Blog with Dr. IrwinCategory >> 0 Are these products safe during pregnancy?Posted in Skin Care Products, Skin Care, Pregnancy, 2011 on Jan 21, 2012 | Permalink Are any SkinCeuticals products safe during pregnancy & breastfeeding? I'm pregnant so I'm looking for a new anti-aging skincare routine & I'm not sure if I can keep using it.
Thank you
The safest products during pregnancy are organic or contain glycolic acid which is just made from a sugar, if you want to be really particular. All of the products sold without... more
Is it possible to relax forehead lines AND lift the brow with Botox?Posted in Botox Mistakes, Botox, 2011 on Dec 31, 2011 | Permalink Hello Dr. Irwin love the site :)
Botox question here. Is it possible to relax the forehead lines AND create a brow lift at the same time? If so....how does this work?
Thank you in advance for your answer and this great site, you are appreciated!
Yes ...... but only to a certain point. Many people who have 'hooding' (that excess skin) of the upper eyelid, use the forehead muscle (the frontalis) to pull up the eyebrows. By... more Can running make facial sagging worse?Posted in Sunscreen, Sun Protection, 2011 on Dec 31, 2011 | Permalink I began running in recent years, but have heard that it can actually make your facial skin sag because of the pounding force. I know exercise in general is good for skin because of helping with circulation, but is running a no-no?? Thank you!
There is no data on this but ...... I've treated runners for many years, have many friends and family who run (including marathoners) and run myself 2-3 times a week. As long as runners... more
Can tretinoin/Retin A etc., cause hair loss?Posted in RenovaRetinoids, Renova Retinoids and Vitamin A Creams, 2011 on Dec 31, 2011 | Permalink Have you ever seen tretinoin/retinol creams cause hair loss or thinning? My doctor does not believe my use of retinoids is related to some hair shedding I've been experiencing, but I have found other reports of bloggers/forum users who say it has made their hair worse. Thank you!
I agree with your doctor on this one. You'd have to be using way too much or eating it (jk) to cause any effect on hair. You just need a pea sized amount for your face. Dr.... more
Is liposuction safe?Posted in Fat reduction, Facial rejuvenation, Body Treatments, 2011 on Dec 31, 2011 | Permalink Hi Dr. Irwin -
I love your book and have purchased copies for friends. In it you advise against liposuction. Is that still your opinion with some of the new treatment options on the market like "smart" lipo?
Thank you! Hmmm ...... what I usually say about liposuction is to be very careful about who does it and realistic about goals. Maybe I didn't get that across clearly! Anyway, on the... more Are hydration masks worthwhile?Posted in Skin Care Products, Skin Care, 2011 on Dec 26, 2011 | Permalink Hello Dr.
I use all of the Skin Medica products but do you know of a hydration mask for normal/dry, I did not see any on that page. I also use some Eminece produts as well any suggestion ? :)
Some women love masks - some masks are made with clays, others with more astringents, still others with humectants (moisturizers). From a dermatologist's point of view their effect is... more A Sculptra complication - what can I do?Posted in Sculptra, Finding a Good Doctor, Fillers, Filler mistakes, 2011 on Dec 26, 2011 | Permalink Dear Dr.
I am russian with a naturally round face, rather flat, and prounounced cheeks. I had Sculptra injections in July this year in the cheek hollows and above the cheekbones, I was badly overfilled the day of injection that I hardly recognized myself. I hate the new volume in my face, it does not suit my face at all. I look so different, it has completely changed the natural anatomy of my face (now the widest point is above the cheeks up to the temple, which makes my face more angled, before or naturally the widest point was just below my cheekbones, having no angles and a round face). My former sweet and young looking face looks harsh and older. The high and overly pronounced cheekbones make me look almost agressive, and my eyes look smaller and more sunken, while the lower cheek next to the mouth look like a chipmunk. A lot of projection and volume next to the mouth and nose. My face feels almost stiff when smiling due to the huge volume and thikness increase. I am crying a lot, before i was a very good looking woman now I became invisible. I am really depressed and stoped going in public. How long I have to live with this? Will my face ever get back to what it was? Is there anything I can do to speed up the process?
Mny thankd for your answer
First of all, I am so, so sad that this happened at all. Sculptra can be lovely when it's done gradually over a period of months and the doctor doing it has a good "aesthetic eye." ... more What is the best treatment for sun damage on the chest and hands?Posted in Lasers, Hands, Brown Spots, 2011 on Dec 26, 2011 | Permalink Hi,
Which treatment is best to treat sundamaged skin on the hands and upper chest area? IPL, or LED rejuventation?
Okay - so this is a complicated question because I don't know your age or exactly what's bothering you. Sun damage has a lot of different problems it can cause. It can make the skin... more HAPPY HOLIDAYS EVERYONE AND I HOPE YOU ALL HAVE AN AMAZING NEW YEAR! And, thank you all this past year for all your wonderful and intelligent questions. I sincerely hope I've been able to give you information which will help you in this confusing cosmetic... more
Type IV skin and acne scarring - which treatment is best??Posted in Pigment problems, 2011 on Dec 21, 2011 | Permalink Hello Dr. Irwin,
I am skin type 4 and have deep acne scars on my face, I was reading so much about Fraxel-Restore as that is only available in my country and had almost made up my mind about going for it. When surprisingly my Dermatologist (She is the most trusted one, and easily the best this country has) told me that No, Fraxel will not help so much for your scars as much a Fractional CO2 laser would do, because my scars are very deep indeed. Now I know the difference is Fraxel Restore is Non-Ablative and the latter being Ablative.
I have seen and read some Horror stories about people getting PIH (Post Inflammatory Hyperpigmentation) with Fractional CO2 laser, Especially with skin type 4-5. So should I be considering it in the first place. My Dermatologist who has almost now 30 years of experience has strictly said no for Fraxel as it would not help and I woulD unnecessarily end up spending lots of money on several Fraxel Restore sessions. She said I don’t think Fraxel will help you atall and that’s Period ! What do I do.
I can go with Fractional C02, but I am most worried about PIH and my skin is very sensitive and I did a Glycolic Peel of 20% some years back and it gave a very bad PIH which still has not gone. But I was just thinking Glycolic Peel and Fractional CO2 are two different things maybe the Fractional CO2 it will not give me a PIH . But I don’t know any suggestions, advise ?
Thanks
My apologies for the delay on this. I think you wrote in November. If you have deep acne scarring, I agree with your dermatologist. You will get much more benefit with the fractional... more Red spots on the body - can anything be done?Posted in Lumps bumps moles, Growths, 2011 on Dec 21, 2011 | Permalink I have about a dozen tiny red dots on my chest and back. Most look like a broken capillary, but some are a little bigger. I'm guessing it is largely from sun damage because although I've never been a sunbather/tanning bed person, I lived in a desert and am very fair skinned. Is there a way to get rid of these dots? I am a 43 yr old female.
You'll want to be sure you see a dermatologist for an accurate diagnosis before removal but often these are small blood vessel growths often referred to as cherry hemangiomas. They are... more Hi Dr Irwin,
I am so glad I found your site and even more excited that your office is close by! My question is regarding sebaceous hyperplasia - how can I get rid of them? I am 56 and they seems to be multiplying. My brother who is 11 years older than I am has them all over his face.
Any advice would be greatly appreciated!
Many thanks,
Karin
You're right that these are usually genetic in that these pesky bumps track with oily skin, large pores and acne (at least in the teens). The first thing you want to do is make a... more
Is there a way to fix a noticeable facial asymmetry on my left?Posted in Thermage and Radiofrequency Devices, Thermage, Sculptra, Fillers, Facial rejuvenation, Carbon Dioxide Lasers, 2011 on Dec 21, 2011 | Permalink Hello Dr. Irwin I LOVE your site! With that said, I've taken the time to go through quite a bit of your blog to get my question answered and still cant quite pin down what I'm looking for. So here is a bit about me and my question will follow.
I just turned 40. The left side of my face is significantly more lax in skin texture (very visible) than my right. The other problem is I have significantly more pronounced crows feet/lines under the left side of my eye opposed to the right as well.
I'm hoping to get the left side to match the age on my right...at least the best I can. I HAVE started botox for all my problem areas. Great stuff.
I've read great things about your thermage treatments and the tightening effects on the skin. I've also read great things on your DOT laser experience and results as well. My question is which one would you suggest to get the skin tightening results I so desperately want and also treat the pronounced crows feet?
Thank you!
Thank you! It would be interesting to have you look back at photos when you were 16-25. Can you see the asymmetry even back then or younger? Some people have an inborn (genetic)... more What is the best sunscreen to use on kids?Posted in Sunscreens, Sun Protection, Children and Babies, Children Babies, 2011 on Dec 13, 2011 | Permalink I have kids, what is the best sunscreen to use on them. I need something that won't go in their eys. Last summer I used the large chapstick type applicators. We live in California and are out a lot in the sun.
Good question and it would help me to have their ages! Here are some general ideas though. For babies and very young children, our office likes the Vive Sana 'Solar to Polar Baby.' It's... more A small brown spot on the legs - what is it?Posted in Brown Spots, 2011 on Dec 13, 2011 | Permalink What does small brown spot in legs indicate? Everyone - just a reminder. A brown spot can be anything from a deadly melanoma skin cancer to a harmless freckle (lentigo). This is not the place for a web or self diagnosis. ... more
I have bruises after Juvederm!! Anything I can do??Posted in JuvedermRestylane, Juvederm and Restylane, Fillers, 2011 on Dec 12, 2011 | Permalink I got Juverderm under lower lip and chin couple days ago. I Have two large purple color bruises each side. How is that treated? How long it will take to go away? or is that treatable at all? Thanks for responding.
Any time a needle is used in skin there is a potential for a bruise! The best option is to try and prevent them in the future. Try these tactics. No aspirin (unless required by a... more Does this sound like a good Thermage plan in London?Posted in Thermage and Radiofrequency Devices, Thermage, 2011 on Dec 12, 2011 | Permalink Hello Dr Irwin, I am a 30 year old male who doesn’t smoke and has fairly loose skin for his age. Am I to young for Thermage? I went to see a Dr in London who recommended Thermage at a heat setting of 4-4.5, under local anesthesia and using 600 pulses. With your experience, is this safe and inline with the guidelines you undertake in your office?
Hmm ...... I'm a little puzzled as to why he/she is recommending local anesthesia. All I can think is that the office might not have the newer Thermage equipment with the sapphire cooled... more
Are injections of filler inside the mouth safe?Posted in Fillers, Filler mistakes, 2011 on Dec 08, 2011 | Permalink Can you use fillers in your gums to hide grey teeth inplants?
The answer to the above is no. And, in my opinion, injecting fillers into the face through the mouth raises safety issues. Think about it! The mouth is one of the most bacteria... more How long do I need to wait after Accutane treatment before I can have my scars treated.Posted in Lasers, Fraxel laser, Carbon Dioxide Lasers, Acne Scars, Acne, 2011 on Dec 08, 2011 | Permalink I got off of Accutane in June. I have some acne scars and would like to use the Fraxel laser. How long do I have to wait? I don't want there to be any complications.
The short answer is this that if you are thinking full face traditional ablative CO2 resurfacing, then you need to wait a full year. If you are considering the Fraxel or the If I only have time for one product, what should it be?Posted in Skin Care Products, Skin Care, RenovaRetinoids, Renova Retinoids and Vitamin A Creams, 2011 on Dec 08, 2011 | Permalink Dear Dr. Irwin, Your website is the best one out there and I have used it for my research prior to a Thermage treatment I'm having done next week. I am one of these women who have always been low maintenance and I hate putting on a bunch of products several times a day. I don't wear makeup unless it's a party but I do use metrocreme for rosacea now aggravated by hot flashes. My question for you is this: Is there a beauty regimen in which I only use one product that will moisturize, de-wrinkle, firm up and shield from sun damage. I know I'm asking for a miracle creme, but I know myself well, and I know I will not buy a handful of products, because they will sit around until I toss them out. I've spent hundreds of dollars on products, and would rather just buy one really good thing for maintenance. What do you say?
Thank you for that wonderful compliment!! I would say that if you only had one product to use and you are over 40, use Renova or Refissa (if you're really dry). Retinoids are still the... more How risky is Fraxel laser for Asian skin?Posted in Fraxel laser, Asian skin, 2011 on Dec 04, 2011 | Permalink Dr. Irwin,
How experienced are you with treating Asian skin with Fraxel? How were the results? I have read that there are some issues with post-inflammatory hyperpigmention, which I am most concerned about.
Thank you
This is a good question. The best data on this comes from Dr. Henry Chan who is based in Hong Kong. One of his papers published in Lasers Surg Med 2007;39:381-5 titled "The prevalence... more Is Thermage safe for African American skin?Posted in Thermage and Radiofrequency Devices, Thermage, Radiofrequency systems, African american skin, 2011 on Dec 04, 2011 | Permalink Is thermage suitable for for African or Afro Americans?
Yes - it's extremely safe because it uses radiofrequency (a sound wave) and is not laser (light waves). Radiofrequency based technologies like Thermage are safe for all skin... more A question about darker skin under the arms and in the groin area.Posted in Pigment problems, Body Treatments, Asian skin, 2011 on Nov 30, 2011 | Permalink Hello Dr. Are the darkened skin in the pubic area and under arm also called melasma and do the medications for melasma such as renova, hydroquinon, and peeling work for those skins? I am an Asian woman and my skin in those areas are 3-4 degrees darker than the olive skin in the rest of my body and I feel embarrassed.Thank you for your help and advice.
First, generally this isn't referred to as melasma because it isn't caused by the interaction of female hormones and light exposure. Other causes can include genetic (other people in... more Hello Dr. Are the darkened skin in the pubic area and under arm also called melasma and do the medications for melasma such as renova, hydroquinon, and peeling work for those skins? I am an Asian woman and my skin in those areas are 3-4 degrees darker than the olive skin in the rest of my body and i feel embarrassed.Thank you for your help and advice
Please see my response just prior but I also wanted to tell you that you are not alone! Many women (and some men) have this also and are concerned about it. I know this doesn't always... more
Hi, I sent a previous question to you, I would very much appreciate it if you would take my name off if you do add it to your list of Q and A's. Thank you.
I never intentionally leave a full name on a question if it's published. Sometimes I'll leave a common first name but there's no way to identify you. If I've left a name on somewhere,... more
A possible Juvederm complication?Posted in JuvedermRestylane, Juvederm and Restylane, Filler mistakes, 2011 on Nov 30, 2011 | Permalink Hi, I had juvederm about 5 weeks ago to my lip area and a tiny line one a wrinkle on my forehead. After the injection I had swelling which on my lips went down but on my forehead was around 2mm all around it. My nurse said it was swelling which could take a couple of weeks to settle and to leave it. 4 weeks after treatment I gently rubbed up and down once to help smooth it and it seems to have aggravated it more still being swelled. It isn't red but is a little uncomfortable. I can notice the swelling at certain angles and light. I am worried it will stay like this and hope the fluid around it will settle. By rubbing it whats the worse damage I could have done? I don't mind that the treatment wasn't successful but will I be left with this until it wears off. Thank you for your time and look forward to hearing from you
Generally, if you have waited a full week and it's still not good, it's time to go back to your doctor/nurse to have them look at it. There is an easy way to eliminate Juvederm bumps... more
Do we really need makeup? Is British skin the best??Posted in Skin Care Products, Skin Care, 2011 on Nov 30, 2011 | Permalink I found your web site very helpful but I want to ask if not wearing make up at all is a good idea? I am British and was never brought up on using makeup and the British are supposed to have the best skin I think! Thanks.
I loved your question because no - none of us really need makeup - humans lived for thousands of years without it. But...... many women love it, find it an affordable luxury, it's... more What about IPL for melasma?Posted in Melasma, IPL and Photorejuvenation, IPL, 2011 on Nov 30, 2011 | Permalink Is IPL an effective treatment for melasma? How does it compare to fractional laser or microdermabrasions? I've read conflicting information regarding IPL for melasma.
Please, please avoid this one. IPL in most patients with melasma is more likely to worsen it than improve it. In very rare instances, if you have very light skin (like a redhead), and... more
I don't have all the money in the world so I can't afford to do everything. However, if I should choose just a couple of lasers for wrinkles and overall appearance, what are the best ones. My doctors office just started offering Pearl Fractional, but there are so many different lasers, my head spins. What is the best types of lasers and specifically what are the best names of lasers for wrinkles. I'm in my mid 30s.
I think a lot of people have the same "my head is spinning" problem on this. There's so much marketing and not a lot of good, real information. Here's how to start. First, what kind of... more How can I continue to look great while I'm raising my children?Posted in Skin Care Products, Skin Care, RenovaRetinoids, Renova Retinoids and Vitamin A Creams, Antioxidants, 2011 on Nov 20, 2011 | Permalink I'm in my mid 30s. I just had my last baby. I want to start looking great again. You have many wonderful products and treatments listed. What are the best products that I should be using. My doctor recommends Obagi, but I'm open to anything that is the best (highest amounts of the good stuff, like a 20% vit. c). I just want to look good while I'm raising my kids. Also, what are the best lasers for wrinkles and general youthful appearance on the market today? Just found your site and love it!
Thank you! See the question right before this for the laser answer. Obagi has some good products my concerns with that line are that it's overly irritating for many and they tend to put... more A possible Juvederm mistake?Posted in JuvedermRestylane, Juvederm and Restylane, Filler mistakes, 2011 on Nov 20, 2011 | Permalink I had Juvederm in my nasolabial folds 8 days ago. It looked great; I had minimal swelling and it looked very natural. Today, I noticed that my smile is very noticeably crooked. It is normal on the left side, but sort of a half-smile on the right, and my cheek seems to be pushing "down". I already looked at pictures to see if this was an asymmetry I hadn't noticed before, but that is not the case. Is it possible the juvederm shifted? I look a little weird!
Only your doctor knows exactly where that Juvederm was injected. You must call and go back to the office so he/she can look at it - it's really the only way to know. A good office will... more
All of the doctors you've recommended are too far from me and after doing a search I found a cosmetic dermotologist in Lubbock that offers Thermage Treatment. Is this as safe as IPL? Will it improve melasma? I'm 37 and starting to get fine lines but I have an issue with melasma even with sunscreen everyday and a 2% hydroquinone cream at night.
Please read this article on melasma before you do anything! And no, Thermage will not improve melasma. Dr.... more
A doctor asks a question about Botox.Posted in Botox Mistakes, Botox, 2011 on Nov 13, 2011 | Permalink I've been injecting Botox for patients for a few years with very good results. Recently a petient returned after her treatment with a horizontal line above the bridge of her nose which was more prominent after the Botox treatment.The forehead and 11 lines of the glabella are fine. What would you suggest. Thanks, Dr Steve W
Dr. Steve - As a doctor you are always welcome to call my office number and ask my staff to take a message. I'm happy to call you to discuss also. In general, if that horizontal... more
A doctor asks a question about Botox.Posted in Botox Mistakes, Botox, 2011 on Nov 13, 2011 | Permalink I've been injecting botox for patients for a few years with very good results. Recently a petient returned after her treatment with a horizontal line above the bridge of her nose which was more prominent after the botox treatment.The forehead and 11's lines of the glabella are fine.What would you suggest .Thanks, Dr Steve W
Dr. Steve - As a doctor you are always welcome to call my office number and ask my staff to take a message. I'm happy to call you to discuss also. In general, if that horizontal line at... more
What is the most effective interval between Fraxel laser treatment?Posted in Melasma, Lasers, Fraxel laser, 2011 on Nov 13, 2011 | Permalink What's the most effective intervals between fraxel laser treatments?? tnx
The answer to this really depends on your goals and your timeline. If you have a wedding in 3 months it might change your planning. In general though, 4-8 weeks is optimal. You'll see... more We'll also be lauching our new improved home page in the next few weeks. :)
Visit our new TOPICS page. We are hoping to have a way for you to tell us what topics you'd really like to see more info on as well. Thank you for coming to SkinTour! Dr.... more How can men avoid that overly feminine look with fillers?Posted in Mens Skin Care, Fillers, 2011 on Nov 09, 2011 | Permalink Can you comment on fillers for men, especially around the cheekbone area? How does a man avoid getting a feminine look from fillers?
Good question - I'm guessing a lot of men are concerned about this. Basically, if you study the face shape and contours of good looking men there is quite a variety, isn't there. But... more What is the most effective interval between Fraxel laser treatments?Posted in Lasers, Fraxel laser, 2011 on Nov 04, 2011 | Permalink What's the most effective intervals between Fraxel laser treatments??
The answer to this depends a little on what your goals are? Are you treating acne scars, wrinkles, texture problems, or sun damage for example? And most studies were a series of two... more What to do about winter dry, itchy skin?Posted in Skin Care Products, Skin Care, Product safety, 2011 on Nov 04, 2011 | Permalink My skin gets quite dry during the winter. Lately when I get out of shower, my face is not only very dry but red too (at night). I basically follow your skin care regimen. I was wondering what else I could do to add moisture. I do moisturize before using Renova, but will that cause the Renova to be less effective? And how often is ok to exfoliate when you have dry skin? Would using a gentle peel instead of a scrub be better? Please help!
Thank you!
One thing to consider is that one or more of your products is irritating you. I really think you should see a dermatologist for help and take all the products you've been using. In the... more A problem with too much Juvederm around the Marionette lines?Posted in JuvedermRestylane, Juvederm and Restylane, Fillers, 2011 on Nov 04, 2011 | Permalink Hi - about 7 months ago I was a model for a visiting Italian doctor, who is highly respected in this field. I was injected with Juvederm for my marionette lines, but immediately noticed swelling on either side of my mouth (the lines were not filled either!) which I massaged over a week, but to no avail. They are still there, and make me look jowly (they throw shadows onto my skin). I was offered the enzyme to remove it, but was also warned that it can make the face saggy and it will require more filler to make good, which could result in a mess. So I am sitting it out, waiting for it to dissolve. My worry is that it is scar tissue, and will never disappear. What do you advise?
Thanks so much!
My apologies that this took so long to answer! In general, if there's too much Juvederm, there is too much! Have it dissolved. Your face will go back to where it was and that won't... more
A good result with Botox/Juvederm around the lips but one small problem?Posted in Fillers, Filler mistakes, 2011 on Nov 04, 2011 | Permalink Dr. Irwin, thank you for answering my question regarding the use of Botox and Juvederm to correct the wrinkles above my upper and lower lips and around my mouth. I had the procedure done. The doctor used 1 unit of Botox in 5 points around the top and bottom lip and then filled in the wrinkles with Juvederm. It worked wonderfully and it's 12 hours later and there are no issues with pursuing my lips! I do have, however, a small lump in my upper lip directly in the center. Will this go away?
I'm so glad you had a good result and kudos to you for taking the time to find a good doctor! Sometimes that is the hardest part. If you have a small bump in the middle, it could... more
Do you have to wait until filler wears off completely before repeating it?Posted in JuvedermRestylane, Juvederm and Restylane, Fillers, 2011 on Oct 31, 2011 | Permalink Hello Dr. Irwin,
With Juvederm, do I have to wait till the products is all gone to have it done again (around my nose and mouth) or can i get it done (maintain it) when I start to see some deflation? Don't like the look when it wears off complete and have to wait I guess.. I get use to my better face until the old one comes back lol..Ty :)
No, in fact I think it's better to schedule your next treatment prior to it's complete resolution. If you do that, you'll gradually build more of a base and your results will keep... more Can I use retinoids while living in a very hot, humid climate?Posted in Sunscreens, Sun Protection, Skin Care Products, 2011 on Oct 31, 2011 | Permalink Can I use retinoids while living in a very hot, humid climate?
Yes, but only as long as you really sunscreen well with a sunscreen that blocks UVA as well as UVB well and wear a hat with a full brim when you're outside in direct sun. Or, if you... more
How do I know if my products are right for me?Posted in Skin Care Products, Skin Care, Acne, 2011 on Oct 31, 2011 | Permalink Dr Irwin,
What are some of the symptoms of over exfoliation? I'm 40, with very fair skin, live in a sunny climate, use Retin-A nightly and gentle facial scrub 2-3 times a week. I also use Skinceuticals Blemish/Age Defense 2-3 times a week in the morning to help with occasional breakouts. Since I've been on this routine my breakouts are gone, which is a wonder as I've had them non-stop for years. But I'm wondering if this is too much, f.e. maybe Retin-A every other night is enough... How do I know that my routine is just right? Thank you.
This is a good question because there really isn't a meter you can plug in that will tell you. Generally though, if you skin looks hydrated and not dry or irritated, and your breakouts are... more How much sunscreen for the face is enough?Posted in Sunscreens, Skin health, Skin Care Products, 2011 on Oct 24, 2011 | Permalink There is a dermatologist who appears on youtube that has explained that when using a physical only (non-carbon sunscreen) only a pea-sized amount is required for the face (not including neck). He says and demonstrates that this pea-sized amount needs to be dotted all over the face then spread and blended. I had never heard this before and am wondering do you agree?
Not really. If you live in the north, spend all day indoors, and don't spend much time in your car (remember UVA comes through glass), then that might be enough. Otherwise, I would... more
What do you think of home high frequency devices for acne?
It depends a little on which one but, in general, they can help individual lesions resolve a little faster, when used as directed. If you're someone who gets occasional acne lesions, this... more
What is the difference between these two lasers?Posted in Carbon Dioxide Lasers, 2011 on Oct 24, 2011 | Permalink Hello,
May you please advise on the difference between Fractional CO2 Laser and Fractional Affirm Laser?? tnx
These are both fractionated (sometimes also called pixilated) CO2 lasers. The first term is a generic way to describe all the CO2 lasers while the last one is a specific brand. Here's a... more
Who performs Fraxel an aesthetician or an MD?Posted in Lasers, Finding a Good Doctor, Carbon Dioxide Lasers, 2011 on Oct 24, 2011 | Permalink Who performs Fraxel an aesthetician or an MD?
I know this is really confusing to consumers because the use of cosmetic lasers are governed by laws and statutes controlled by the states in the United States. In other countries, legal... more Does the new Elure Skin Lightening cream with 'Melanozyme' work for melasma?Posted in Melasma, Brown Spots, 2011 on Oct 19, 2011 | Permalink --------------------------------------------------------------
Hi Dr. Irwin-
I am a woman in my early thirties that experienced melasma from my pregnancies. I am no longer on any birth control and I VERY careful about sunscreen and sun exposure. I have Asian skin and have tried tri-luma. I recently read an article stating that a new product called Elure Advanced Skin Lightening actually "dissolves hyper pigmentation using melanozyme to destroy melanin accumulation on the surface of skin." Have you heard of this line or tried this product. Thank you.
So far, I think this is another triumph of marketing over substance/science - but time will tell. Elure's patented 'Melanozyme' is the enzyme lignin peroxidase which is an enzyme... more Is this a reasonable price for a syringe of Radiesse?Posted in Radiesse, Fillers, 2011 on Oct 19, 2011 | Permalink How much does a syringe of Radiesse cost? I was quoted $1000. How much does that cover? I want my lip folds and around the mouth to be treated. I think the price is outrageous.
That seems high to me unless you live in the poshest area of a large city like New York, London, etc. See my article on the Average Costs of Cosmetic Procedures to get a better idea of... more
Is eyelid Thermage okay with permanent eye liner?Posted in Thermage and Radiofrequency Devices, Thermage, Eyelid Treatments, 2011 on Oct 19, 2011 | Permalink Can a person with permanent eye liner (upper and lower) have thermage?
Does it do anything to the eye liner?
Each case is unique, but usually Thermage, which is a sound wave (radiofrequency), should not affect permanent eyeliner. Be sure to tell your physician about your permanent eyeliner during... more
What is the best treatment for lip wrinkles. Not the smile lines or wrinkles above the lip, but my actual lips. They are full, however, they don't appear smooth. When I put on my lipstick, my lips appear to be full of verticle lines.
It would be very reasonable to try, in this situation, a series of 3 light beta hydroxy peels or light glycolic peels about 2-4 weeks apart. Find someone experienced with these. Then... more
What is the latest laser technology for acne scars?Posted in Carbon Dioxide Lasers, Acne Scars, 2011 on Oct 17, 2011 | Permalink Dear Dr. Irwin,
Kindly advise on the latest technology in acne scars after the Fraxel laser. I heard there's a new kind of laser recently released but i really cant remember it's name. Thank you. -Areej
Here is a link to the article I wrote on fractionated CO2 lasers. Sometimes in our practice here, we will combine several modalities like subscision, CO2 or Fraxel, and certain fillers... more
Hi Dr. Irwin,
What is your opinion about peels? I am 41 years old and I have good skin. I was thinking of getting a series of peels for antiaging benefits. I have never done Botox or any fillers or anything like that. Is doing a series of peels a good idea? Would you recommend glycolic peels or a vitalize peel? I have some fine lines, but no major wrinkles.
Thanks so much!
I'm a fan of peels, as are many dermatologists, when done by trained medical personnel and matched to goals and skin type. In general, you will get better results from nurses or... more How does Thermage compare to the Titan?Posted in Thermage and Radiofrequency Devices, Thermage, Facial rejuvenation, 2011 on Oct 14, 2011 | Permalink Can you tell me how Thermage compares with the Titan laser?
The Titan has much less data and experience behind it although it claims to do the same thing. It uses an infrared wavelength (1100-1800 nm) of light instead of radiofrequency (sound... more What's the best skin care at age 23?Posted in Skin Care Products, Skin Care, Antioxidants, 2011 on Oct 14, 2011 | Permalink Hi Dr Irwin! I am 23 years old and have good skin, but am wondering what products I should be using to keep it healthy. I have really fair skin and sunscreen is my best friend, so I already have that covered. I currently use Cetaphil cleanser and moisturizer. Are there better quality products I should be using to prevent my skin from aging? Thanks!!!
I love that you're thinking about this because it's so much easier to prevent wrinkles, blotchiness, sagging etc. than it is to prevent it! And, I love that you are using sunscreen on your... more Advanced skin care - in what order do I use these products?Posted in Skin Care Products, Skin Care, RenovaRetinoids, Renova Retinoids and Vitamin A Creams, 2011 on Sep 30, 2011 | Permalink I use Renova at least 5 nights a week; I use a cream with glycolic acid on other nights to help with dryness. I am wanting to incorporate the TNS Recovery Complex in my daily regimen. I read that for best results it needs to be used twice a day for the first 3 months. Would I need to use this each night under my Renova at night or alternate these two?
Thank you
You bring up some good issues. In general, if you use Renova regularly, you don't need to use the glycolic (can often aggravate dryness and does similar things but less). If you're having... more I recently went for a consult for the area around my mouth and lips. I have pretty severe wrinkle damage in that area due to years of sun damage and smoking.
The MD recommended doing a small amount of botox in five point areas around my mouth BEFORE doing Juvederm. I am confused by this and slightly nervous. Have you heard of this before?
Yes, this is a fairly common use of Botox but is an "off-label" area for the FDA. The product itself is still safe, of course, but the MD should be very experienced to get this right. ... more Is there a good over the counter hydroquinone cream for hyperpigmentation?Posted in Pigment problems, Melasma, Brown Spots, 2011 on Sep 24, 2011 | Permalink Can you please recommend some over the counter hydroquinone cream brands? I have hyper-pigmentation and would like to try and over the counter bleach cream. Thank you.
All of the over the counter "bleaching" products that contain hydroquinone are limited to a 2.0% concentration in the United States. Prescription creams are usually 4% and dermatologists... more Would it be a good idea to use the DOT CO2 laser on the legs for wrinkles/lines?Posted in Wrinkles, Lasers, Body Treatments, 2011 on Sep 24, 2011 | Permalink Hi Dr. Irwin.. I'm now 40 years old. I had written a long time ago about DOT Therapy. Also I know there are different machines out there-which ones the best? Do you suggest having it done on the thighs and lower legs for crepiness/skin lines? I have tried everything other then lasers. I'm extremely embarassed of the way my legs look. I had a test spot done but not sure if one time testing will actually show me any difference. What's your thought and do you know of a good doctor in the Thousand Oaks/Los Angeles area that is reasonable. Thank you - thank you....i am so thankful for your input-
This is a tough one because the answer to this really isn't known. I think there are a LOT of women (include me on this one) who would love to get rid of the sun damage, and some of that... more Hi Dr Irwin,
Your website is excellent for skin information but I think is poor on the hair information and there are many many ladies like myself that suffer from dry, frizzy, breaking hair due to excessive colouring. Could you please tell us a good product to help restoring healthy hair or could you please enrich information on the hair section. Thank you very much.
You're right about that! I sometimes think though that there's so much new going on in the skin world that it may be quite awhile before I get to it - my apologies! In the meantime,... more
I'm getting married soon - can you help?Posted in Peels, Microdermabrasion, 2011 on Sep 21, 2011 | Permalink Hi,
I am 41 and have started to see fine lines around my eyes.
I am getting married in three months and would like your advice on any procedures that would help. Thermage? Botox?
I am also very unhappy with the tops of my arms as I have untoned arms which I think are baggy. What would you reccommend?
A friend said Laser lipo but do I have enough time for something like this.
Hope you can advise me as Im not sure if I would see any results in time for my wedding.
Thankyou for your time.
Okay - so I'm going to assume that you've maximized your products - sunscreen, tretinoin or retinol, and an antioxidant at least. Here are some of my favorite skincare products. Then... more Things I'm reading on the web about Sculptra???Posted in Sculptra, JuvedermRestylane, Juvederm and Restylane, Fillers, 2011 on Sep 21, 2011 | Permalink Dear Dr, Irwin
I had my 1st series of Sculptra placed in my temple region and cheeks on August 11th 2011. ( one week ago) I am a 46 yr old female & have been a runner for years which left my face somewhat hollow. My question is this. I am reading many negative things about Sculptra. I guess I should have done my research prior to the injections. Nonetheless, I am thinking about discontinuing the next two series of Sculptra injections & was wondering if I could get Juvaderm Plus injected into my temples instead? If so, how long should I wait before having the Juvaderm injected into that area?
I'm hoping that you don't believe even a quarter of what you read on the web! It's really not always very accurate. You may be very happy with the Sculptra since, when it's done well,... more What can I do about small scars on the face after a procedure?Posted in Fraxel laser, 2011 on Sep 21, 2011 | Permalink Hi Dr. Irwin,
I have been reading your articles and blogs for several months now. I have a question: I had facial warts removal surgery by electrotrautory ( think that's what it's called) 8 months ago and it left me with some depressed scarring on the face. And I'd like to know what can I do to remove these scars? Appreciate you could answer my question, many thanks!!!!! Ellie
Ellie - you didn't give me your age, but in general the Fraxel (a fractionated erbium laser) works well for small, depressed scars. It's used frequently to treat smaller, depreseed... more
Is it ok to have Botox or fillers if you have high blood pressure?
In general, as long as your blood pressure is well controlled, the answer is yes! You should not have any problems with Botox or filler injections. Dr.... more
Do I need to change my moisturizer for different seasons?Posted in Skin Care Products, Skin Care, Moisturizers, 2011 on Sep 17, 2011 | Permalink Do I need to change my moisturizer/skin care for Fall & Winter seasons?
That depends on where you live and how oily you are. If your weather really doesn't change much with the seasons, than probably not. On the otherhand, if you have dryer skin and live in... more
What might help sagging skin on the breasts after child birth?Posted in Body Treatments, Body Thermage, 2011 on Sep 17, 2011 | Permalink Hello Doctor,
I am 32 years old and I have a lot of loose skin at my breast (sagging) due to pregnancy and child birth. Can I use Thermage CPT for skin tightening?
Thank you,
sagging
Okay - I really wish that the Thermage body tip worked well for this but it doesn't! Please don't waste your money. There is an occasional person who gets a great result from the... more
What are these tiny bumps on my forehead, neck and chest?Posted in Lumps bumps moles, Acne, 2011 on Sep 17, 2011 | Permalink I have multiple tiny bumps all over my forehead, neck and chest from last 4 years.They do not seem like acne as they never go away and never grow in that size. I have observed that the edge of the bump is slightly red and top of the bump is of skin color. they are not visible from far but under light clearly visible. On the neck it appears as if someone has pasted skin color muster seeds. I have tired BP (5%) which keep them in control but does not go away completely. Please advise what skin disorder I am suffering from and how to treat this.
Ladies, ladies ......... please remember that to really treat something well, it's important to know what it is! This is a situation where you really need your dermatologist because... more
How can I really make good product choices for myself?Posted in Skin Care Products, Skin Care, Acne, 2011 on Sep 17, 2011 | Permalink Dr Irwin,
In your product recommendations you often say for which skin type a product is suitable, but I couldn't figure out how to tell for which skin type a certain product will work best. I live in a warm humid climate, and this makes me a bit more acne prone compared to when I used to live in dry climates. I'd love to know for myself how to make skin friendly choices of skin care products that I should use. Thanks.
You bring up a good point because the best skin care really is individual - not a clone of someone else's plan. Try thinking about it starting with 3 basic things -
Overwhelmed by information at a consult - how can I sort it out?Posted in Finding a Good Doctor, 2011 on Sep 17, 2011 | Permalink --------------------------------------------------------------
Hi Dr. Irwin,
I'm in my early 30s and went in for my very first consultation with a reputable cosmetic dermatologist to find out what I could start doing now to keep myself looking great through my 30s and into my early 40s- My goal was to prioritize treatments for now and find out what to save up for over the next few years. I'm writing because I came away overwhelmed and ended up not booking any treatments- I felt like they threw the kitchen sink at me! You name it; fillers, botox, thermage, fraxel- and all in the near future. I'm definitely starting to show some signs of aging, but I'm still often mistaken for being in my late 20s and show few signs of sun damage, thanks to religious sunscreen use.
Is it common for someone as young as me to have all those procedures or is it up to the patient to prioritize what treatment they have to do? I've consequently booked a consultation with another dermatologist to get a second opinion, but I'd love to hear your thoughts- How do you know when a dermatologist is being too aggressive?
Thanks!
I think this is a frequent problem and I've heard this from many other women too! So a couple of things - no - at your age you do not need all these treatments. If you're in your early... more Hi Dr irwin,
Thank you so much for all this great information! I just read your article on Rosacea.
I do have a question though. I have tried all of the options and still have the redness even after the V-Beam treatments. My question is: Could Accutane be prescribed by my dermatologist at a low dose for a short amount of time for the redness? Thanks again!
Accutane is not a good option for rosacea redness. I feel like I need more information about that laser treatment(s) but here are some things to think about: 1. Always maximize your... more Which moisturizers are good?Posted in Skin Care Products, Skin Care, Moisturizers, 2011 on Sep 14, 2011 | Permalink In your recent article "Dr. Irwin's Skin Care Regimen" you never mentioned if you use a night time moisturizer, you went straight to eye products after you use prescription Renova vitamin A cream. I use Tazorac but always use both an eye cream and then moisturizer last. I was wondering what moisturizer you use if any?
Oops - I need to fix that don't I. And I need to update the products generally - I'll do that in Sept-Oct. Thanks for letting me know. I do use a moisturizer but I vary it summer to... more Is this Botox info true?Posted in Botox Mistakes, Botox, 2011 on Sep 14, 2011 | Permalink Hello Dr Irwin,
I have booked an appointment to have Botox injected into my forehead for the first time. When I spoke to the Doctor she said that there was a 20% chance of drooping of my eyes if I didn't get another injection between my eyes also. Is this true?
Andrea
Wow - maybe this was a misunderstanding? ? It's hard to know if that' s what she really meant. A Botox injection between your eyes won't droop your eyelids. And as for droopy eyelids,... more
Are Botox and Thermage compatible?Posted in Thermage and Radiofrequency Devices, Thermage, Radiofrequency systems, Botox Mistakes, Botox, 2011 on Sep 11, 2011 | Permalink Hi Dr Irwin,
Can you please tell me if Thermage or radio frequency treatment can be performed if you have had had Botox within a month? I was about to have a radio frequency treatment and when my therapist realized I had recently had Botox, she said I have to wait 4 months to have the treatment as the paralyzed muscle would become irritated from the increased collagen... Is this correct? I have read your article about Thermage and you only mention to avoid dermal fillers and Sculptura...
Regards Sharon,
Perth Western Australia
She's not correct on this one. Botox is injected into muscles and binds there within about 6 hours. Most doctors tell their patients to be moderately careful for 24 hours or so - ie don't... more A question about mint extract?Posted in Skin Care Products, Skin Care, 2011 on Sep 11, 2011 | Permalink I noticed that you recommend the COTZ sunscreen: http://skincarerx.com/Fallene-CoTZ-SPF-58.html
It contains Melissa Officinalis (Balm Mint) Leaf Extract as one of its inactive ingredients. I know that any mint extract is irritating to skin. Since irritation (even some that is not noticeable) is problematic for any skin type, especially sensitive skin, I am not sure if it is okay to use it. Do you think that this harms the skin (even though it is an excellent sunscreen otherwise)?
Most plant extracts that are in skin care creams are in such low concentrations and processed enough that any effect of them is negligible. This applies to irritation but also,... more Can Botoxing some muscles create other lines?Posted in Wrinkles, Botox Mistakes, Botox, 2011 on Sep 11, 2011 | Permalink I've been happy with Botox injections on the "11's" for several years. But recently I noticed that to the outside of one injected line, I get a raised puffy area when I smile. It creates a visible vertical line that to me looks much worse than the original wrinkle. I have an appointment with my doctor but while I am waiting for that am wondering if this is from another muscle compensating for the original and what might be done about it. The other side of the forehead is nice and flat but this raised area is very upsetting.
The muscles that causes the "11s" frown lines are the corrugator muscles - one on each side. Their anatomy actually varies more than you would think from person to person. Some people... more What is the difference between generic and brand Vitamin A prescriptions? And, what about primers?Posted in Skin Care Products, Skin Care, RenovaRetinoids, Renova Retinoids and Vitamin A Creams, 2011 on Sep 11, 2011 | Permalink Dr Irwin,
Would you please clarify the difference between generic and brand versions of prescription Vitamin A (tretinoin vs Retin-A/Renova, yes?) and explain your preference?
What do you think about such cosmetics product as primer in light of its good or bad effect on skin? Thanks.
The difference is in the base if you have the same concentration. But...... the base can really matter. Most of the generics and brand versions are formulated for 16 year old skin with Is there a SkinTour office near me?Posted in Finding a Good Doctor, 2011 on Sep 11, 2011 | Permalink Hello Dr. Irwin, I was wondering if there was a Skin Tour office in San Jose Ca.?
You are so kind - thank you for the compliment. No, unfortunately there isn't but here a link to some good dermatologists in your area. Dr.... more
Could you please acknowledge the receipt of my message?
I have sent several questions, non answered. I suspect you are not getting my questions. Would be grateful if you could acknowledge this please.
I really wish I could answer all the questions I get but there are just too many! And, most of you write such great questions - thank you!!! I try to pick the questions that I think will... more
What do I do about a Dysport mistake?Posted in Dysport, Botox Mistakes, Botox, 2011 on Sep 07, 2011 | Permalink I just had Dysport injections a few days ago. Both of my brows are considerably lower, and both eyelids are droopy as well. Although that is a problem in itself, the more important situation, is my right eyelid is drooping so much that it is covering my eye! My neighbor said it looks like I've had a stroke! Is there anything at all that I can do to reverse this and if not, how long will I have to suffer with it?
Okay - I don't want to sound like a nag but........ have you called your doctor??? He/she is the person who needs to hear about this! And, yes there are things to help you with this... more
What anti-aging products might work with rosacea and sensitive skin?Posted in Skin Care Products, Skin Care, Sensitive skin, Rosacea, 2011 on Sep 07, 2011 | Permalink Like most people with rosacea, I can't tolerata AHAs or vitamin A derivatives. I've used sunblock religiously for years, but even so, at 40, I'm starting to see fine lines and sagging skin. Are there any anti-aging treatments available to people with rosacea?
I love to hear that you're regular with your sunscreen!! Here are some products to consider and two other options. What about the TNS recovery with antioxidants, peptides and cell... more Can Thermage make melasma worse?Posted in Thermage and Radiofrequency Devices, Thermage, Radiofrequency systems, Melasma, 2011 on Sep 07, 2011 | Permalink I am a 43-year-old female with melasma. I have minimal sagging (cheeks, jowls) for which I am considering Thermage. Will the heat generated by the Thermage procedure aggravate my melasma? My melasma is under control with daily application of a hydroquinone mixture which also includes Vitamin A, Vit C and kojic acid prescribed by my dermatologist. I have read that lasers can worsen melasma so I want to be well-informed before I decide on the procedure. Thank you!
I never say never because we are all individuals but ....... in over 10 years of working with Thermage and several thousand treatments, we've not had a patient who's melasma became worse. ... more
What can I do about a Sculptra problem?Posted in Sculptra, Fillers, 2011 on Sep 03, 2011 | Permalink Dear Dr. Irwin,
I had Sculptra injected to my cheeks 2.5 month ago, and I developed a visible lump. I have two other lumps under the skin (not visible), and now I'm getting worried. I was told before treatment, that the lumps would disappear after a while, but after reading Sculptra horror stories I got very worried. My doctor is supposed to be very experienced, she has done a lot of Sculptra treatments in denmark, but she didn't treat my lumps, she just told me they would disappear with time. Can I trust that, and how many more lumps can I expect to get within the next year. I hope I will get an answer!
Sincerely,
Worried woman from Denmark
As most of you know I think Sculptra (when done well) is a wonderful product. The results are noticeable, but not puffy and sometimes you can get an almost facelift like effect with... more The dreaded over Botoxed problem!Posted in Botox Mistakes, Botox, 2011 on Sep 03, 2011 | Permalink I had a Botox treatment a week ago and I really don''t like it... Is there a way to make it go away faster and how long is it going to take to wear off?
One of my pet peeves is over Botoxing. It seems to me that many injectors really have a heavy hand and often less is better! Sometimes much less! In your situation, you just have let... more Fractionated laser systems vs. radiofrequencyPosted in Thermage and Radiofrequency Devices, Thermage, Radiofrequency systems, Lasers, Carbon Dioxide Lasers, 2011 on Sep 03, 2011 | Permalink Hi there --
I thought your comparison of fractionated laser systems was very interesting. Could you compare these results with results/downtime of the eMatrix sublative rejuvenation system (radio frequency waves)?
Thanks,
Ginge I've never seen a radiofrenquency system that equaled the overall results of a well done fractionated CO2 treatment with a good system (like Deka or the new Cynosure CO2). BUT, if you are... more
Hi Dr. I,
What would or lack of, make hair brake off around my face? My stylist told me she normally sees braking hairs after pregnancy. I'm 54 yrs old and going through menopause. I take 1 mg prescription folic acid, but my hair is still very weak. I don't need iron and I know its not a tyroid problem. Any thing I missed? Thanks :)
So it sounds like you've seen your doctor for a basic evaluation of internal causes of hair falling out or breaking! Always the right thing to do. Still, by a long shot, the most common... more
Dear Doctor Irwin,
I recently got the vertical lines in my upper lip filled and apart from thje fact that I was bruised for a week, I noticed that my lips for some reason now look smaller. I always used to pride myself in the fact that I had full lips and now they just seem "different"....is that normal?
Again, this is tough to say without seeing you but here are some thoughts. In general, as we age, the upper lip gets longer and loses it slight concave (like a gentle ski jump) shape. ... more
What are good products to use on lips overnight that will possibly renew and re-condition?Posted in Skin Care Products, Skin Care, Lips, 2011 on Aug 31, 2011 | Permalink What are good products to use on lips overnight that will possibly renew and re-condition as Retin-A and moisturizer work for skin?
Lips tend to be sensitive like the skin around the eyes. I use the same products I use on my eyelids on my lips with good results. I really don't think you need separate skin care... more
How can I get a small black mole on my face removed?Posted in Lumps bumps moles, 2011 on Aug 31, 2011 | Permalink Dear Dr. Iriwn,
I have small black mole on my face. Can you tell me how it can be removed please?
PLEASE, please, please see your dermatologist to make sure this isn't a melanoma which is a deadly form of skin cancer if it's caught late. If diagnosed early, it's completely curable. ... more
Is there a good cream for crepiness and puffiness on the lids?Posted in Eyelid Treatments, Eye Creams, 2011 on Aug 25, 2011 | Permalink Which eye cream can be used on eyelids. Have puffiness and a crepy look.
Just remember that allergies to all sorts of things like grasses, moulds, trees, etc can sometimes cause eyelid puffiness. Please see an allergist if you are not sure. Also, eyelid skin... more
How can I tell if I need a moisturizer?Posted in Skin Care Products, Skin Care, 2011 on Aug 25, 2011 | Permalink Dr Irwin, I went through all your older answers and didn't find an answer to the question I have for you. Based on your am and pm regimen recommendations I don't see when moisturizer can be used, while as I understand everyone needs to use it for skin repair, to help with wrinkles, etc. Retin-A doesn't flake my skin, so that's all I use at night. In the morning, it's vitamin C serum, cell growth factors product and sunscreen. I'm fair skinned female in late 30s who lives in CA. How do I figure out if I do need moisturizer?
You bring up a good point and this confuses a lot of people. Moisturizer is tricky because that decision is a combination of your basic skin type (which changes as we age and with... more Any opinion on Cetaphil cleansers?Posted in Skin Care Products, Skin Care, 2011 on Aug 25, 2011 | Permalink Regareding cleansers, what's your opinion/experience with Cetaphil?
I love them and use them with my patients all the time - especially the lotion cleanser in the pump bottle! It is inexpensive, doesn't strip natural oil off the skin, and it's rare to... more
A question about the home skin renewing device - Palovia.Posted in Lasers, Home use devices, 2011 on Aug 23, 2011 | Permalink Hello,
I read your blog post regarding at-home laser devices, which you said usually do not work. However, I have been hearing about the Palovia Skin Renewing Laser on Paula Begoun's radio show and on QVC. Here is what the brochure says about the device:
Wavelength 1410 (+/- 20) nm
Beam Divergence 0.15 (+/- .03) mrad
Pulse Duration 10ms
Maximum Output Energy 15mJ
Would you mind giving your thoughts on this? It's expensive but so tempting to buy.
Dear reader - my apologies for taking awhile on this one. And, dear readers, we are going to see more and more of these home ("laser-like") devices over the next few years. In my... more Hi Dr Irwin,
My 13 year old daughter has been getting a lot of acne on her back over the past 6 months. She is an active girl, and I am wondering if maybe it is from playing soccer all day and the sweat getting trapped inside of her jersey. We have tried changing her body soap and using a wash cloth to exfoliate, but the bacne won't go away. Do you have any recommendations about how to make it go away? Thanks!
Here are the drugstore products that are helpful for back acne. If it doesn't clear in a month or two though, please see a dermatologist. Using a salicylic acid based acne wash twice a day... more Can any or some of these steps to reduce/minimize deep marionette lines be done if you are taking blood pressure medication..??
Thank you,
Be sure to let your dermtologist know, but no - there is generally no problem at all with blood pressure medication and fillers. Dr.... more If I'm dry after an IPL or laser procedure, should I use a loofah?Posted in Lasers, IPL and Photorejuvenation, IPL, 2011 on Aug 22, 2011 | Permalink I had IPL 5 days ago - I notice the flaking...should I be patient or can I loofah?? I have only been washing my face fently with my fingertips
In general, after any laser procedure, including the IPL, you want to treat your skin very gently to avoid irritating it while it's healing. Even though it doesn't look like it sometimes,... more
A question about green tea based antioxidants.Posted in Skin Care Products, Skin Care, Antioxidants, 2011 on Aug 22, 2011 | Permalink Hi Dr. Irwin,
I know that you like some of the Replenix products. I purchased the Replenix cream based on your recommendation and love it! I just also purchased the new Power of Three cream with resveratrol, caffeine, and green tea and am wondering what you think of it if you have tried it.
Thanks!
I'm wondering if there is a high enough concentration of the resveratrol and green tea to really make any difference. I'm doing some research on this now. Also, I do think that the... more
Hi Dr. Brandith, My name is Katrin, I’m 26 years old and for the past years I have suffered a lot of ance, I been to many dermatologists, the first dermatologist sent me Accutane I have it for two years, after 3 months to take Accutane my skin was God and I had nothing of acne. my Dr. told me that after the two years of drinking accutane I would never suffer again with acne, I went back to another doctor and they send me again Accutane, but I do not want to take this medicine because it is bad, I’m writing to you because I need help and some advice , what you can recommend me?? thanks Dear Katrin,
I’m so sorry but your problem is way too complicated for an email response. You clearly have suffered quite a bit with this acne and seen several dermatologists. I would... more The Problems Behind Yoga, Sweating, Acne & Vitamin APosted in Sweating, RenovaRetinoids, Renova Retinoids and Vitamin A Creams, Acne, 2011 on Aug 18, 2011 | Permalink For the past seven months I’ve been practicing Bikram yoga 4-5 times a week, I love the practice but experience acne in the areas that most of the sweat occurs. I keep a very strict clean diet and have started taking Vitamin A, C, D, E, B-complex and Zinc in hopes of clearing my skin. The problem I’m having now is Vitamin A [I think] is interfering with my periods [late last month and this month]. Is there anything else you recommend me doing, should I stop Vitamin A to get my periods back on track?
Thank you! These are all good questions. Your period change could be due to many things. It makes sense to me to try stopping the vitamin A first (and never take more than 5,000 iu a day anyway). ... more When Acne Products Do Not WorkPosted in Acne Scars, Acne, 2011 on Aug 18, 2011 | Permalink I’ve been battling acne for almost 8 years now. It’s been getting worse. I have acne prone, oily, sensitive skin. I’ve tried everything from drugstore to proactiv to murad to burtsbees. Nothing has worked for me. I’ve stuck out each regimen for the recommended time and each time, my skin is filled with pimples and later, acne scars. I’m traumatized at how my skin’s behaving. I have been to a dermatologist who just prescribed benzoyl peroxide and tazorac both of which my skin is sensitive too. I’m about to try birth control pills but Do you have any recommendations of what I should do? Thank you I would recommend getting a second opinion from another dermatologist. If you have true cystic or pustular acne with scarring, you are a candidate for Accutane. A 6 month course of... more I have recently brought a kathy dallas kd-12 cream. I am having doubts about using it because I can't find any reviews online about it. Can you please tell me your opinion about it. I’m sorry but I’m not familiar with that brand cream, so cannot advise about it. However, here is a link to the antioxidant, anti-aging and repair creams I have tried and absolutely... more Can Tumeric Powder Remove Hair?Posted in Hair Removal, Hair, 2011 on Aug 18, 2011 | Permalink I'm 19 year girl my doctor advised me to use acne-star soap to reduce pimples. After using that I had small dark hairs in my upper lip. My family advised me to rub it off with turmeric powder and now the hair is gone but I notice dark stains. What should I do to get rid off it? Wow - that’s one I’ve never heard - about rubbing tumeric powder on the skin to remove hair. I love tumeric to cook with but I really wouldn’t advise rubbing it on your skin because it... more Alternative Help For Severe Acne?Posted in Finding a Good Doctor, Acne, 2011 on Aug 18, 2011 | Permalink I’ve been suffering from severe acne for the past 13 years! I’ve tried everything from Diane-35 birth control pills to Accutane. Nothing helps, the Accutane did helped when i was on it. But once i stop, my acne came back as well. Not as severe as before but my skin is not totally healed. Because of the severe ance i had in the past & now, i have severe pitted holes scares all over my entire face. I undergo laser - C02 Fractional Laser which most Dermatologist advised me to do to help smoothen my scars. I’ve already done it 8 times but i see no improvement. And now I’m starting to doubt if this laser even works. The scars are still deep & ugly. I am at the end of the knot, i don’t know what to do anymore. The acne, the scars is just tearing myself esteem down. Please advise. Thank you My heart goes out to you. It sounds like you’ve been through a lot and the acne problem still isn’t solved. I’m not sure why all the different treatments you’ve done aren’t... more Can Thermage Or Ultherapy Reduce Wrinkles?Posted in Wrinkles, Ultherapy, Thermage and Radiofrequency Devices, Thermage, 2011 on Aug 18, 2011 | Permalink Have explored different wrinkle reducing methods and do not like the idea of fillers, injections, laser or facelifts. Is Ultherapy a sound and effective way to help this issue? I have read about Thermage but read mixed reviews. Both Ultherapy and Thermage generally do NOT reduce wrinkles. They are intended to tighten and lift slightly. Of the two, Thermage is better, in my opinion. It requires one treatment... more I'm 25 yr old female who has tried about everything there is for acne and was on antibiotics for almost 2 yrs when i stopped and began my studies in holistic health.. i healed my candida through raw super food candida diet… i am big into raw food/ superfoods/superherbs and am considering accutane going against all my studies and career path.. after cleanse… my acne got super bad all around my chin for past yr. (basically boils it runs in my family) so i know it was not from diet… it must be hormones… i'm really nervous to get on accutane and am getting blood work done tomorrow to get a rx for accutane on monday… i've been dealing with this my whole life and is ruining my career as a holistic health coach and raw food chef… my derm wants to put me on very low dose for short amt of time…will loading up on probiotics.. superfood and superherbs help me at all with a small cycle of accutane? need some help.. so confused.. You raise good issues. One thing to remember about Accutane is that the molecule is almost identical to the Vitamin A molecule. Please don’t try treating yourself with megadose Vitamin... more Dermatologist In Denver?Posted in Finding a Good Doctor, 2011 on Aug 18, 2011 | Permalink Dr.Irwin,
I heard you on Paula’s radio blog and would love you to direct me to a skilled derm in Denver for fillers and even an excellent plastic surgeon for a possible future mini-lift. i would really appreciate some direction.
Thanks.
Miro I highly recommend dermatologist Dr Joel Cohen, who has an office just outside of Denver in Englewood. His website is www.aboutskinderm.com or call 303-756-7546. Dr Cohen is very renowned... more Hi Dr.Irwin,
I am a newbie to skincare and had encounter with some problems lately. I am having dry and sensitive skin. After I mixed my pure beauty toner and a cybercolour sleeping mask. Reaction after this step left rashes on my face and was only subside after I brought the La roche posay moisturizer. Recently I notice I get breakouts easily and stopped all products for 1 week and switch to Neogence hyaluronic acid hydrating oil control water gel with the hyaluronic acid hydrating essence and problem didn’t subside.
Please advice!
Thank you. Reactions to skin care products are surprisingly common. And we women often use multiple products on our faces, making it difficult to tell which product is the culprit. If the rash is... more Do you have an opinion on Nia24 skincare line? Thanks :)Posted in Wrinkles, Vitamins for Skin, Vitamin C, RenovaRetinoids, Renova Retinoids and Vitamin A Creams, 2011 on Aug 18, 2011 | Permalink There's no data that niacin in these concentrations in skin care products performs better than tretinoin (Retin A, Renova, etc) and a Vitamin C serum in the 10-20% range. You'll very... more
Can you help with these issues dermatologists don't seem to agree upon?Posted in Skin Care Products, Skin Care, 2011 on Aug 15, 2011 | Permalink Dr. Irwin,
I have read your book and quite a few other dermatologist's books. There is one thing that is hard for me to decipher: how often an exfoliator should be used? Some say a 1-2% BHA can be used everyday. Some say it does not matter how gentle the exfoliator is, it should not be used more than one or twice a week. Some say it can be left over night. Some say it should be rinsed after a few minutes.
Another thing that dermatologists can not agree upon is if the following ingredients are beneficial or not:
Copper peptide
Epidermal growth factors
DMAE
What are your opinions on these issues? I feel the scientific study is not sufficient yet. Otherwise all the dermatologists would have a consensus.
Thank you Doctor
H in Seattle
You bring up several excellent points. The first is that when there isn't much good scientific evidence, then doctors will rely more on their experience and those experiences may... more Can you help with large oil glands on the chest?Posted in Oily skin, Acne Scars, Acne, 2011 on Aug 10, 2011 | Permalink --------------------------------------------------------------
I have very oily skin and even enlarged oil glands all over my chest that are embarrassing. I am 22 yrs old and considering the cosmetic surgery to melt them down. Do u thing it would be beneficial to go through with this procedure? I have tried everything and it doesnt seem to work so im desperate.
I really think you should see a good dermatologist as soon as possible. Often when the pores are enlarging on the chest like you are describing, it's really a type of acne. There are... more
What do you think about the Zerona?Posted in Fat reduction, 2011 on Aug 10, 2011 | Permalink Hi Dr Irwin.
Hello Dr Irwin.
I am a client at your center on Madison.
Have you heard of Zerona? I'm considering it for some excessive weight I am carrying around my thighs, stomach and waist. These are trouble areas that I haven't been able to tone and I've been trying for 1.5 years (gym 3x/week, eating healthy). I notice you don't offer it at your center and I'm curious why not. I look forward to your feedback if you have any.
The Zerona is based on a sound wave that creates a small hole in the fat cell membrane but the cell is still there. The fat empties out temporarily and the area looks better for awhile. ... more
What didn't the UV camera show sun damage?Posted in Melasma, Brown Spots, 2011 on Aug 07, 2011 | Permalink Hi Dr. Iwin, My derm's assistance took a polarized picture of me. The picture showed that I did not have any sun damage. How it that possible when I have brown spots on my face? What's the best topicals to get rid of the brown spots? I know for sure I got these brown spots from staying out in the sun and not melasma.
You bring up a good point which is that lab tests, cameras, computer imaging, etc can all be in error sometimes or just not functioning well that day. Since almost everyone has at least... more
A question on Radiesse vs Juvederm.Posted in Radiesse, JuvedermRestylane, Juvederm and Restylane, Fillers, 2011 on Aug 07, 2011 | Permalink Hello Dr I,
Would you explain why you don't like Radiesse? and the difference between two. i tryed juvaderm loved it but lasted on only 2 months and i don't have deep lines..what is your thoughts
Ty
As I've mentioned before, there are many good doctors who use Radiesse and love it. In my opinion, there is just as much variability in response to Radiesse as there is with Juvederm Ultra... more Could growth factors in TNS Recovery and other similiar products promote cancer?Posted in Sun Protection, Sun Damage, Skin Care Products, Skin Care, 2011 on Aug 07, 2011 | Permalink Hello,
I really appreciate your Website and all of the helpful information that you provide! You really help people to take care of their skin.
I have read about the TNS Recovery Complex, and I have used it, but one dermatologist who has written a book wonders if the growth factors could stimulate growth in cells that cause cancer? Have you seen this criticism and do you think it has merit?
Thanks You!
That's an interesting conjecture, isn't it? There have been no studies done on that particular question. Anecdotally, I have a fairly large group of patients between 40-70 (skin cancer... more Does the "vampire" facelift really work?Posted in Selphyl, Sculptra, Fillers, 2011 on Aug 03, 2011 | Permalink This question from a reader in Chattanooga - so sorry - I accidentally deleted your exact wording on this one! :) Dear Readers - I will do an article on this procedure soon - it will be posted in resources. I'm trying to finish one on sensitive skin first! In the meantime, unless money is no... more What can I do about sleep lines on my cheeks parallel to my nose?Posted in Wrinkles, Fillers, 2011 on Aug 03, 2011 | Permalink Hi,
Your website is a great read and full of infromation. I am a 38 year old male and have developed deep lines running parallel to my nose of both sides of my face. I am trying to sleep on my back to stop these but wanted to know what type of product I should use for sensitive skin to tighten up my skin again around my nose area?
In Ireland and the infromation is not great for men!!
Thanks
J
Thank you! The kind of lines that you describe are often from sleeping with our faces scrunched on the pillow a certain way each night. Changing position frequently and trying to sleep on... more What to do about the darkening caused by tweezing in african american skin?Posted in Pigment problems, Hair Removal, Hair, African american skin, 2011 on Jul 29, 2011 | Permalink Not sure what to use..I have been removing hair from chin by tweezing I am african american and this has caused hyperpigmentation so that the area is extremely dark and very noticeable. I have been on the website looking at bleaching and lightening products but sort of wary because there are so many and my skin does tend to breakout. what can i use to bring that part of my face back to the same color as the rest of my face or should i see a dermatologist.
I think a lot of women have this problem. In lighter skin types, it shows up as reddish discoloration around the hair follicles and, in darker skin types, more dark brown. It's caused by... more What would provide a good sunscreen with a matte finish for oily skin?Posted in Sunscreen, Sun Protection, Skin Care Products, Skin Care, 2011 on Jul 29, 2011 | Permalink Dr Irwin,
I'd love to own a quality sunscreen for face with matte finish. I've tried some that promise so but shine shows up anyway. Could you please suggest? Would you trust quality of sunscreens made by make up - or even clothes' - makers such as Clarins and Chanel? Thanks.
Have you tried the mineral powder makeups with sunscreens that are SPF 15 or above? What about the Jane Iredale SPF 20 powder compact - that might be perfect for you - or look at Bare... more
Is a "firming" mask helpful?Posted in Skin Care Products, Skin Care, 2011 on Jul 28, 2011 | Permalink I am 42 years old and I have combination skin. My question is about firming masks. Will I need to use a firming mask a couple of times per week? If so, which products do you recommend?
I'm glad you asked this. "Firming" masks really don't firm anything. This is because your skin's "firmness" is due to the amount, health, and strength of the collagen and elastic fibers... more I have combination acne prone skin which has become even more oily since being off birth control for about 2.5 months now and my cheeks are sensitive. I'm asian with light skin tone in the 25-30 age range living CA. Currently my derm has me on acanya for AM, and atralin in the PM for almost 2.5 mos now. For the past month, I've been having issues with continuous hormonal breakouts on my chin and now I feel like my breakouts are coming back (though not as severe) on my forehead, and sides of my face. I visited my derm 2 wks ago to address these concerns and he suggested I give the acanya more time to work and also gave me a trial of revision brightening face wash to use instead of my philosophy purity cleanser. So far I feel my acne is gradually getting worse. Also in the past i was taking solydyn but considering how it makes you sun sensitive i also stopped that about 4 mos ago. Any suggestions on what/how I should tweak my routine for better results? Please let me know as sometimes it seems you need to tell the doctor what you want! Thanks and looking forward to your response.
So many good questions from all of you!!! Again, I just wish I had time to answer all of them. I think this question brings up some good points. For example, how long is a reasonable... more For men, is there a way to avoid looking feminine when work is being done?Posted in Lasers, Finding a Good Doctor, Fillers, Botox, 2011 on Jul 24, 2011 | Permalink Dear Dr. Irwin,
I've found your website very informative. I appreciate all your posts and articles, they have been quite helpful. I have one question I would like to ask though. I am a man and I have been considering fillers and a good maintenance program so that I can stay looking as young and fresh as possible for as long as possible. So my main concern is going to a qualified doctor that knows the appropriate way to administer fillers to a masculine face and keep it looking masculine and not "enhanced" or "feminine". I say this because I see men that look like they have been overdone and that isn't the look I'm going for. I'm guessing you are informed about the medical community and who does good work with men in keeping them young and fresh so I had to ask who you might recommend me to go see to have these procedures, or Botox and dermal fillers. The goal for me is to retain my natural features and prevent further wrinkles and restore the fullness to my face lost from years of exercise and of course sagging from age. Any suggestion on a doctor in the Orange County or Los Angeles area that is qualified and known for working well with men and keeping their facial features masculine would be greatly appreciated. Doctor, thank you again for your informative and educational articles and I look forward to hearing your input.
In Health,
M
You raise a good point. There are some facial characteristics that are culturally labelled masculine or feminine traditionally. So if the doctor doing your work isn't sensitive to... more Lumps on the chest after Restylane injectionsPosted in Restylane, JuvedermRestylane, Juvederm and Restylane, 2011 on Jul 24, 2011 | Permalink How do I get rid of lumps on my decolletage after injections with restylane for sundamage. It has now been 4 weeks since the treatment and I am still lumpy? Would dermaroller help I have been massaging? Donna
It would be very upsetting to see lumps on your chest! But lumps from fillers are generally easy to fix. In my opinion, you should see your doctor. It is very easy to inject the area... more
How to find a good doctor in Kansas?Posted in Finding a Good Doctor, 2011 on Jul 24, 2011 | Permalink Hi Dr. Irwin,
First of all, thank you so much for putting this website together. It's very helpful and much appreciated! I saw your list of recommended dermatologists, however, Kansas wasn't on the list. I'm currently residing in Kansas and need to see a dermatologist, but I'm scared I will not pick a "good" one. I have been researching and researching, but I haven't had any luck finding a dermatologist that stands out amongst the rest, which to me doesn't seem like a good sign. I don't want to just trust anybody with my skincare, so if you know of any respectable dermatologists in the Wichita, Topeka, Lawrence or Kansas City areas, I'd really appreciate your input. Thank you so much. Keep up the fabulous work!
I really wish we had great doctors in all areas to put on the site. I know there are many out there that we just don't know about. We try to add good docs as we find out about them from... more
Dr. Irwin, I had juvederm injected into my lips. This was to help smooth the lines around my mouth and slightly enhance the volume of my lips. After the injections my lips had swelled a great deal. I truely looked like a duck. On the sixth day after the injections I woke up to very pretty slightly larger lips and was pleased. Here is my delima. After the injections I expected the swelling and the hardness around my lip line. However, I did not expect the continued burning and itching of my lips. One day later after I seen my beautiful lips my world fell apart. Today, During the day, my lips began to swell once again with burning and itching. I am worried that I am either having an allergic reaction or my lips will never stop swelling. I called the person who did the injections and she thinks I am having an allergic reaction to the facial produts that I am using. Three days ago when I called to tell her what was going on she told me to stop all of the facial products I was using and to use Benadryl for itching and Ibuprophine for the swelling. I have done all of that and today my lips are swollen once again. I called the Person and explained what was going on and quite frankly she is stumped and has no clue how to correct this. Can you help me please? I can't stand this incessant burning, itching and swelling. I work outside in extreme heat four close to ten hours a day, always were a hat. I dont know if that has something to do with it. The person who injected me knew of this fact but she and I are completely confused as to what is going on.
You sound miserable! And, very understandably, discouraged. While true allergic reactions to Juvederm or other hyaluronic acid fillers are rare, they can occur. First, PLEASE MAKE... more Is there any technology that can help with fat on the neck?Posted in Body Treatments, Body Thermage, 2011 on Jul 20, 2011 | Permalink Hi Dr Irwin,
My lower nape is a bit fatty. It looks like as if i had a hump. Will radio frequency work to melt away the fat?
Depending on how long you've had this and your overall body type, it would be a good idea to talk to your doctor before doing anything cosmetic. Sometimes that fatty "hump" can be a... more Update on the roller needle question.Posted in Skin Care Products, Skin Care, Home use devices, Acne Scars, 2011 on Jul 20, 2011 | Permalink Is there any science showing the roller needle product being sold by SkinMedix and others is effective at allowing better penetration of skin care products into the skin?
Okay so this is getting a little complicated and is taking a little longer than I'd hoped. Here's why. I have and have had for some time medical grade roller needles of different depths... more A Radiesse complication - what to do?Posted in Radiesse, JuvedermRestylane, Juvederm and Restylane, Fillers, 2011 on Jul 20, 2011 | Permalink Hi Dr. I, I know you are not a fan of Radiesse but I was hoping you can give me your opinion on it. My mom had a syringe injected into her nasolabial folds. One side of her nose became very swollen, it formed a large cluster of white/yellowish bumps and the skin under/around the bumps turned greenish, grayish and was very painful. It was a horrible experience for us all. She looked awful and I feel the guilt because I recommended the place to her!!!!
We contacted the doctor and he put her on 2 antibiotics, anti-inflammatories and valtrex. He explained that the product caused the veins in the area to constrict and therefore became inflamed. The explanation was along the line that her veins were sensitive and had a negative reaction to the product. It doesn't really make sense to me. I was hoping you could explain it better. I know that without seeing it its hard but does the explanation make any type of sense to you? It has been 15 days and after the cocktail of pills she had to take it dried up, formed a scab and fell off a few days ago. The area is still red and the pores on her nostril are very open and still tender to the touch. I have pictures if they would help. Words can't describe how terrible it looked, she couldn't leave the house for a week and a half. I wonder what your opinion is on the explanation the doctor gave us. I know it is hard to say without seeing it but have you heard of this type of thing happening with Radiesse? Thank you again for your time.
I'm am so sad this happened to your mom. These problems are the reason I don't use Radiesse. First the good news, the fact that it's healing, the scab has fallen off and her nose is red... more I got a salycilic acid peel on my face and now I have little white bumps on my cheeks and around my mouth that are very itchy. Is this a normal reaction to a salycilic acid peel?
This is a little tough to answer not knowing how long ago you had it. If you just had the peel a day or two ago, they could be due to a mild irritant reaction. Then, bland creams like... more
A question regarding how long Juvederm should last.Posted in JuvedermRestylane, Juvederm and Restylane, Fillers, 2011 on Jul 08, 2011 | Permalink Hi Dr. I,
Had juverderm done only 2 weeks ago, love it. The Dr. did a good job, but it seems to be fading already. Is Juverderm a mantence program if it doesn't last 1 year and can I go back again for touch ups?
ty
Depending on your facial structure and your age, it's possible that you really just needed an extra syringe to get a good base in the first place. Juvederm Ultra Plus tends to last longer... more
A re-answer to a question about fine lines.Posted in Wrinkles, Fraxel laser, 2011 on Jul 08, 2011 | Permalink Hi Dr Irwin,
Below is my post to you and your answer, but I didn't mean nasolabial folds or marionette lines. I meant horizontal and vertical lines that are fine lines. The fillers won't work for these lines and I cant use Retin-a or AHA's due to the shiny waxy look I get from using them. My skin is not sagging or lax and I don't have wrinkles. So is there anything that would work for these lines? Thanks in advance!
I am confused about which procedure would work for moderate facial lines. I am a 46 year old caucasian female. I don't have loose, sagging skin or wrinkles. The lines are mostly around my mouth but to the sides not above my lips. I do not smoke. AHA's and retin a cause an unnatural shinny waxy look on my skin so I prefer not to use them. What procedure would work for this issue? Thanks so much.
Since you don't have sagging (laxity) or wrinkles, these lines to the sides of the mouth are usually from the nose to the mouth (nasolabial fold) or the mouth to the chin (mesolabial or marionette), are best treated with a filller like Juvederm or Restylane. Both would work well. On average maintenance for this in your age range would be about twice a year. Dr. I
Okay - I know this is hard to describe sometimes so I'm think you mean on the cheeks themselves - that fine, sometimes crisscrossed wrinkling. You might want to look into the Fraxel... more Thanks for your many wonderful questions. I wish I could answer them... more
Is there anything that can help with dark circles under the eyes?Posted in Eyelid Treatments, Eye Creams, 2011 on Jun 20, 2011 | Permalink Is there anything that can help with dark circles under the eyes? Thanks in advance!
Dark circles are difficult because they can be caused by different things ..... and sometimes have multiple causes. Since treatments are different depending on the cause, it can get... more If you are using the Skin Medica Essential Serum do you still need the Skin Medica Vitamin C and E product?Posted in Skin Care Products, Skin Care, Antioxidants, 2011 on Jun 20, 2011 | Permalink If you are using the Skin Medica Essential Serum do you still need the Skin Medica Vitamin C and E product?
Technically no because the Essential Serum has antioxidants in it but if you're outdoors a lot in summer or year around, it's not a bad idea to use a second, more concentrated form of... more
How long do fillers like Restylane/Juvederm last especially in the marionette lines?Posted in JuvedermRestylane, Juvederm and Restylane, Fillers, Chin Lines, 2011 on Jun 20, 2011 | Permalink How long do fillers like Restylane/Juvederm last especially in the marionette lines?
I think there's a lot of confusion about this. The very general answer is 4-9 months. Also, fillers will often begin to last longer as time goes on if you get treated 2-3 times a year in... more If I'm 46, what would work best for lines around my mouth?Posted in JuvedermRestylane, Juvederm and Restylane, 2011 on Jun 19, 2011 | Permalink I am confused about which procedure would work for moderate facial lines. I am a 46 year old caucasian female. I don't have loose, sagging skin or wrinkles. The lines are mostly around my mouth but to the sides not above my lips. I do not smoke. AHA's and retin a cause an unnatural shinny waxy look on my skin so I prefer not to use them. What procedure would work for this issue? Thanks so much.
Since you don't have sagging (laxity) or wrinkles, these lines to the sides of the mouth are usually from the nose to the mouth (nasolabial fold) or the mouth to the chin (mesolabial or... more
Product confusion! Which is better the TNS Recovery Complex or TNS Essential Serum?Posted in Skin Care Products, Skin Care, Cell growth factors, 2011 on Jun 11, 2011 | Permalink HI DR. IRWIN, I LOVE YOUR BOOKS! DO YOU PREFER THE TNS RECOVERY COMPLEX OVER THE TNS ESSENTIAL SERUM? I HAVE USED BOTH AND LIKE THE ESSENTIAL SERUM, BUT IT IS SO EXPENSIVE. THANKS, JOANNE
Thank you! Okay - so here's what I think about these. I prefer the TNS Essential (yes, very expensive!) because it has a 3 in 1 thing going for it. It has the cell growth factors,... more Help with dull looking skin.Posted in Pigment problems, Brown Spots, Blotchiness, 2011 on Jun 11, 2011 | Permalink hello Dr. Irwin
first of all i love your suggestions it helped me a lot.
so my problem is like this- i am from India. naturally i have fair coloured skin. i am 14 years old . but from 2 or 3 years . my skin is getting dull. when i clean my skin it gets glowing but after few hours it again gets dull. is it because my diet? and i have dark circles also. i sleep enough ? how can i get rid of them.
Thank you for writing. Can you write again and give me a little more information. Is your skin dry, oily, acne prone? Are you putting anything on your skin after you wash? Are you... more
Is it okay to have Restylane and Juvederm in your face at the same time?Posted in JuvedermRestylane, Juvederm and Restylane, 2011 on Jun 11, 2011 | Permalink Can you have Restylane on top of Juvederm? I had Juvederm into my cheeks to lift them a couple of months ago but it hasn't achieved the effect I hoped. I have found a practitioner who uses Restylane but is it ok to have that when it's so soon after Juvederm?
Yes. These two products are compatible. I often explain to patients that it's like comparing a Gala apple to a Fuji apple - they are just slightly different but still apples. These are... more
Does Differin work as well as the other retinoids?Posted in RenovaRetinoids, Renova Retinoids and Vitamin A Creams, 2011 on Jun 11, 2011 | Permalink I read you tip of the week on May 19, How to get the glow back in your skin. Will Differin work as well as the other retinoids? Thanks!
Yes. There are slight differences among the retinoids but over the long term (months-years) they are not significant. The main thing is that you find one you like and can tolerate well so... more
Should I buy my skin care products from E-Bay?Posted in Skin Care Products, Skin Care, 2011 on Jun 11, 2011 | Permalink I recently went on-line to purchase a Jan Marini product - C'Esta serum. To my surprise, it came up on Amazon.com at a reduced price. I ordered it. After ordering, the confirmation was from E-Bay. What does it mean that you can buy these, and other, products on E-Bay? Should I be concerned about the quality?
Personally, I wouldn't buy my products on e-bay. I think it 's too easy for sleezy companies to fake things these days. I would recommend reputable sites like SkinTour.com, ... more
What are these bumps on my chin?Posted in Growths, Chin Lines, Acne Scars, 2011 on Jun 05, 2011 | Permalink Dear Doctor,
I believe I have the condition that you refer to as "cobble chin", but when I look at pictures that show people who have this condition they sometimes say it looks like dimpling. My condition under my chin actually looks like small bumps under my skin. They do not hurt and they give me no problems. If I pull in my lips (tightening the skin on my chin) they actually disappear. What is the best way to treat this condition? Sincerely, Donna
A common complaint is a bumpy texture on the chin area. Here are the 3 most common causes. 1) The first is old acne scarring. Some people have their most severe acne on their chins... more hi Dr. Irwin, I'm 22 year-old female from Asia and i am having problems on my face that it has become red ever since i used wrong product when i was teenager probably about 6 to 7 years ago and now my facial pores tend to enlarge that gives me an embarrassing look. so i have red and enlarged facial pores. my dermatologist said this is a rosacea condition and he gave me only Clindoxyl gel but this doesnt seem to help with my redness at all so i would like to ask you if you have any good suggestions for my conditions. thanks in advance
Leeza
If you are completely healthly, then you probably do have rosacea like your doctor diagnosed. However, if you have any other symptoms like joint pain or swelling, hair loss, sores in your... more
Is there anything that really benefits acne scars?Posted in Acne Scars, Acne, 2011 on Jun 05, 2011 | Permalink Is there anything that really benefits acne scars? Yes, read my article on Acne Scars and Other Scars In Depth for information on what options are available to reduce the appearance of acne scars. Dr.... more
What about brown scarring from picking?Posted in Brown Spots, 2011 on Jun 05, 2011 | Permalink Hello DR.
does tri-luma help with brown sccaring from picking? I.. like to try it ty
Most of the time, the brown spots you see after picking aren't really scars. Meaning they aren't truly depressed below the level of the skin or a different texture. Most of the time... more
Picking and acne scars - what to do?Posted in Acne Scars, 2011 on Jun 05, 2011 | Permalink Hi. My acne is very mild but unfortunately over the past couple of years I have used picking and squeezing my skin as a form of stress relief, which at times has caused rather horrific wounds. I have mostly gotten my behavior under control but am now left with multiple scars along my shoulders, chest, and back of every variety (raised, flat, red and white, from 2mm diameter to 1.5 cm). I am fairly certain that the rosehip seed oil I am looking into will work with my skin very well, especially on my face, but from the majority of my findings I'm afraid those raised white scars are going to need something a bit more rigorous... is there any non surgical way to return the pigment to those areas and shave them down a bit?
My heart goes out to you on this. You're very honest too in your understanding that this is a form of stress relief for you. To some extent everyone "picks" something at least... more Should I have an IPL treatment in June? I'm going on vacation in July.Posted in Lasers, IPL and Photorejuvenation, IPL, 2011 on Jun 04, 2011 | Permalink --------------------------------------------------------------
Hi Dr. Irwin!! I am planning on having an IPL treatment in June. Is this a good idea since summer is fast approaching?? I will be diligent with sunscreen but is it worth it? I will be at the beach for two weeks in July but will be careful to wear sunscreen/hat, etc. Will spots appear??? Help!!! Thanks!
There are really two issues here. Is it safe? And is it worth it? On the safety issue first, as long as you don't have melasma, are a lighter skin type and really use your sunscreen and... more Anyone know a doctor in Chicago who's an artist with lasers and injectibles?Posted in Lasers, Finding a Good Doctor, Fillers, Botox, 2011 on Jun 04, 2011 | Permalink I live in chicago and am trying to find and "artist" who is good with all fillers, botox etc. I am a redhead and I have had a fat transfer where placement is not ideal. It is important to have someone who can help with volume and poor skin tone(large pores, fine lines etc.). I am 48 and my skin looks much older than it should. I have had some great things done and some bad things done and would like to just find one person to work with in all areas. Thank you
This is such a tough one and I know women all over the country/world are struggling with this right now. I think demand for high quality services in this "new beauty" area has outstripped... more Hi Dr. Irwin,
I'm thinking of buying a pillow that claims to help position your face while sleeping to help prevent creases caused by sleeping on your side with a traditional pillow. Would I be wasting my money? I do see a deep crease on the side of my cheek sometimes in the morning.
thanks,
Kathy I think this is a fun questions! First, there's no data on this. But............ most people have more wrinkles and less volume on the side they sleep on most. You can probably see... more
Hello Dr Irwin,
Your site is amazing. I have lost a lot of weight and this has affected my face, I am getting sculptra done on the 23rd of June, but what really upsets me is my smoker lines over my lips and my frown lines on my forehead can these be treated with sculptra, I know you might take month to answer as you are so busy but as i am being done on the 23rd of June maybe you could answer me before this. I would really appreciate this.
Thank You.
Thank you - I really, really wish I had time to answer all of the great questions you all send me! I'm sad that there's just not enough time in every day. Sculptra is great for certain... more Can this Botox mistake be fixed?Posted in Botox Mistakes, Botox, 2011 on May 25, 2011 | Permalink I had botox on my forehead and the results were fantastic however, the np talked me into it for my marionette lines instead of restylin becaue they are tiny. One week later and one side of my lower lip is a bit paraylized and achy. Is there anything you know of to decrease this besides exercising the muscle?
No, unfortunately, you are stuck with this one until it wears off. Trying to activate the muscles involved frequently may help a little. Please see my article on Botox Mistakes and How... more
Can I come see you if I live somewhere else?Posted in Finding a Good Doctor, 2011 on May 25, 2011 | Permalink I live in India and would like to schedule an appointment with you for December 2011,and as per your recommendation would like to go through a cosmetic procedure as per my little research its the latest version of Thermage that i am looking at for my entire face and neck.I am 40 years of age and would like to know how long should i plan this trip to U.S. for and how much will this cost me?
You are very kind and I am honored that you would consider this. But...... I really think you can find someone excellent closer to home. Also, please remember that any good office... more
I have multiple acne scars on my chest and back. What can I do?Posted in Scars, Fraxel laser, Carbon Dioxide Lasers, Acne Scars, Acne, 2011 on May 25, 2011 | Permalink Hi,
I have body acne and over the years the number of breakouts has diminished but has left a lot of scars which of them are mostly skin discoloration. I am dark skinned. I have tried varies things like micro crystal dermabrasion, topical cremes and glycol peels. I was not sure about the peel first but then I have tried most of the stuff out there and risked it and it left a couple of very dark spots which hasn't faded even a little bit after 2 months. I am starting to feel that the only option would be expensive laser treatments. I would really appreciate if you could offer me some advice. Thanks.
I really agree with your conclusion on this. With most acne scarring, it is deep enough that superficial treatments like microdermabrasion, creams and glycolic peels won't help much. ... more
What Causes Milia?
A milia is just a pore that gets clogged with sebum/dead skin cells and then the sebum hardens under the skin. These show up as tiny white bumps under the skin that persist. They are... more There is not much information of the ulthera laser in terms of results.
THe only thing I have read is that it is very painful. I wanted your
opinion on the "dot" fractionated laser versus the ulthera and what results you are seeing with both. I noticed that Dr Perry is now advocating for the ulthera. I am interested in delaying a face lift
and am looking for a procedure that can tighten the skin. I am looking
and investigating a fraxel restore --? treatments with little down time, vs the deka smartxide "dot", vs ulthera. Which would you
recommend for fair skin 55 year old female with skin that is starting
to give(could use subtle tightening) with fine wrinkling mostly around mouth and marionette
lines. I would opt for the fraxel nonablative 2-3 treatments that is
less downtime if I thought that would be worth it. Would appreciate
your feedback. I could send you a picture or maybe go to Seatle for a vacation and come to see you. THanks so much Maggie
I'm hoping I summarized that well! Things to consider are these. If you are a 55 yo female with a little sagging and mild wrinkles, remember that the Fraxel Restore (erbium) does not... more
I am planning to have a chemical peel when I get back from vacation this summer. After spending a week in the sun (with sunscreen, of course!), will it be just as effective to get a peel then?
Plan peels when you will be out of the sun for at least a month afterwards. Summer is generally not a good time. Also, in general avoid the months around the summer soltice (June 21) when... more
What is better for antiaging-Thermage or Fraxel?Posted in Thermage and Radiofrequency Devices, Thermage, Lasers, Fraxel laser, Carbon Dioxide Lasers, 2011 on May 22, 2011 | Permalink What is the best anti aging for face & neck ... thermage or fraxel. I'd like to prevent or improve sagging and wrinkles. My eyelids are bad and I'm starting to get wrinkles over my lips. I've been using Botox & restylane but am thinking after reading your article that Sculptra may be better.
This depends on many factors like your age, the amount of sagging you have, severity of wrinkles, and your facial contours, etc. As a general guideline, if you are under 45ish and you... more
Is Artefill a good filler for the under eye area?Posted in Fillers, Eyelid Treatments, 2011 on May 22, 2011 | Permalink What do you think of arteform? Particularly for slight hollows in the undereye area?
I'm thinking you might mean Artefill even though you wrote Arteform?? If I'm mistaken, please write again. Artefill is a terrible idea in general and especially under the eyes. It... more
Any help for oily skin and under eye bags??Posted in Oily skin, Eyelid Treatments, 2011 on May 22, 2011 | Permalink Hello Dr. - Even at the age of 59 I still have super oily skin--particularly the nose area. also, I was born with bags under my eyes what non-surgical fix would you recommend, please. Have daughter's wedding 9/4/11. Thank you greatly, VJ
Hi VJ - Have you talked to your dermatologist about trying spironolactone (decreases testosterone slightly in women but still keeps it in the normal range)? It will decrease your oil... more I was wanted to know if I can use a laser on my face due to the fact that I have a silcon chin implant and a small drop of silcon on the bridge of my nose.
Generally the silicone, both the implants and the injectible forms, are placed quite deeply. Below the dermis or in the deep dermis. Depending on the laser, the level of would be higher... more
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Hello what can I do or use for a few blisters that I have on my face after getting a laser treatment. I am afraid that these blisters are going to scar and I am very upset.
You must absolutely call your doctor's office where you had the laser performed. Only they know exactly what was done and can help you make sure you heal properly. If you don't get a... more
A Juvederm mistake???Posted in JuvedermRestylane, Juvederm and Restylane, Fillers, 2011 on May 16, 2011 | Permalink I had Juvaderm in my Glabellar Furrows and it looks as if nothing was put in especially on the right side. I also look like my right eye is swollen and I can feel some of the Juvaderm close to the corner of my eye which I assume is causing my eye to look swollen. I paid a $1000 dollars for 2 syringes and the fine lines around my lips do look better, I certaily don't feel I got a $1000 worth of improvement especially the way my Glabellar Furrows still look. I was told by the nurse at the plastic surgeons office that it would take care of this. The nurse is the one who did the procedure. Please help?
Thanks
You bring up two good issues. Was a good job done? And, was the value for the money there? Let's face it........this stuff is expensive and the responsiblity is with the doctor to make... more How to treat growths under the eyes?Posted in Growths, Eyelid Treatments, 2011 on May 16, 2011 | Permalink I have these small flat growth under both of my eyes. I've been told that they are nothing but clogged pores. I got them after my second pregnancy. What kind of treatment would be best?
To know how to treat something like this, first you really need a diagnosis. There are about 10 things that can cause growths under the eyes. You doctor may know that they are benign... more
What could I do before my wedding in a month to look better??Posted in Thermage and Radiofrequency Devices, Thermage, JuvedermRestylane, Juvederm and Restylane, 2011 on May 16, 2011 | Permalink Hello Dr. Irwin. Your website is very informative. I am getting married in 4 weeks and will be vacationing on a cruise ship which will be in the Caribbean for 3 days. I where wide brimmed hats and sunscreen. I have been thinking of having full facial Thermage. I am 48 and my skin is definitely sagging. I want to look a little better for the wedding especially because the photos will be a permanent record. My self esteem is not very good these days because of these aging changes. I know I will feel so much better if I could do a little something about this for the wedding day. If I had the procedure done very soon, will I see some improvement by the wedding day? Also, if I want to get some lines and/or lips filled with Juvederm, how long after Thermage do I have to wait? Thank you in advanced for your time.
Congratulations on your wedding! This is a little close to the time to see much with Thermage and it's tough to know without a picture if you have a good facial structure for it. I... more Pigment under the arms and on the inner thighs - what can I do?Posted in Pigment problems, 2011 on May 10, 2011 | Permalink Hi there,
I have a question about skin discoloration under my arms and on the inside of my upper thighs. I'm guessing that this is from my skin rubbing on itself. For the last few years I've been lifting weights regularly and have noticed that as my legs have become more muscular - the skin on the upper part of my inner thigh has darkened.
Are there any over-the-counter products that you would recommend to lighten this area? Would it be best to see a dermatologist and get a product that is prescription strength?
Thanks for your input, and I LOVE skintour!
You bring up a couple of good points. First, increased pigment can occur lots of other places besides the face and second, it can be just as annoying and cause self consciousness! ... more I am a 57 yr old female who has had beautiful skin my entire life and look 15 yrs younger than my age. About 6 yrs ago, during perimenopause years (I am now post menop) I was diagnosed with Rosacea which apparently no one can tell me why I have it, what causes it or how to rid my life of it..most infuriating after numerous seeing top specialists. I am at the end of my rope. I understand what exacerbates it, which seems to be EVERYTHING. I have a particular patch and the side of my chin that is constantly flakey and so so red. I use bare escential makeup to cover it and use nothing with a fragrance. I was on Oracea which helped with swelling and some creams which in my opinion do not work. I have an appt end of April to have this patch looked at. Have you had any success at all with Rosacea?
I would say that 99.9% of our patients are completely clear in 6 months with occasional flare ups only. We, and many other offices, use a combination of lifestyle changes including... more How long does Radiesse really last?Posted in Restylane, Radiesse, JuvedermRestylane, Juvederm and Restylane, 2011 on May 06, 2011 | Permalink Do you have any updates on how long radiesse lasts especially in the marionette lines?
This is my main issue with Radiesse and why I don't use it much. In my opinion, the longevity of it is less predictable than with the Juvederm/Restylane products. In some patients the... more
After Juvederm, if I'm a little lumpy 3 days later, do I need to see my doctor?Posted in Restylane, JuvedermRestylane, Juvederm and Restylane, Fillers, 2011 on May 06, 2011 | Permalink Dr. Irwin,
I had Juvederm in my marionette lines three days ago. The right side looks great, the left is still a bit lumpy. Should I worry, is this normal? Or, do I need to go in and see the doctor?
Generally, I ask my patients to wait 7-10 days before calling our office. This is because there is a some natural evolution of the product for about a week. 3 reasons - it absorbs... more
Can the tip of the nose be lifted without surgery?Posted in Restylane, Radiesse, JuvedermRestylane, Juvederm and Restylane, Fillers, 2011 on May 06, 2011 | Permalink Hi Dr. Irwin,
Can the tip of the nose be lifted without surgery?
Yes, a little with certain fillers. This requires some skill. Some of the better cosmetic dermatologists are good at it. I think though that a facial plastics ENT (ear, nose & throat)... more
Can the CO2 DOT laser improve stretch marks?Posted in Stretch marks, Carbon Dioxide Lasers, Body Treatments, 2011 on May 06, 2011 | Permalink I have loose skin mixed with light stretch marks around my belly button following my pregnancy 5 1/2 months ago. I am lucky to be back down to my weight (104 lbs. and 5'2, fair skinned), but I am left with some record of my pregnancy on my abdomen! I have been told that my stretch marks are minimal. If I pull my stomach skin tight, you can't even see them. I have heard the C02 DOT laser is very promising in removing stretch marks. My question is, have you heard anything more on this laser to make you believe it actually is effective in removing stretch marks? I am willing to spend money to make them heal, but I just want to know I won't be wasting it. Thank you for your time.
I'm going to say a tentative yes on this one. While there isn't much data available yet, different centers around the country are doing it and getting definite improvement in blending the... more
Can a laser be used safely if I'm on a medication that makes me photosenstive?Posted in Rosacea, Lasers, IPL and Photorejuvenation, IPL, 2011 on Apr 16, 2011 | Permalink I'm 47 and I am seeing a dermatologist/aesthetician, I have red broken vessles or capalaries on my face and laser therapy is being recommended, but I'm on a medication that causes photosensitivity.(It's not an option to stop the medication it is for diabetes(glyburide). I really want those blood vessles gone, what are your recommendations? Can a laser be used safely??
Usually lasers and IPL systems can be used safely in this circumstance. The key is for the nurse, PA-C or doctor to do several test areas on your face before treating the entire face. ... more
Dysport/Botox mistakes!Posted in Dysport, Botox Mistakes, Botox, 2011 on Apr 16, 2011 | Permalink I had 60 units of dysport injected a week ago in my forehead/between my brows for the first time. I am very unhappy with what seems like the bridge of nose being widened making my eyes seem wideset and the lids are heavy. My forehead feels like cement and my eyes kind of ache. Do you think the distorted look of my eyes and nose will resolve?
To reassure you, the effects of Dysport/Botox are temporary and will resolve. It's difficult to predict the time frame but in general it takes 3-6 months to wear off completely. You may... more How can I sort out all the different laser technologies and find a good doctor?Posted in Lasers, Finding a Good Doctor, Brown Spots, Blotchiness, 2011 on Apr 16, 2011 | Permalink I am considering a laser treatment for my face to just rejuvenate and even out the skin tone. I would also like to fix some broken blood vessels. I have no idea what type of laser procedure to look for and how to make sure the doctor is qualified to perform it. Is it a dermatologist or a plastic surgeon that I need to find? Any advice would be appreciated. Thank you.
Okay - to start, read my articles on lasers to learn what type of results each laser can provide. Also, look at my directory of excellent cosmetic dermatologists in the U.S. to help you... more At a recent consultation re forehead wrinkles the surgeon told me that he did not recommend injecting the forehead only. Instead he suggested injecting in the middle of my brow and forehead as this gave more control. He said with forehead only the botox would defuse and I might end up with wonky eyebrows. Is what he suggests a real risk or and I being swindled into having 2 areas done and therefore paying double??
This is why I don't like the "area" method of billing for Botox. You don't really know, do you? If the Botox is billed by volume (we do it this way) or units (many offices), then you... more Was this a Juvederm mistake?Posted in JuvedermRestylane, Juvederm and Restylane, 2011 on Apr 15, 2011 | Permalink Hi Dr. Irwin, I Had Juvederm injected into the my smile lines two weeks ago and I still feel a burning/tingling sensation and puffiness, worse in the morning. If I am active it appears to get worse. Any suggestions for this water retention. I look like I was hit in the face on the right side. Thank you
Please go back to your dermatologist/provider and let him/her look at you. A good office witll be very responsive and should invite you back (at no charge) so your doctor can see the... more
Are all chemical peels created equal? A local "medspa" is offering chemical peels for a discount price. Is it possible to know if this is worth trying?
I've been seeing a lot of these on the local sites like Groupon. They really can be quite different depending on what product line the spa uses, the experience of the aesthetician, and... more Dear Dr. Irwin,
I switched from Yaz to the Nuvaring about a year ago. I noticed after last summer that I was getting melasma on my upper lip (I assume from the new birth conrol hormones). Will the damage be permanent if I don't switch? I have just been very careful to cover my lip with sunscreen at all times, because I love the Nuvaring otherwise. Also, why would a supposedly lower-dose birth control cause this when Nuvaring did not and I was on it for 3 years?
Thanks for your help!
Please see your gynecologist (or whoever prescribed these)!! In general, if the melasma is being caused by hormones, whether it's from pregnancy or from oral contraceptives, it will... more
Are facial exercises helpful for sagging skin?Posted in Premature Aging, Jowlsjawline, Jowls and Jawline, Aging Skin, 2011 on Apr 12, 2011 | Permalink Hi Dr Irwin,
Do you feel that face exercises are beneficial to help
with sagging skin?
Thank you,
Nina
There is no great research on this. In my opinion, they don't help because it isn't the muscles that are sagging! Sometimes, they even make things worse because some wrinkles are caused... more Why did my brown spots come back after IPL treatments when I wore sunscreen?Posted in Sunscreen, IPL and Photorejuvenation, IPL, Brown Spots, 2011 on Apr 04, 2011 | Permalink Hi Dr. Irwin,
I had a two IPL treatments for brown spots/previous sun damage. I was very please with my resuls. I went to Costa Rica a month after my ipl treatment and my spots are back!!! I wore Neutragena SPF 100, a hat and wasn't basking out in the sun. I was very good with reapplying the sunscreen. I am perplexed! What do you recommend? I would get another IPL treatment, but is it really worth the cost? I was so disappointed that after two days in the sun, with heavy sunscreen on, they came back. Is there a better sunscreen then Neutragena 100? Any over the counter creams do you recommend or should I try another IPL? Thanks so much!
Okay - this is good - because there are some important points here. Remember that for brown spots the SPF doesn't matter much as long as it's at least an SPF 30. You want an SPF 30 AND a... more I had a reaction to Retin A and my skin hasn't gone back to normal.Posted in Skin Care Products, Skin Care, 2011 on Apr 04, 2011 | Permalink | View Comments (1) I'm 20 and a half and i was using retin a 0.5% for the past 3 months. I suddenly got an allergic reaction on my face so i had to stop using the cream because it appeared to be burning it.
Anyway my main concern is the wrinkles it has causes under my eyes and on my forehead. I've stopped using it for about 5 weeks now and they are still there!! I've read that it doesnt cause wrinkles but i find this hard to accept when they haven't budged after 5 whole weeks! I use a hyaluronic and b5 serum (medik8 hydr8) during the day with a moisturiser (medik8 hydr8) ontop and at night i use clarins skin repair conc. at night. Any advice or guesses as to what is going on? How long can it take for my skin to return to normal after retin a?
* I had light nasolabial lines to begin with that get worse after prolonged smiling, i stay out of the sun, eat extremly well, drink lots of water and exercise. Maybe i had dry skin before retin a and then just dried it out more using it perhaps?? Hellpp!! :(
It's possible you have become allergic to one of the ingredients that are common in many skin creams. See your dermatologist to understand what's going on and what you should do. Some... more
Does Triluma help with scarring from picking!Posted in Skin Care Products, Skin Care, Pigment problems, Brown Spots, Acne, 2011 on Apr 04, 2011 | Permalink Hello DR.
does tri-luma help with brown sccaring from picking? I.. like to try it ty
The short answer is yes............ but only if you stop picking! So here's my question to you. I'd like you to think about why you're picking. If you have acne, please see a... more Is there any way to control these benign growths (keratoses) on the body?Posted in Skin Care Products, Skin Care, Growths, Body Treatments, 2011 on Apr 04, 2011 | Permalink Dr. Irwin, I am 48 years old and really battling keratosis. Some are raised and some are flat. Is there a lotion that can help me get rid of these and fade them?
Okay - I'm making some assumptions. I'm assuming these are the benign form (seborrheic keratoses (seb kers)) not the precancerous ones (actinic keratoses). Sometimes people get these... more Dr. Brandith Irwin, a nationally known skin expert and board certified dermatologist says the appearance of people's complexions reveals a lot about their general health. "Aside from when someone has sun damage, which makes it harder to see the underlying health of the skin, I can look at someone and tell if their nutrition is optimal or not."
I question this...if you looked at my skin you might think my nutrition sucks...I have psoriasis...I eat healthy but my skin doesn't necessarily reflect that. I took slight offense to your statement about being able to tell if a person's nutrition is optimal or not. Check out NPF's forum on Facebook...a lot of us talk about diet...we constantly watch it. Just saying.......
You are absolutely right. I should have said "in the absence of skin disease" to preface that statement because I agree with you! I also think that the younger someone is the harder it is... more
Is there a difference between prescription "bleaching" creams?Posted in Melasma, Hair Removal, Hair, Brown Spots, 2011 on Mar 31, 2011 | Permalink Dr I,
What do you think about Epiquin micro. I try Tri_luma was thinking aobut switching. I use Renova at night, but does it help what brown spots that well?...I also like to try Vaniqa cream for unwanted facial hair, Your thought. ty
The Triluma is very hard to find right now. We are having the equivalent specially compounded for our patients when we need it. The Epiquin micro is excellent. It doesn't have the mild... more Would a hydrating complex be as good as a filler?Posted in Wrinkles, Skin Care Products, Skin Care, Dry Skin, 2011 on Mar 31, 2011 | Permalink Hello Dr. Irwin,
I use skin medica ( luv it)...What do you think of the Hydrating Complex.. I don't use fillers but would this work as well on top of the skin. Thank you
For dryness or very fine lines, use a great moisturizer - the SkinMedica one is good. For true wrinkles, no cream will be able to compare to a filler at this point in time. The... more
Will my eczema skin care be a good antiaging regimen?Posted in Skin Care Products, Skin Care, RenovaRetinoids, Renova Retinoids and Vitamin A Creams, 2011 on Mar 31, 2011 | Permalink | View Comments (1) Dr. Irwin, I am 41 y/o and recently diagnosed with eczema. The PA I saw at the dermatologist office recommended that I use Cerva-Ve cleanser, lotion (for face), cream (for body). Then Aqua phor for flare ups.
Are these products still good as part of an anti aging regimin? I currently have only fine lines across my forehead. The PA did prescribe a retin A cream for me. Any other recommendations?
Your products are really for eczema control - not antiaging. But....... they are very important. Get your eczema under control first and then you can cautiously add some antiaging... more
I had 60 units of dysport injected a week ago in my forehead/between my brows for the first time. I am very unhappy with what seems like the bridge of nose being widened making my eyes seem wideset and the lids are heavy. My forehead feels like cement and my eyes kind of ache. Do you think the distorted look of my eyes and nose will resolve?
First, let me reassure you. It will go away but it may take 2-4 weeks before it feels substantially better. If you are female, in my opinion, 60 units is WAY too much. Botox and... more What would be the longest acting filler in my chin?Posted in Sculptra, Restylane, Radiesse, JuvedermRestylane, Juvederm and Restylane, Fillers, 2011 on Mar 27, 2011 | Permalink Would scuptra be a good choice to fill volume loss in my chin? I am 50 years old and the loss of volume in my chin brings out marionette lines. I have filled it with fat, restlene, and radiasse.Nothing has lasted more than 6 months. I have been told it is because it is such an active area. WIll scupltra last in this area. I was told it will last up to 2 years , But I was told radiasse would last 1 year too.
You bring up several good issues. On the longevity issue, you are not alone in that fat transfer (while we all love the idea) is just not very predictable still. As for Radiesse, I agree... more Hair is thinning like crazy. Any suggestions?
Yes! Please go see a board certified dermatologist! We are experts in the health and diseases of our skin, hair and nails. We all have 3 years of training (in addition to medical school... more
Skin care products for women of color.Posted in Skin Care Products, Skin Care, Pigment problems, African american skin, 2011 on Mar 27, 2011 | Permalink Dr.I,
I love skin medica ( i use it) but can a person of color ( african american) use this product and get the results? I was not sure to recommend this produt to a friend of color.. Ty
Yes, this skin care line is excellent for women of all skin colors. Just remember anyone can have an individual reaction to an individual product. I usually vote for starting new products... more
When is it okay to do Thermage after Botox?Posted in Thermage and Radiofrequency Devices, Thermage, Dysport, Botox Mistakes, Botox, 2011 on Mar 27, 2011 | Permalink Is it safe to have thermage done around 2 days after botox for crow's fleet and forehead lines? Will it cause the migration of botox to other regions and thus causing complication or ineffectiveness?
It's fine to do the Thermage the next day even after Botox. It doesn't take the Botox long to bind to the proper receptors at the junction between the nerve fiber and the muscle. And,... more
Question from the Netherlands regarding brown spots.Posted in Skin Care Products, Skin Care, Brown Spots, Acne, 2011 on Mar 23, 2011 | Permalink Hi Dr Irwin, I learn a lot from your blog and it gives me hope! Just wanted to share an observation on brown spots. I am 42, type 2 skin, dry but with monthly cyctic acne on jawline, and increasingly large lentigoes on cheeks/eye area. I tried Comet laser treatments (spots came back next summer), 4% hydroquinone (made the area redder not lighter) but whats surprizingly helped the last few months is using ROC vit A+C+E moisturizer. Why would this cream reduce the brown spots so drastically? It only seems to work on the lentigoes not red acne scars. I am resigned to them coming back this summer though, given i break out with most sunscreen including all the paula's choice ones :( And the ones you recommend are not avail. in the Netherlands. Any Euroepan suncreens you'd recommend? Thanks!
Thanks for sharing this. I'm not too surprised though that the Roc Vit A,C,E product helped because the vitamins C & E are antioxidants and the Vitamin A (probably Retinol since it's... more Is it okay to do the DOT laser before treating rosacea?Posted in Rosacea, Lasers, Carbon Dioxide Lasers, 2011 on Mar 23, 2011 | Permalink Hello Doctor Irwin, Fantastic site! I'm 39, fair skinned with plenty of sun damage and considering your DOT laser treatment. However, I do have rosacea on my nose and a bit on my cheeks. Nothing over the top, just redness and some broken blood vessels on my nostril areas. Is it necessary to take care of my rosacea before your DOT laser treatment?
Thanks so Much!
DC
In general, it's nice for your rosacea to be under control at least before undertaking a fractionated CO2 laser treatment like the DOT. I'm assuming you're avoiding your particular... more I am 40 years old and move constantly because of my husband's job (military). I had a total of 4 Botox treatments in my life, 2 of those were here in Washington in the same office, however, the second time i had it done i was not completely satisfied with the results. I was told i was given the same 40 units i got last time. I am due now for my next treatment and am looking for other offices. Basically i get Botox in the following areas: Frown, eyes, forehead, and nose, and the price i have been paying for 40 units is $500.00. Is it possible to have these same areas treated at your office for this amount of money? . I live in Lacey and my the dermatologist office is in this same city.
Please just call our office directly on this: (206)215-6600. You can also learn more at www.MadisonSkin.com. Dr.... more
A hand held device that emits red and blue light which is supposed to tighten the skin and produce collagen can be purchased by anyone($250.00). What is your opinion ? Joanne
I don't think you'll see much result. It also requires a lot of patience. Dr.... more
What are these red spots on my forehead?Posted in Brown Spots, Blotchiness, 2011 on Mar 23, 2011 | Permalink About 2 years ago I started getting red spots on my forehead that eventualy turned to brown spots. This is happening more lately, last Sunday I woke up and the whole section above my left eyebrown was freckled red. What is this stuff? I am 52 years old, no hormone replacement.
There are about 10 (at least!) different skin diseases or problems that can cause red spots on the face that then turn brown. Please, please see a good Dermatologist and get an accurate... more
In what order should I use my products????Posted in Skin Care Products, Skin Care, RenovaRetinoids, Renova Retinoids and Vitamin A Creams, Antioxidants, 2011 on Mar 20, 2011 | Permalink ello Dr.
If i use Renova at night, should i still use skinceuticals C E Ferulic? in day or night?.. In day put on skin medica Essential Serum then a suncreen after. Thanks :)
I answered something similar to this last week so I know this is confusing. In general, put your antioxidant (C E Ferulic) under your sunscreen because it helps to prevent the damage from... more What should I use for hollowing under the cheeks?Posted in Sculptra, Restylane, JuvedermRestylane, Juvederm and Restylane, Cheeks, 2011 on Mar 20, 2011 | Permalink I recently heard you speak on Pauls Choice blog radio and would like your opinion on what to do for hollowing under the cheek. I know there is sculptra, but I have heard it is not all it is cracked up to be and can leave little bumps under skin even 4 years out. I have good skin but because I am thin, need to do something. What injectable and/or laser should I consider?
N If you're nervous about Sculptra, find a good cosmetic dermatolgist (this is the key part) or very experienced nurse injector and start with the hyaluronic acids like Perlane or Juvederm... more Do I need a moisturizer with a sunscreen?Posted in Sunscreens, Sunscreen, Sun Protection, Oily skin, 2011 on Mar 20, 2011 | Permalink Hi Dr. Irwin. My question is about Sunscreens. They all feel like moisturizers but most skin care programs suggest using a moisturizer before a sunscreen. I am 50 and have oily skin but with the use of the skin Medica retinol I do tend to be surface-dry right after washing. Do I need to use a moisturizer or is a sunscreen like Ti Silc spf 60 or SkinMedica SPF 30 enough?
You really don't need an extra moisturizer with the sunscreen if you're oily. Here are 3 options. One, just use the sunscreen alone. Two, use the moisturizer you like and put a... more
Can I use Renova cream near my eyes on upper and lower lids?Posted in RenovaRetinoids, Renova Retinoids and Vitamin A Creams, 2011 on Mar 20, 2011 | Permalink Can I use Renova cream near my eyes on upper and lower lids?
The eyelid skin is usually too thin and sensitive to tolerate the retinoids like Renova. You could try it but I'm guessing you'll get red and irritated! Dr.... more
How can I put together an optimal product regimen?Posted in Skin Care Products, Skin Care, RenovaRetinoids, Renova Retinoids and Vitamin A Creams, Antioxidants, 2011 on Mar 16, 2011 | Permalink Hello Dr Irwin,
I use renova at night ( luv it) and skin medica produts in the day> Can you help me put together a day routine from my produts with skin medica, so i dont repeat or over product my skin. TNS essnecial serum after i wash my face Should i use a toner? and what moisturiner from skin medica Here's what I would do. It's hard to get all the categories in .... sunscreen, Renova/Retin A (Vit A cousin), antioxidants, cell growth factors and possibly some peptides or anti-glycation... more Which do you recommend and why: tretinoin or a vitamin A cousin?Posted in RenovaRetinoids, Renova Retinoids and Vitamin A Creams, 2011 on Mar 16, 2011 | Permalink Which do you recommend and why: tretinoin or a vitamin A cousin?
I wish this whole area was less confusing to consumers! And, it is confusing! For your specific question, the answer is easy because tretinoin IS a Vitamin A cousin. This whole group... more
Are there any treatments which prevent the use of other treatments in the future?Posted in Sculptra, Restylane, Lasers, JuvedermRestylane, Juvederm and Restylane, 2011 on Mar 16, 2011 | Permalink Does use of any treatment (for example -- laser - co2, fraxel, etc..., or injectibles - sculptra, rejuvaderm, etc.) prevent use by any other treatment (either same kind, ie. laser to different laser or different, ie. laser to injectable or vice-versa, etc.) at any point in the future?
Good question. This is a little complicated for a blog but in general, no. The exception is anything permanent like silicone, Artecoll/Artefill, and others available outside the United... more Is it okay to have Thermage done right after Botox?Posted in Thermage and Radiofrequency Devices, Thermage, Botox, 2011 on Mar 12, 2011 | Permalink I am interested in having Thermage done, but I just had botox done two weeks ago. Would it be wise to wait 6 months before having this done?
You're fine having the Thermage done anytime. Occasionally we will do them 1 day apart if we have someone coming from Alaska, for example. Botox is injected into the muscle and it binds... more
Is it ok to use the dual fraxel laser for melasma and brown spotsPosted in Melasma, Fraxel laser, Brown Spots, 2011 on Mar 12, 2011 | Permalink Is it ok to use the dual fraxel laser for melasma and brown spots
Okay - so this is a much more complicated question than you think which is why you need a good dermatologist to work with you. Here are the things I would want to know.
What do you think of Skin Tyte (infrared tightening)?Posted in Thermage and Radiofrequency Devices, Thermage, 2011 on Mar 12, 2011 | Permalink Dr. Irwin, what do you think of Skin Tyte (infrared tightening)? How do the results compare to Thermage? Thanks!
So far I'm not impressed. Dr.... more
I'm 49 and have rosacea with some challenges: oral antibiotics taken daily over a period of years has created a liklihood of yeast overgrowth, so antibiotics aren't something I can do. None of the prescription topicals have shown any impact (tried Metrocream, Metrogel, Finacea, Noritate, Oracea). I am working with a dermatologist on IPL laster treatments every 12 weeks. Where I struggle is the daily care products, especially how to exfoliate effectively (without overstimulating and causing breakouts). Do you have any suggestions? Like many of us, figuring out what will be effective is a like walking a fine line. Thank you for your efforts!
Okay - so hold everything on this one. You didn't mention anything about optomizing dietary and lifestyle factors which are critical to good rosacea control. So I'm hoping you would... more Hellooo doctor,
i just want to know more about melasma after reading your post. i have been on some estrogenic herbs, which caused me to develop melasma around my mouth and jaw.. i have completely stopped taking the product and the melasma has reduced.. but now i am on high dose of spironolactone alone.. will it cause the same problem?
No, it doesn't because it's an androgen inhibitor not an estrogenic compound. I'm glad you wrote because many women don't remember that estrogenic herbs can have the same bad effects on... more
if you are over 65(Like 66) can one still use a filler for around the mouth?
Yes! FDA approved fillers can be used safely indefinately as long as you don't have an individual adverse reaction to them (these are rare). I'm not sure I've ever had a request by... more Fillers around the eyes - are they safe?Posted in Fillers, Eyelid Treatments, 2011 on Mar 04, 2011 | Permalink I have just read and enjoyed your book!
There was a very small paragraph on putting filler into the channel under the eye to smooth it out which mentions this can be dangerous and may cause blindness - can you tell me any more about this?
Many Thanks
I really have to say yes and no. The eye area is not FDA approved for any filler to my knowledge although it's often done as an "off-label" use. This is a tricky area and my... more Is it okay to use different fillers in the face?Posted in Sculptra, Radiesse, JuvedermRestylane, Juvederm and Restylane, Fillers, 2011 on Mar 02, 2011 | Permalink | View Comments (2) Hi there,
I am considering having sculptra to help with volume lost in my cheeks. After having the sculptra and due to economic issues could one (after 1 year) get Perlane or Radiesse injected into that same cheek area (where the sculptra was injected) for continued cheek volume? Thank you for your thoughts.
LC
Good question. There are no studies that I have seen on this. But from talking to some of my collegues and my experience, here's what I'd recommend. There doesn't seem to be any problem at... more Does body Thermage work for stretch marks?Posted in Thermage and Radiofrequency Devices, Thermage, Stretch marks, 2011 on Mar 02, 2011 | Permalink Dear Dr Irwin,
Your site mentions that Thermage is coming out with a new body tip in 2008. I would love to know what your assessment of this new tip is, and whether it might be appropriate for reducing the atrophy associated with stretchmarks. I have stretchmarks on my breasts which appear 'indented' and would love to address this.
Thank you.
Yes - they did come out with that reengineered Thermage body tip in 2008 but it was a disappointment. I wish I could recommend it, but I really can't. The body tip is expensive and the... more
What is the best way to permanently remove facial hair, especially along the lip line?Posted in Hair Removal, Hair, 2011 on Mar 02, 2011 | Permalink What is the best way to permanently remove facial hair, especially along the lip line? I'm menopausal and new facial hair is very annoying.
Suzanne
The answer to this depends on your skin type (color) and the color of the hair. If your skin is darker, look for someone who does a lot of hair removal and has a YAG based hair removal... more
Are there any products made especially for men that you recommend?Posted in Skin Care Products, Skin Care, 2011 on Mar 02, 2011 | Permalink Skin care for men. Are there any products made especially for men that you recommend? I want to get my husband a present but I'm sure he would be much more likely to use it if it was something made just for men!
There are more every year which is great! Look at the Clinique products for men. Leaf & Rusher (more boutique line - probably online), and Kiehls has a lot of nice products that men... more
What is the difference between a chemical peel and a laser treatment for fine lines and wrinkles?Posted in Wrinkles, Peels, Fraxel laser, Carbon Dioxide Lasers, 2011 on Feb 16, 2011 | Permalink What is difference in improvement between a chemical peel and a laser treatment? Do they both work to treat wrinkles and fine lines?
This is a good question because I think many are puzzled by this also. I'd like to give you the broad differences and then links to two places in the site for more information. Since you... more Does packaging matter to keep the potency of the product?Posted in Vitamins for Skin, Vitamin C, Skin Care Products, Skin Care, Cosmeceuticals, 2011 on Feb 16, 2011 | Permalink Dear Dr. I, I bought your recommended IS Clinical Eye Complex,which I like very much and was contemplating reordering. Question...you never seem to mention packaging (like Paula Begoun) and mine has been opened tons of times. Am I loosing potency with this type of jar after repeated openings?
cheryl in CA
Most products are not significantly affected by exposure to air assuming you're not leaving it open continuously or in a over heated car, for example. The one exception is antioxidants... more Is the Lumixyl skin lightening product a good one?Posted in Pigment problems, Melasma, 2011 on Feb 13, 2011 | Permalink Hello:
What are your thoughts on Lumixyl? I've been hearing buzz about it, and interested in skin lightning/brightening. I am fair skinned naturally (light hair/blue eyes), but would like to even out and get my skin as pale porcelain perfect as possible :)
As you know, it contains multiple plant based "lightening" agents. Like the prescription hydroquinones these products don't really "lighten" or "bleach" anything. They work mostly by... more I received a Jessner's/TCA 35% medium depth chemical on my face and have a slight line of demarcation on my upper lip just about the outline of my lips. What would be the best way to correct this?
I'm going to assume that you went back to the Dermatologist who did the TCA peel and asked about this??? I'm also guessing that he/she didn't run the peel solution down just over the... more
Hi Dr Irwin I have hispanic skin Im 32 years old and I have smile lines that I want to get rid of I've heard of fillers but I really want to do a treatment that has longer results like laser I heard that fraxel is the best for any tipe of skin would the laser would get rid of smile lines? I also went to a place and I bought a package of 5 skin tightenings they said that It will improve my smile lines I really don't know what to do. I also wanted to know if the fraxel laser would also be good to improve the apperance of old white stretch marks in my tipe of skin Thanks
Okay - so I think you bring up some good issues. It's critically important to understand first why you have the smile lines. Do these same smile lines tend to run in your family in the... more What to do about 1 under eye bag remaining after surgery?Posted in Eyelid Treatments, 2011 on Feb 09, 2011 | Permalink Dear Dr. Irwin:
I underwent lower blepharoplaty 8 months ago for fat repositioning and fat pad removal. I still have a large bag on one cheek that was present prior to the surgery. I have consulted my physician about this and was told this is a separate problem requiring additional surgery. I do not have excess skin just the "pad" which gives my face a lopsided appearance. I consulted another surgeon who recommended Juvederm to correct the appearance of the asymmetry, Juvederm made it worse. Are there any options other than surgery? Is the procedure to correct this condition similar to blepharoplasty? Rhonda
Rhonda - I can't tell you what the right thing to do here is but I think I can help you in your thinking about it to help get you to a good solution. Hope that makes sense. The first... more What is the cost of Juvederm?Posted in JuvedermRestylane, Juvederm and Restylane, Fillers, 2011 on Feb 09, 2011 | Permalink Hello Dr Irwin i am 52 years old and thinking of starting to use fillers like juvederm for my cheeks ,i was wondering how much is the cost for it?
Thank you, Marie.
Marie - This varies quite a bit by area and country. In the United States, the range is usually $450-800 per syringe. Areas like New York and Los Angeles tend to be at the higher end. ... more
How long should Restylane last?Posted in JuvedermRestylane, Juvederm and Restylane, Fillers, 2011 on Feb 09, 2011 | Permalink how long is restylane supposed to last?
I think today is filler question day! If you are using what I call the "mid weight" version - not the Perlane, it generally lasts 4-6 months. Over time, if you are regular with... more
I have been reading a lot about using Estriol to treat under-eye wrinkles. What are your thoughts?Posted in Skin Care Products, Skin Care, Eye Creams, 2011 on Feb 08, 2011 | Permalink I have been reading a lot about using Estriol to treat under-eye wrinkles. What are your thoughts?
I would vote a strong no on this. Think of the effect that estrogens have on the uterus, vaginal tissue and breasts. Do you really want to be experimenting with this around your eyes? ... more
What can I do to look great for my wedding?Posted in Skin Care Products, Skin Care, Peels, Microdermabrasion, 2011 on Feb 08, 2011 | Permalink Hi Dr Irwin,
I am 28 and getting married in 4 months. What do you suggest so my skin looks fabulous in time for the wedding? Also, some of my friends have told me I should start using the Clarisonic, what do you think about that?
Thanks!
I love weddings! I think it's all that crazy dancing, all the relatives, beautiful dresses, etc. Anyway, I'm guessing that your skin is pretty good since you didn't mention acne or... more
When is it best to use Vitamin C serum?Posted in Vitamins for Skin, Vitamin C, Antioxidants, 2011 on Feb 08, 2011 | Permalink Hi Dr. Irwin,
I am wondering about using a Vitamin C serum in the morning under my sunscreen. I have read on several places online (and had one aesthetician tell me) that Vitamin C breaks down in the sunlight. She said that your skin won't benefit from it if you wear it during the day under your sunscreen. I'm wondering if I should only use it at night?
Thanks so much. I read your book and changed my skincare routine based on it, and I'm lovining your recommendations and the results!
Wendy
Well, she's sort of half right on this but here's why you should still use in the morning. When you put in on it binds to your skin cells. When the UV rays hit the cells and create free... more
What is the best method to removed small, raised brown growths (seborrheic keratoses) on asian skin?Posted in Growths, Brown Spots, 2011 on Feb 05, 2011 | Permalink Please help me! I am a 50 year old Asian female. I have a benign, slightly raised, seborrheic keratoses on my cheek, the result of staying out in the sun too long and getting sunburned. I have seen a couple of dermatologist already but I don't know what to do. The first dermatologist wants to shave it off. Another wants to spray liquid nitrogen on it. One says I can try laser and the other says I can't do laser because the spot is raised and I am Asian. Since the raised brown spot is on my cheek, I don't want a scar. What should I do? Since I'm Asian, can I do laser? Would laser remove and flatten the brown spot? Or should I just let the doctor spray the liquid nitrogen on my face? Also will liquid nitrogen flatten the raised spot? Please help me!!! I am so tormented every time I see my face. Thank you!
I'm guessing you are getting more than a little frustrated with all these different answers! Here's my "2 cents" and I've have removed thousands of these on my asian patients over the... more How can I get the best results from in-office peels?Posted in Peels, Microdermabrasion, 2011 on Feb 03, 2011 | Permalink Dear Dr Irwin,
Thank you for your excellent website sharing unbaised skincare information. I am 37 years old and I interested in including medical grade peels and microdermabrasion into my skin-care routine, primarily to help with blackheads, but also to assist with overall skin texture over time. I understand from reading Paula Begoun's books that BHA and AHA products work most effectively within a certain pH range (approximately 3-4 for AHAs and 3 for BHAs. My question is, how can I go about selecting which skin care provider to use for a medical grade peel when information about the pH level of the products they use is difficult or impossible to access?
Your welcome! I'm afraid that short of calling the companies and being very persistent, you really can't be sure. The best thing to do is find reputable doctors who use companies with a... more Questions regarding Tazorac!Posted in RenovaRetinoids, Renova Retinoids and Vitamin A Creams, 2011 on Jan 31, 2011 | Permalink I have been using Tazorac 0.1% cream for about 5 years and tolerate it well accept for a few days in winter(live in Utah). I read that Tazorac 0.1% gel is the most affective retinoid for wrinkles and sun damage but is more irritating. Is this true? Should I use the gel in summer months and the cream in winter? Which is the most effective retinoid? I am 38 with combination skin and have a lot of sun damage.
It's actually not true that Tazorac is the most effective for wrinkles and sun damage. The studies done showed a slightly faster onset of improvement but there is no difference long term. ... more I'm on a blood thinner could I be a candidate for Thermage?Posted in Thermage and Radiofrequency Devices, Thermage, Radiofrequency systems, 2011 on Jan 31, 2011 | Permalink I'm on a blood thinner could I be a candidate for thermage?
You're very unlikely to have any bruising with Thermage. With radiofrequency devices like Thermage, blood thinners like warfarin are not a problem. Dr.... more
Do you like obagi products?Posted in Skin Care Products, Skin Care, 2011 on Jan 31, 2011 | Permalink Do you like Obagi products?
I wish there was a simple answer to this one because I'd have to say yes and no. Yes, because I think he's done a good job of taking easily available active ingredients (some prescription... more Dr. Irwin,
I have used cosmoplast before, but, it is not available anymore. What do you think of Preville? Jevederm? Are they comparable?
thank you
The nice quality that Cosmoplast had was how well it filled smaller, more subtle lines without causing any bumps or ridges. The only comparable product in the United States right now is... more I'm an African American with laugh lines and uneven skin tone.Posted in Wrinkles, Pigment problems, 2011 on Jan 28, 2011 | Permalink I'm a african American with uneven skin tone and small laugh wrinkels around my eyes. What do you suggest?
For your uneven skin tone, it depends on whether the blotchiness is being caused by hormone related melasma, sun damage, inflammation from acne or irritated hair follicles, etc. I think... more What is the best high quality sunscreen for someone who has melasma?Posted in Sunscreen, Melasma, 2011 on Jan 28, 2011 | Permalink what is the best high quality sunscreen for someone who has melasma?
Use the highest percentage zinc you can find and tolerate. I often use the Dermaquest Zinclear SPF 30 with 18.6 zinc. It also comes in a tinted form and the tint is a more medium... more
Multiple issues with melasma.Posted in Rosacea, Melasma, 2011 on Jan 28, 2011 | Permalink What is the best way to treat melasma and rosacea without worsening them? Bleaching creams irritate me. I am one of the lucky ones to have both conditions. I've heard the IPL can make melasma worse, and peels can make rosacea worse. What do I do? Would Renova .025 help with the brown? Should I try IPL? Thanks so much!
I hate to say this but your issues are too complicated for this format. I know what you mean about the options being limited if the usual hydroquinone based "bleaching" creams irritate... more
What would be an alternative to Obagi ?Posted in Wrinkles, Sun Damage, Skin Care Products, Skin Care, RenovaRetinoids, Renova Retinoids and Vitamin A Creams, 2011 on Jan 28, 2011 | Permalink Dear Dr Irwin
I amm 44 with fair skin which freckles in the sun, oily t zone and wrinkles around eyes. In august i started to use obagi nu derm with great reluctance because of the hydroquinone. However i thought i would do the 18 wks then stop and go onto something else i am now being told i need to stay on it for life as my skin will return to its previous state and i could suffer hyperpigmentation. pigmentation was not a problem for me anyway i went on nuderm for wrinkling and sundamage and to refine the skin. i enjoy using the tretinoin but have been told it doesnt work if i dont use the blender with it. I just want to follow one of your regimes and have purchased tns already> please help. regards Jo
The ingredients in Obagi are the same ones available both by prescription and over the counter. In the Obagi system, they are just packaged and applied in a certain order which can be very... more
What is the best timing for Sculptra and a fractionated CO2 laser?Posted in Sculptra, Carbon Dioxide Lasers, 2011 on Jan 28, 2011 | Permalink I have had two sculptra sessions-receiving one vial at each session. My Dr. and I think I will benefit from a total of four. I am now thinking that I would like a Fraxel repair CO2 laser treatment. How soon after the sculptra series can I have this treatment-or can it be done during the series?
In general, I recommend finishing (or being close to it) the volume replacement with the Sculptra before the CO2 laser. If you have more dermal support and volume in your face with the... more Do you or your partner sell Retin A or Renova?Posted in RenovaRetinoids, Renova Retinoids and Vitamin A Creams, 2011 on Jan 28, 2011 | Permalink Do you or your partner sell Retin A or Renova?
We do not sell it online. For our in office patients only, we sell in the office (legally) 4 prescription products - Biafine, Triluma, (when it's available), Latisse and Renova. We price... more
Which is better for volume loss in the chin area Sculptra or Radiesse?Posted in Sculptra, Radiesse, JuvedermRestylane, Juvederm and Restylane, Fillers, 2011 on Jan 24, 2011 | Permalink DR Irwin, i got your message and will ask my question again. I am 50 years old but have skin that looks more like 40. I do have volume loss in my chin and this shows the marionette lines. I have been using radiasse for this area because I had a bad reaction to restylene. Would sculptra be a better choice for this area? I have had good results with radiasse but do not yet know how long it will last as I had it put in in September and added to it in December.
Everyone's face is so different that it's almost impossible to answer without seeing you but some general principles still apply. Look at your cheek area. Is volume loss in your cheeks... more I am a huge fan of yours and of your website. I value your knowledge and advice. I am a 46 yr. old woman, and recently I was told I have rosacea. I never knew for years, but recently I have been getting flares with pustules on the lower part of my face. I had a salicylic peels, a pca, peel, and two days later got pustules again. Can that kind of peel bring on a flare, or could it have been a reaction to a mineral makeup I tried? I don't know if I should have another peel or not. I have melasma as well, and thought it would help that and help with bumps, but instead I got a lot of bumps for a good few days. I am on Metrogel, Renova 0.25%, CEFerulic serum..What do you recommend for sensitive, acne prone, dry skin for maintenance and anti aging? I got an IPL, and my melasma got darker, and I really didn't notice a big difference in the redness. Could RevaleSkin Night Cream, with Coffeeberry be breaking me out? That seems to help with redness, just about more than anything else, but can't seem to narrow it down to what is causing the bumps, pustules. Thank you in advance.
Sadly, the problems you are having with your rosacea are way too complicated for a website! Please, go to your board certified dermatologist to help you with these issues. You'll... more How many Fraxels are enough?Posted in Fraxel laser, Carbon Dioxide Lasers, 2011 on Jan 24, 2011 | Permalink I've been having a series of Fraxel treatments on my face for both pigmentation and to improve skin texture. One practioner has told me that I can only have 5 treatments in the first year and then once every year following that Another provider has told me that I can continue to have as many treatments as I choose provided there is at least 4 weeks apart. Can you share your opinion on the number of fraxel that is most beneficial. Thank you.
I think that depends on how much improvement you are seeing with each treatment. If the Fraxel settings are good you should be getting about 15-20% coverage with each treatment so at... more What would you recommend as a first step to enlarged pores on the cheeks?Posted in Lasers, Large Pores and Texture, Large pores, Fraxel laser, Carbon Dioxide Lasers, 2011 on Jan 22, 2011 | Permalink What would you recommend as a first step to enlarged pores on the cheeks. I am 48.
Thanks
Deanna
Hi Deanna. If they aren't too large, I would recommend Fraxel (the original - not the Fraxel CO2). You will probably need to do a series of at least 3 to see a real difference. If they... more
Should I use both Retin A and a glycolic?Posted in Skin Care Products, Skin Care, RenovaRetinoids, Renova Retinoids and Vitamin A Creams, Antioxidants, 2011 on Jan 22, 2011 | Permalink I would like to know if it is beneficial to use both Retin A and glycolic acid. I use the Cellex C serum in the morning and usually Retin A at night but I have heard that you should also use a glycolic product. If you should use both can I alternate nights and still get the benefit.
I'm glad you asked this. If you are using Retin A or one of the other Vitamin A category creams, you don't need to use a glycolic also. You would be better off with an antioxidant (like... more
What do you think about Refirme?Posted in Thermage and Radiofrequency Devices, Thermage, Radiofrequency systems, 2011 on Jan 22, 2011 | Permalink I have had Thermage, but I was wondering what you think about Refirme? Is there anything new for skin tightening? Thanks
I really don't think (at least so far) that the results are better. In my opinion, they are about the same, with the disadvantage of Refirme requiring 3 treatments instead of 1, being... more
Problems with Radiesse.Posted in Sculptra, Radiesse, JuvedermRestylane, Juvederm and Restylane, 2011 on Jan 20, 2011 | Permalink Radiesse injected in the upper cheek area and and 2nd injection a week later in lower cheek bone area. Nodules have now formed in this area after swelling for a number of weeks. I have since. I now have sagging cheeks, sagging/pouches either side of my mouth, all of which I did not have before. Could this be from the heaviness of the product? Once the product has left my face, should my skin return to normal or is there permanent damage due to swelling and sagging over a period of time? I am 37years of age. Thank you.
You bring up some good points. But, first let me reassure you that your skin should return to normal once the product is gone. I am assuming though that you have seen the doctor who... more Can I use tretinoin at age 24 for acne? What about for aging?Posted in RenovaRetinoids, Renova Retinoids and Vitamin A Creams, 2011 on Jan 20, 2011 | Permalink Hi Dr.Irwin i'm a woman of 24 years old I used to have very bad breakouts but since I started to use tretinoin in gel at 0,025% per 3 months now my skin is all clean so my question is can I keep using it? only at night? if I want to prevent the wrinkles under the eye area can I use tretinoin 0.05% in cream? my skin is very light and sensible I get red quickly, thankyou for your time, Love your website!.
That's great that it's working so well for your acne. It's fine to keep using it as long as you are sunscreening every day. I usually have my patients stop it one week before sunny... more I'm starting 8 treatments of one of Syneron's products (not eMatrix). The Doctor calls it "ST". It's called sublative rejuvenation. I'm hoping to rejuvenate my skin, improve wrinkles and help with a drooping jowl line. I didn't see any information on Syneron's products on your website and was wondering what you thought? The Dr. is not a dermatologist; he's a family practioner.
Okay - so here's where I really need your age, your approximate weight, and the degree of sagging at your jowl line. The answer really depends on that so please write back. Dr.... more
Radiesse vs Sculptra - which is better?Posted in Sculptra, Radiesse, JuvedermRestylane, Juvederm and Restylane, 2011 on Jan 18, 2011 | Permalink I have used radiasse in the area of my chin and marionette lines. Would sculptra be a better choice for this area?
Okay wonderful readers - you have to give me your ages!! The answer to this really depends on your age and the depth of the crease. Sculptra can be a great solution but don't rule out the... more
What would be good to treat early eyelid wrinkles? I'm in my 30s.Posted in Thermage and Radiofrequency Devices, Thermage, Fraxel laser, Eyelid Treatments, 2011 on Jan 18, 2011 | Permalink Hi Dr. Irwin,
I'm interested in doing Thermage around the eyes. I'm in my late 30s and have good skin although very thin around the eyes. When not animated (resting state) the skin under my eyes looks fine. However, when I smile and the skin under my eyes is pushed up, it gets a bit bunchy and crepey looking. Is there anything I can do to improve that? I do a little Botox for my crows feet which completely helps minimize my crows feet. I also had a lower lid blephoraplasty with fat repositioning over a year ago so there is no extraneous skin or fat in this area now. Do you think Thermage around the eyes would help? I know I might not see the results for 4 to 6 months. Any other suggestions? Thanks.
This is a good question since you are in your 30s still. If the problem is more that there's a little loose skin, then eyelid Thermage is a good choice at your age. If the problem is more... more
Hello to all of you. I'm sorry that I haven't been answering as many of your great questions as usual. My mother died just before Thanksgiving. And although she lived a long and full... more
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