send! I also wish I could do it quickly but that doesn't work with a job and children - something you all... more Is it better to do Botox before or after Thermage?Posted in Thermage and Radiofrequency Devices, Thermage, Lasers, Botox, 2010 on May 18, 2010 | Permalink Should botox or other injectables be done before or after thermage?
Since the purpose of Thermage is to tighten a little, maintain the jawline and eyebrow position, and build collagen, the timing of Botox with it really isn't important. But, if you're... more
What is the best filler for hollow cheeks?Posted in Sculptra, Radiesse, JuvedermRestylane, Juvederm and Restylane, Fillers, 2010 on May 13, 2010 | Permalink What is the best filler for hollow checks? I am 57 and have good skin, but I see some hollowing in the middle of my upper center of my cheeks. I have a full face, but not fat. I do Thermage and it works great for me so far. I tred Radiesse, but I agree with your opinion that it looks a little wooden when smiling. It has worn off some since I tried it last year.
If you have only mild to moderate hollows, then try the more robust forms of hyaluronic acid like Juvederm Ultra Plus or Perlane. These should last 6-9 months the first time and slightly... more
Can Thermage lift the brow in our 50s?Posted in Thermage and Radiofrequency Devices, Thermage, 2010 on May 13, 2010 | Permalink Does thermage for eyes work in women over 58 years of age to lift the brow area?
If you don't have too much sagging it will help. Plan on doing 2, or even possibly 3, treatments over 6-9 months for the best result nonsurgically. Dr.... more
Can Botox cause a problem with keloids?Posted in Scars, Botox, African american skin, 2010 on May 13, 2010 | Permalink Dr Irwin i am a african american 68 years old reasonable good health and i have this horizontal line between both eyes which causes one to not look pleasnt i also have those cooma on the side of face or labia and question is this i keloid and i am wondering if it botox would cause big problem for me i would so badly like to have just a little something done for me oh my what a life lift that would be
thanks
warmly
Dear Fran - Good question. Fortunately, the answer is no (or let's just say 99.9% no) is doesn't cause keloids. There are several reasons for this. First, we get less prone to keloids... more Should I keep using a product that burns and stings?Posted in Product safety, 2010 on May 06, 2010 | Permalink I have been using TNS Recovery Complex for 2 days now and my skin feels like it is burning & stinging. Is this expected or should I discontinue use. My daily regimen for past years is Obagi foaming gel cleanser, Paula's Choice skin refreshing toner and MD Forte SPF 30 sunscreen. At night I use Benzoyl Peroxide 4% and neutrogena moisturizer. I am 57 years old and a dark olive skin tone.
The answer to this is no, no and no!!! If any product burns and stings, you should stop it and report it to the doctor who sold it to you. You are probably allergic to one of the... more
What is the best treatment for under eye crinkles?Posted in Thermage and Radiofrequency Devices, Thermage, Lasers, JuvedermRestylane, Juvederm and Restylane, Fraxel laser, Eyelid Treatments, Eye Creams, Crows Feet, Carbon Dioxide Lasers, 2010 on May 06, 2010 | Permalink What is the best treatment for the under eye crinkles? Is it thermage or fillers or retin a or something else? Thanks, Bonnie
This is such a complicated question because it depends on sooooo many factors. I'll try to make a long story short! But, please see the section on eyes on this site. If you just have a... more Does the Ulthera system work?Posted in Thermage and Radiofrequency Devices, Thermage, Skin Care, Premature Aging, Maintenance, Jowlsjawline, Jowls and Jawline, Aging Skin, 2010 on May 06, 2010 | Permalink Have you heard of Ultherapy? Ulther.com is the manufacturer's site. I understand that it has just been approved this last fall. Would appreciate your opinion.
Ulthera is a ultrasound based technology designed as a competitor to Thermage the radiofrequency (also a sound wave) based system that can tighten facial skin and build collagen. Neither... more Which order is the best for products?Posted in RenovaRetinoids, Renova Retinoids and Vitamin A Creams, 2010 on May 04, 2010 | Permalink Hi Dr. Irwin
You recommend that you use Retin A after your moisturizer. Does the Vitamin A penetrate the skin as well as it would if you used it first and can you use a Vitamin C moisturizer in combination with the Retin A? I was also wondering if it was safe to use the Retin A around the eye area?
Thanks
Yes with a couple of adjustments! You can't use a Retin A gel over a moisturizer but it works with the creams. Put a light layer of moisturizer on - WAIT 10 minutes - and then apply... more |
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