Blog with Dr. IrwinCategory >> 0 If I'm 55, would I get some skin tightening from the Candela Gentle Yag laser?Posted in Skin Tightening, Jowls and Jawline, 2012 on May 19, 2012 | Permalink
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Thank you for such a helpful web site! A local med spa is offering a great deal on Candela laser skin tightening and I wonder what you think of it. I am 55 with medium-toned caucasian skin and lots of tiny red veins in my face. My main concern is the lower half of my face: sagging jowls, a double chin and marionette lines. However, I am not a candidate for a face lift because of certain health conditions, and I am on a very limited budget. Would Candela (Gentle Yag) skin tightening be appropriate for me? Should I go for the 3 or 6-treatment package? What other treatments would be good as an alternative or addition to this? Thank yo so much!
Ter Thank you! Here are some things to think about - both pro and con. On the results issue, if you truly have visible sagging and a double chin (you sound like an honest woman!!), then this... more What about the Avon anti-aging products?Posted in Skin Care Products, Skin Care, 2012 on May 19, 2012 | Permalink What's your take on Avon's anti-aging products: (Anew) genics and 6+platinum in particular? Where's the data and proof in humans?? Seems to me like another attempt by a company to address the current fad in skin care marketing. The current fad is to put very long, impressive... more
Side effects of hydroquinone 4% - is ochronosis really a concern?Posted in Pigment problems, Asian skin, African american skin, 2012 on May 19, 2012 | Permalink I am using hydroquinone 4% prescribed by a dermatologist. After reading about ochronosis on the internet, I'm quite scared. What are the symtoms of this? Does it appear immediately or is it gradual?
In the United States, the drugstore 'lightening' products are generally 1-2% hydroquinone. Over that percentage, hydroquinone is available only by prescription through a doctor. In the... more A Juvederm mistake/problem!Posted in Finding a Good Doctor, Fillers, Filler mistakes, 2012 on May 19, 2012 | Permalink Hi Dr. Irwin. I had Juvederm injected over my right eyebrow two weeks ago. The Injector (visiting from Florida)was not a Board Certified Doctor. I had bruising and swelling. I now have about a two inch oblong bump on my brow bone. Can I use Hyaluronidase to disolve it? Or should I try to massage it out? What should I do? I don't want to make it worse.
Okay - I'm trying to bite my tongue on this and I know you know why!! Please, please don't let anyone who's untrained and not Board Certified or closely supervised by someone who is Board... more Which laser would be best for acne scars if I'm Asian and had cystic acne?Posted in Lasers, Asian skin, Acne Scars, Acne, 2012 on May 12, 2012 | Permalink Dear Dr. Irwin,
Being a fair Asian lady who had suffered from high grade cystic acne and completed a course of accutance, all I'm left with now is a face that is still somewhat pink and highly uneven. Certain parts of my face have sunk after accutane as previously, the lesions were protruding so much.
I'd like to know if fraxel or mosaic would serve me better in leveling my skin and what I can do to lighten the pink patches left by the acne.
Thank you.
Between these two, I would vote for the Fraxel (not the Fraxel Dual). It has much more data and experience behind it including several studies in Asian patients. The depth of... more Hi Dr. Irwin, I am very impressed with your high quality, evidence based dermatological advice. Therefore I was surprised to read the following in your blog:
"Sculptra is the synthetic lactic acid that stimulates natural collagen production and in time results in added volume to areas of the face, like hollow areas beneath the eyes. Sculptra is FDA approved for HIV lipodystrophy with broader cosmetic approval pending in 2008-2009. The eye area is particular prone to Sculptra bumps. Experts only."
I thought periocular sculptra injections were verboten....?
Dear reader - Thanks for pointing this out!! I thought I'd gotten rid of all the old language regarding Sculptra. This was true back in 2008 but has changed since. We will fix... more
Which SkinCeuticals antioxidant should I get?Posted in Skin Care Products, Skin Care, Antioxidants, 2012 on May 12, 2012 | Permalink I just can't decide which SkinCeuticals C product to purchase. Is the CE Ferulic equally as good at the C Phloretin? I am 42 with neither oily or dry skin. I like the gel but am told i should use the ce ferulic because it is more of an antiager.
I think you might be over thinking this a little. They are both excellent! Why not try one until it's used up and the other one the next time. You'll probably be able to decide which... more
At 72, what types of procedures would be safe?Posted in Finding a Good Doctor, 2012 on May 12, 2012 | Permalink I have a heart pacemaker, and although I am 72, my skin is not that wrinkled, but would like to maybe tighten my neck a little, and maybe do something with the start of the area of nose & mouth! I would like to know if you have any suggestions as to what is safe in my situation. Thank you, Jo
First, I think it would be reasonable to collect information and decide on a 'wish list' but then run that list by your cardiologist. He/she can help you figure out what's safe for you. ... more What about dermarollers and snake cream?Posted in Skin Care, Microroller, Home use devices, 2012 on May 12, 2012 | Permalink i am a woman 43 years if I use snake complex cream will be good for me or try derma roller by doctor or by my own. Thanks
I would avoid both of these! There is little or no evidence that either of them work for wrinkles or anything else. The dermarollers are interesting but have potential for harm also.... more
I'm fit and 42. How can I get rid of this pregnancy tummy skin/fat?Posted in Fat reduction, 2012 on May 12, 2012 | Permalink Dear Dr I, I am a 42 year old mother of two. I work out every day and am my ideal body weight but I have really loose skin on my stomach. I really do not want to go down the route of tummy tuck. Is there any other alternative procedures available?
Two years ago I would have said that you can't (without surgery). But things are changing. The CoolSculpting by Zeltiq which is a cold based fat spot therapy would be your best bet... more What are these white spots on my face???Posted in Pigment problems, 2012 on May 06, 2012 | Permalink Hi Dr. I, I have been suffering from hypopigmentation under both eyes (nearer the outer corners and on the cheekbones, worse on the left than the right) since last fall (about seven months in total).....I tried everything, from using just plain soap and water (oatmeal soap) and sunblock (SPF 45) and nothing else product wise, to BioOil, to Palmer's Cocoa Butter Dry Oil, to that plain old big tub of Eucerin. Finally over a month ago, I went in to see a skin esthetician (out of a local plastic surgeon's office) who recommended the Obagi "Nu Derm" line of skincare. I have been using this religiously ever since (and ONLY this, no outside moisterizers, soaps, washes, etc. ) including the sunblock that is provided with the starter kit. (Really like this sunblock, it is greaseless, scentless and makes my makeup go on like a dream!)....anyway, the skin under both of my eyes, nearer the outer corners, and also on the actual cheekbones but much more pronounced on the left side is seemingly BRIGHT white without makeup and especially in the morning. I DID used to sleep on my sides and retain fluid which made this skin area stretch and shrink for a long time, (this was after a separate phone consult with a NYC plastic surgeon who viewed the pics I sent him of this with me online/via phone in 'real time"). He suggested that fillers might make them less noticable, etc. (not really much explanation of the whiteness/lack of pigment though, he thought it might be from a vitamin deficiency possibly)....he was wonderful though and suggested starting to sleep with my head elevated at night (been doing that ever since January and no more bags in the morning), better vitamin intake and better diet. However this mentioned skin on the cheeks especially seems worse and more wrinkly in addition to being BRIGHT WHITE in the mornings when I wake up. I avoid direct sun like the plague these days and NEVER leave the house without a GOOD sunblock and sunglasses (a ballcap too on days off). Do you have any idea if this could be permanent pigment loss? A dermatologist told me that it is NOT vitiligo which is what I first suspected back when it appeared initially back in the fall but that I have a mottled complexion and sunscreen should be my best friend (as it is and has been these past months)...she also said this is most likely sun damage and could or might not repigment on its own.its been four months since that diagnosis appt. and still no change.....Is there any hope this could be blended better (if it is permanent) by using the Obagi Nu Derm (I don't put under my eyes but was advised by my esthetician to use it from the cheekbone "down" which I have done since day one)....
Wow - okay - you gave a lot of good information here and the bottom line is still this.......you need an accurate diagnosis! I would guess that most board certified dermatologists in... more Can you help? I'm a male, 25 with acne and lots of oil.Posted in Oily skin, Acne Scars, Acne, 2012 on May 06, 2012 | Permalink Hello doctor, Iam 25 years old male Suffering with oily skin and acne from 4 years. My parents never had oily skin. Do I suffer with oily skin life long? Is there any product to reduce my oily skin? Please tell me
This is a little tough because you don't tell me how bad your acne/oil is? There are basically 4 types of acne.
THANK YOU, THANK YOU FOR SUCH A WONDERFUL WEBSITE!! I heard you on Paula's radio show last week~great job!! I feel like I know you personally...I think I have watched ALL your videos on your site! :) Now...finally my question.
I filled out the skin questionnaire which recommended that I use retinol products with roseacea. I just saw Dr. David Vasily-Allentown, Pa. (you should see his credentials and website...I think you will want to add him to your recommended doctor's list. He is a collegue of Dr. Eric Bernstein -Bryn Mawr, Pa. that you do recommend-who is also great!!) Anyway...he told me not to use any products suchas Renova, etc. because it could cause more red veins in my face?? Therefore...I am confused!!!
Thank you for taking the time to help us all!! God Bless You!! :) Elizabeth K.
Thank you for reading and listening!! And, for the doctor recommendations - we'll look at that practice. When many of us trained, probably including Dr. Vasily, we were taught that... more Is there anything i can do about Sculptra bumps around the eyes?Posted in Sculptra, Fillers, Filler mistakes, 2012 on May 04, 2012 | Permalink dr Irwin it's been over 2 years I had sculptra injected by dr ____ ___________. I have the lumps from sculptra on the surface under my eyes. My gp said they have to be cut out by a plastic surgen. Why are doctors injecting sculptra under eyes? I'm disfigured and will end up with scars from this product? Can sculptra cause cancer? The company I contacted don't care... My name is margaritta from Brisbane Australia.
I am so sad that you had this experience. As you know the company who makes this product (now Valeant) is not recommending using this product around the eyes. This is because a small... more What do you think of Neocutis products?Posted in Skin Care Products, Skin Care, 2012 on May 04, 2012 | Permalink Hello Dr. Irwin,
Have you ever tryed Neocutis Products?
Thanks :)
Yes - they are interesting. I'm in the process of evaluating several now and will let you all know in several months. It sometimes takes awhile to track down the science that goes... more
Listen to Dr. Irwin talk about the newest anti-aging devices & treatments on The Cosmetic Cop podcast with Paula Begoun.
... more
How can I get the most out of my products?Posted in Skin Care Products, Skin Care, Cell growth factors, 2012 on Apr 24, 2012 | Permalink Hi Dr. Irwin,
Love, Love your site. Great information. I like to use TNS Recovery complex in my skincare regime. Like a lot of people the budget is tight. Is it OK to use this product once a day and still get some benefit.
Sorry about the silence on this end. We were on spring break with our children. Thank you and you raise a good point! There are a few products now that most of us are using that... more Are these broken blood vessels or purplish color a side effect of Restylane?Posted in Rosacea, Juvederm and Restylane, Fillers, Filler mistakes, 2012 on Apr 24, 2012 | Permalink I had Restylane injected into my nasolabial folds about 3 years ago and still have a purplish hue skin color that is hard to cover with makeup. If I look at my skin under magnification I have some broken blood vessels. How can I get rid of this discoloration? Also I would like to have some filer in my marionet lines but do not know what filer to use. Can you make a suggestion? Joy
In our experience, there are usually three main causes for these. One, some people are prone to these around the nose and nasolabial folds, probably genetically (look at your parents - do... more Products for the eye area?Posted in Skin Care Products, Skin Care, Moisturizers, Eyelid Treatments, 2012 on Apr 24, 2012 | Permalink Is there an eyecream that offers hydration without being a treatment for puffiness, dark circles etc? I can never apply make-up over these creams without it rolling or sliding off leaving a less than desirable look.
Try the SkinCeuticals Eye Balm - just the plain one. Here is a list of some of my other favorite eye creams. Or, for something really basic, Cetaphil or CeraVe Cream (not the... more
I have a lump in my lip from Juvederm!Posted in Juvederm and Restylane, Filler mistakes, 2012 on Apr 13, 2012 | Permalink I have had lip injection with Juvedrem ulta n 2 hours after procedure I have developed a lump on my upper lip
And lumps inside my mouth as well. Today has been 5 days post op and I went back to the dr and he said it will go down!! He says if u want to massage it then do so but he said he doesn't think that's a good idea?? I asked him to put a needle in the Lump on my lip and remove it and he said no to early!! I have no bruises and lips look good besides that !! Should I go to another doctor ??
I usually tell my patients to give any filler about a week to mature. Sometimes an injection could cause a bruise that's deep and not very visible. Approximately a week, gives the... more Will hydroquinone help with brown spots after IPL?Posted in Pigment problems, IPL and Photorejuvenation, Brown Spots, 2012 on Apr 12, 2012 | Permalink i have had IPL done on my face and now i have dark spots. I am using hydroquinone. Will that help fade the spots? Generally yes, the prescription 4% (USA) is more effective than the 2%. Don't go over the 4% without discussing with a dermatologist if you live overseas. But the question is really... more
In what order should I use these products??? It's so confusing!Posted in Skin Care Products, Skin Care, Renova Retinoids and Vitamin A Creams, Cell growth factors, Antioxidants, 2012 on Apr 12, 2012 | Permalink New reader and I love your site. You have already answered a lot of questions except I am still a bit confused on order of product application. Currently, in the
AM.
Cleanse
Skinceuticals CE Ferulic, wait 15 min
Skinceuticals B5 gel
Skinmedica TNS Essential Serum
Journee bio restortative day cream w/ SPF 30 or Skinceuticals UV physical 50 tint
PM.
Cleanse
Skinceuticals 1% Retinol
Confused on the TNS Essential Serum and think I should apply in the evening, but would not know which order is most effective to use first. I thought Retin a should be applied to a clean dry face to be most effective with no other products. Please help, don't want to be using all these great products and not be using them properly.
Thank you! It's so confusing isn't it, but you have the basics down. So here's some fine tuning. Part of the problem is there really isn't much data on this so what I'm telling you is... more Help!! A Restylane problem.Posted in Juvederm and Restylane, 2012 on Apr 12, 2012 | Permalink I had Restaylane yesterday and my lips are enormous and the area between my nose and top lip is massive and shiny :( I'm taking nurofen for swelling but this morning they are insane I look freakish! I can't see this being normal, I had them done at 5pm yesterday :( I know they can be reversed but do I need to be quick about it? I'm unbelievably stressed out :'( x
First - call your doctor right away and report what happened. Hopefully they can look at you right away. Secondly though - just to reassure you - this will go away. I and other... more Acne, oily skin and Retin A gelPosted in Renova Retinoids and Vitamin A Creams, Acne, 2012 on Apr 04, 2012 | Permalink I've been using Retin A Gel for my acne... but since I started using it at night, I wake up with a super super oily skin... I thought this was supposed to make my skin drier but no, it is more oily, am I doing something wrong? Thanks for your advice!
You don't mention how long you've been using it and whether or not you are male or female. You're probably thinking .... why does that matter? For example, oil production is primarily... more
For upper lip lines, how to best use Botox and Juvederm together?Posted in Juvederm and Restylane, Botox, 2012 on Apr 04, 2012 | Permalink I have deep upper lip lines that have been sucessfully treated with botox and juvederm. One nurse says to do the botox first and then the juvederm. Another says to do the juvederm first and then the botox treatment. Which is better? Thank you.
In general, it doesn't matter. You'll get good results either way. Remember that Botox takes about 5-7 days to take effect so you won't see that at the treatment anyway. One... more
In treating acne scars, is the timing of Fraxel treatments important??Posted in Fraxel laser, Acne Scars, 2012 on Apr 04, 2012 | Permalink I am a fair-skinned Asian and I have a mix of deep ice pick acne scars and shallow rolling ones on my cheeks, along with large pores. I am considering having Fraxel done on my cheeks and nose. What is the suggested interval between the treatments? I went to a dermatologist consultation and he told me I will need 3 treatments, but the timing depended on me. I did some research and later on saw that the recommended timing is 4-8 weeks between treatments - is this what you would recommend as well? Is there any disadvantage to spacing the treatments out (for 5-6 months between each one)?
Thank you in advance
Most of the research that was done on the Fraxel and acne scars used treatment intervals in that 4-8 weeks range. But partly that was because it is more convenient for the researchers... more Dr. I - where did the product section go?Posted in Skin Care Products, Skin Care, 2012 on Apr 04, 2012 | Permalink Why don't I see the product section anymore? Well..... because I'm working on it. We took it down about a week ago and it will be back up by the end of next week. I'm updating all the products and editing them down to the top 50. ... more
When is the best time to have the Fraxel Restore?Posted in Pigment problems, Brown Spots, Asian skin, 2012 on Mar 28, 2012 | Permalink What is the best time to have the first treatment for Fraxel 1550 Restore? I have an appointment to do my first treatment in late March but I am going on vacation to the Caribbeans in late May. I am Asian and am worried that going into the sun too much will lead to hyperpigmentation. Also, since the treatments are spaced out 4-8 weeks, my rest of my treatments will be in the summer-time.
These are all good questions to ask your doctor before your Fraxel laser treatment. The answers to these depend on a lot of factors. Questions your doctor may have could include the... more
I got quite a bit of sun after my laser treatment. What are my risks?Posted in Skin Cancer, Moles, 2012 on Mar 28, 2012 | Permalink Hello Dr, My question is about unprotected sun exposure during healing after laser skin treatment. Will it increase the risk of sun induced skin cancer as laser make skin vulnerable to sun? I have taken 2 q switched nd yag laser sessions on some nevi to lighten them and 6 non ablative nd yag laser sesssions on post acne scars. During the period of treatment (6 months) I could not apply the sunblock regularly and it was about 200 hours collectively of indirect sunlight (morning light) exposure coming from the window when indoors or in my car as well as some (but not much) direct sun exposure. SO What are the risks of such light exposure on lasered skin or nevi and non regular use of sun block during healing period after laser treatment ? Is there a non invasive imaging test done as a chech up? THANKS SO MUCH
There really isn't a good answer for this because there is no data on it. But, from a common sense approach, your best bet is to get skin exams regularly - once or twice a year - with... more
Dear Dr Irwin
I am in my thirties and have fine lines. I would like to try glycolic peels, laser rejuvination, microdermabrasion but have been told as I am prone to keloid scars they are not suitable. Please could you let me know if there are any anti ageing options open to me. I am reluctant to use Botox. Many thanks.
I wondering if a dermatologist told you that?? In general, the risk of keloids goes down in the thirties, and also, the sites of past keloids really matter. For example, keloids are... more Problems after a laser treatment!!Posted in Lasers, Fraxel laser, 2012 on Mar 25, 2012 | Permalink Hello Doctor
I had pixel laser treatment on 9th March 2012. For enlarged pores nad hyperpigmentation on my forehead. After I peeled completely in 5 days my skin was light pink on cheeks n forehead. I was out the 6th day in my car for 3 to 4 hrs. I did use sunscreen. From that evening I started using a tretinoin .05% and hydroquinone 2% cream every alternate day. where ever my skin was pink, it had turned dark reddish brown.. Can this be because i started using tretinoin too soon on skin that had not healed completely? Also can i so something to improve my skin condition like cold compress or warm compress?
Would a corticosteroid cream help?
Okay - I'm very sad that this is happening to you. I want to emphasize to you 1,000,000 times that this is when you need your doctor. Please call your dermatologist pronto!! I... more
What about using cannulas instead of needles for fillers?Posted in Sculptra, Juvederm and Restylane, Fillers, 2012 on Mar 25, 2012 | Permalink Have you heard of using cannula needle for fillers?
Yes - there was a lot of discussion about using cannulas instead of needles for fillers at both the IMCAS meeting in Paris and the AAD meeting in San Diego this year. To make a long... more I'm doing fine with Retin A (tretinoin) everywhere except one spot on my forehead??Posted in Skin Diseases, Skin Cancer, Aging Skin, 2012 on Mar 25, 2012 | Permalink I use Retin-A, 0.5% on my face, and 0.25% on my forehead. One patch of skin on my forhead always gets red and peels, itches, get rets red, etc......everything else is fine!! Any suggestions for that area? Should I use Renove instead of Retin-A?
Thank you
You didn't mention your age but you bring up a good point and I would like to emphasize it again for everyone. If you have specific spots that are red, pink, flakey, growing or itchy for... more
Melasma in pregnancy.Posted in Pregnancy, Melasma, 2012 on Mar 25, 2012 | Permalink Hello Dr.
I’m on my second trimester and dealing with horrible melasma.
Can you please recommend skin care products that will treat my melasma and safe during pregnancy?
I’m really happy for being pregnant I’m 41 yrs old and it’s a miracle itself. But these patches on my cheeks and upper lip are taking a toll on my confidence. Please help me.
Here's the link to more info on melasma. Since you can't use any hydroquinones or tretinoin, try to create an almost total light/sun block over these areas. For example, you could use... more Why am I having these constant problems with Tazorac, Retin A, Retin A Micro, etc.?Posted in Skin Care Products, Skin Care, Renova Retinoids and Vitamin A Creams, Acne, 2012 on Mar 20, 2012 | Permalink Hello Dr. Irwin
thank you for taking your time to answer my question.
I used tazorac years ago and it was fine but for a last year i've tried so many creams like tazorac,retin a,retin a micro,atralin..all they do is make my skin oily/shiny and moisturizer sits on top. it also burns. nothing i use on face make it better.even vaseline irritates. my skin does peel but does nothing for clogged pores. i can see a layer of creepey dehydrated layer on top. should i go with retin a 0.025? i used tazorac gel around eyes now that area is so irritated.my lashes fall and gets swollen.
please help.
PS you are sooo beautiful..
I think the problem you are describing is not uncommon. I was just at the American Academy of Dermtology medical meeting in San Diego. To make a long story short, one of the lectures I... more With my Asian skin, when would be the best time to do a series of Fraxel Restore treatments?Posted in Pigment problems, Fraxel laser, Asian skin, 2012 on Mar 20, 2012 | Permalink What is the best time to have the first treatment for Fraxel 1550 Restore? I have an appointment to do my first treatment in late March but I am going on vacation to the Caribbeans in late May. I am Asian and am worried that going into the sun too much will lead to hyperpigmentation. Also, since the treatments are spaced out 4-8 weeks, my rest of my treatments will be in the summer-time.
I hear your concern and share it. You didn't mention where you live but since you mention summer, I'm thinking you live in a more four season climate. People who live in colder northern... more Brown spots - what more can I do?Posted in Skin Care Products, Skin Care, Pigment problems, Brown Spots, Aging Skin, 2012 on Mar 11, 2012 | Permalink Hi Dr. Irwin-
I wanted to ask you about post-inflammatory hyperpigmentation. My skin is pretty even overall, but I have a few darker spots from some acne I had two years ago. I have used both over-the-counter and prescription retinol products since then, and am very religious about sunscreen, but they just aren't going away. I was hopeful when I read about Elure, but would like professional advice. What do you think is the best treatment for these types of dark spots?
This is such a vexing problem for both patients and doctors because there's no one perfect solution that fits everyone and ...... in some cases, there really is no cure, just good... more What to do about chest wrinkles?? I have them and don't want them!Posted in Skin Care Products, Chest, Body Treatments, 2012 on Mar 11, 2012 | Permalink What to do about chest wrinkles?? I have them and don't want them!
Okay - so here's how to start thinking about this. First, how old are you? The older you are the deeper the wrinkles usually and the depth determines the options to some extent. Are the... more Cystic acne with hyperpigmentation - what can I do?Posted in Acne Scars, Acne, 2012 on Mar 11, 2012 | Permalink Hi! I have been dealing with really bad skin the past few months. I had severe cystic acne. Now I am left with the hyperpigmation and dark spots. I am using retin a micro. It has been one month on it and I am more super oily then before, but it has not anything just made my spots darker and my face red. Any suggestions or should i wait it out?
Please, please, please run, don't walk to the nearest dermatologist. If you truly have severe cystic acne, it can and will leave permanent scarring on your face. Neither of us want... more
What is the advantage of the use of derma rollers? Any?Posted in Aging Skin, 2012 on Mar 11, 2012 | Permalink What is the advantage of the use of derma rollers? Any?
Please see this blog post I wrote a few weeks ago. Link more info. Dr.... more
Can IPL be used if I'm on HRT?Posted in Rosacea, IPL and Photorejuvenation, IPL, 2012 on Mar 11, 2012 | Permalink I have been told that if I am on HRT I cannot have IPL treatments because the IPL does not work if the skin is already affected by HRT.
IPL is still effective even if you are on HRT. I have never seen any evidence to the contrary. It's more the reverse, it's sometimes difficult to get control of flushing and... more
Several readers have written us to say you are not getting your tip of the week! If that's you, please send your email address to feedback@skintour.com and we will make sure you are on the list. Computer gremlins??? Dr.... more
Some positive feedback from Houston!Posted in Finding a Good Doctor, 2012 on Mar 03, 2012 | Permalink I just wanted to say THANK YOU for the wonderful information on your website, especially the guide to excellent cosmetic dermatologists. I was very nervous about having Sculptra done, so I decided to have a consultation with Suzanne Bruce & Associates in Houston based on your recommendation. I have had an absolutely amazing result. I never would have found that office if it weren't for your website. Thanks again for your help! (No need to post this. Just wanted to say thanks!)
So happy you had a good experience and great results. Thank you for sharing. Dr.... more
Hormones and melasma - a complicated question?Posted in Melasma, Brown Spots, Asian skin, 2012 on Mar 03, 2012 | Permalink Dr. Irwin,
My wife is an Asian in her late 40s and is suffering from melasma which appeared after extended sun exposure from a summer vacation last year. HQ, IPA (one cheek), and Fraxel Dual all made the melasma worse; Fraxel Dual, in particular, did the worst damage. She underwent a partial hysterectomy in late 2003 (ovaries intact). Our dermatologist recommended that her hormone levels be checked; blood tests are underway. The reproductive endocrinologist that we visited said that a visual exam of the vaginal wall indicated malfunctioning ovaries (hormones low), but the blood tests will give accurate measurements of how much. Everything that my wife has found regarding melasma is that hormone therapy makes the condition worse, but there must be a positive reason for my wife being referred to an endocrinologist. Do you think that hormone therapy might help or hurt her melasma (if the blood tests indicate low estrogen)? I can see other benefits for hormone therapy, but melasma has seriously adversely affected my wife's mental state; I would not want to encoursage her to seek hormone therapy if it might make her melasma even worse.
I appreciate any insight you might provide.
Thank you!
KO
In general, estrogens in particular, more than progesterones or testosterone, make melasma worse. I have a couple of thoughts for you though. At the recent Paris conference (IMCAS 2012)... more Is CO2 laser safe for wrinkles on the eyelids?Posted in Wrinkles, Eyelid Treatments, Carbon Dioxide Lasers, 2012 on Mar 03, 2012 | Permalink Hello Dr. Irwin,
I'm 44 and have wrinkled skin on the top eyelids which makes me look tired. I also have other wrinkles all over the face. So I have dicided to get CO2 done for the full face including eyelids.
Is it safe to have CO2 perform on the eyelids?
Thank you for your help.
Okay - so 3 thoughts on this question. The answer is yes with these restrictions: 1) The fractional CO2 is safer than the traditional CO2 on the eyelids so make sure they are using the... more A question about Ultherapy?Posted in Ultherapy, Thermage and Radiofrequency Devices, 2012 on Mar 03, 2012 | Permalink There has been so much buzz over Ultratherapy- Ultrasound for sagging skin at the jaw line and neck (turkey gobbler) and would love to hear your opinion on this. I guess it's apparently good for a brow lift as well. Sounds wonderful and the photos I've seen are amazing! Do you do this procedure?
I'm thinking you might mean Ultheraphy as opposed to Ultratherapy? Here is some information on Ultherapy for you to look over. Dr.... more
Can I use Tazorac at night and retinol in the morning?Posted in Skin Care Products, Skin Care, Renova Retinoids and Vitamin A Creams, Cosmeceuticals, Antioxidants, 2012 on Feb 27, 2012 | Permalink I'm 47 years old and have been using Tazorac for years. I started using the cream and have now been using the gel for the past year. My skin is very tough, this product doesn't cause me any drying or redness. The question is, I use the Tazorac at night, can I use a retinol during the day such as Skin Ceuticals Retinol or would I just be wasting my money?
You'd be wasting your money since light tends to inactivate the retinoids (Renova, Tazorac, tretinoin, Retin A, retinol, etc.). You'd be far better off adding a good antioxidant Vitamin C... more
I signed up for the "tip of the week", but I never receive anything. Is there a problem?
I'll check on this. Thank you for letting me know!!! Please try once more - maybe a glitch?? Dr.... more
Would the fractional CO2 or the 'Mosaic' laser be better for treating acne scarring?Posted in Carbon Dioxide Lasers, Acne Scars, 2012 on Feb 27, 2012 | Permalink Hi Dr Irwin, I'm glad to come across your website. I'm a Asian male living in Singapore & I've spoken with several clinics here that offer a new Mosaic laser treatment for deep acne scar problems. I'll like to know whether is it safe & effective, & what is the difference between the Mosaic & Fraxel or Fractional CO2 treatments. Thanks a lot!
In general, unless your acne scarring is almost invisible, you will get better results with a fractional CO2 system like the Lumenis Active Fx or the DEKA DOT. The 'Mosaic' is an erbium... more I'm 27 - why is Botox not working for me?Posted in Botox Mistakes, Botox, 2012 on Feb 18, 2012 | Permalink I am 27 years old and have had botox done for my crow's feet and glabellar lines 3 times to date. I was however not satisfied with the results, and I have even noticed that the lines around my left eye have actually grown deeper since I started treatment. I would like to know what is the normal dose for a patient of my age and what is the highest recommended dose that should not be exceeded per eye. Thank you for taking the time to look into my query.
You raise an interesting question. At age 27, I'm guessing you really don't have actual frown lines or crow's feet but maybe just a hint of them when your face makes certain... more What do you think about using Radiesse for the jowls and around the mouth?Posted in Radiesse, Fillers, Filler mistakes, 2012 on Feb 18, 2012 | Permalink What do you think about using Radiesse for the jowls and around the mouth?
In the hands of an experienced doctor or injector, around the jawline and the jowls, Radiesse can give a nice support that looks very natural. It can also be quite effective around... more Is the DOT CO2 laser the right one for me?Posted in Finding a Good Doctor, Carbon Dioxide Lasers, 2012 on Feb 18, 2012 | Permalink Hi Dr. Irwin,
I am 48-year-old white female with a lot of lines and wrinkles all over my face with some acne scaring on both cheeks. I have been doing a lot of research on the DOT CO2 laser and went and had a consultation today with a dermatologist in Dallas,Texas. We discussed it and he stated that because I was most likely a type 3 skin I might have a problem with hyperpigmentation after the procedure. I have some brown spots now on my right cheek from sun exposure. I was really disappointed to hear this as I had decided that this procedure was exactly what would give me the best result. The doctor suggested I start using a hydroquinone cream before the procedure (which is in about a month) and, then, would "have to take my chances" afterward.
Can you offer your opinion on this problem?
Thank you,
CS
In general, with plastic surgery or any major laser work, it's good to plan on getting 2-3 consultations. You will hear several different opinions, get a chance to see how different... more Do home or spa dermaroller systems work?Posted in Spa Salon Treatments, Home use devices, 2012 on Feb 14, 2012 | Permalink Just heard about a new service my spa is going to offer. Collagen treatment where they roll a roller over your face that has fine spikes and may cause a little bleeding to induce your own body to produce collagen. What are your thoughts on this and does it work?
Carrie Cruise
These systems induce small wounds that do, in fact, induce some collagen. The question is - do they induce enough collagen to make a visible, not just theoretical, difference. And,... more Am I overfilled with Juvederm? What about other fillers or Artefill?Posted in Juvederm and Restylane, Finding a Good Doctor, Fillers, Filler mistakes, 2012 on Feb 14, 2012 | Permalink Hello i just stumbled across this blog and thought you might be able to help me. I am 37 years old and have been getting fillers Juvenerm and Restalyin injected for the last couple of years, I now have puffy bags under my eyes from being over filled and a blue tint to the point where people ask me if i was punched. I was thinking of either going to another Dr. or possibly going with Artefill as one Dr. suggested, is there any advise you can give me about the current desolvable fillers or Artefill?
In general, if you have puffy bags and a blue tint under your eyes after hyaluronic acid fillers like Juvederm or Restylane, you have too much filler under there!!! Please find a board... more Is eye injury a risk with IPL photorejuvenation treatments?Posted in IPL and Photorejuvenation, IPL, 2012 on Feb 14, 2012 | Permalink What is the risk of eye injury with IPL Photorejuvenation therapy? The risk is virtually zero as long as your eyes are covered with proper laser eye protection. These can range from sticky pads that cover the eyes and hold them closed to metal eye cups... more What is causing these brown spots? Why can't I get rid of them?Posted in Pigment problems, Menopause, Brown Spots, Asian skin, African american skin, 2012 on Feb 14, 2012 | Permalink At age 55 I developed brown spots on my cheeks. I started the Obagi skin care regimen. About three years later, a large splotchy brown patch appeared on my cheek as well as patches on my jaws and brown spots on my forehead. I tried IPL and CO2 laser but they did not help. I went off the hydroquinone and went back on. Initially there is marked improvement but at about 7-8 weeks, the dark spot on the cheek starts to come back. I use a hat and sunscreen with 18 % zinc anytime I step out. I have never had HRT, never used oral contraceptives and have no family history of melasma. Despite following the doctor’s advice, I can’t seem to control the melasma. Should I use sunscreen even when I am indoors and not sitting in direct sunlight? Thank you for any advice that you can provide.
I recently returned from the IMCAS European conference on skin that was in Paris. There were excellent talks on pigmentation problems. There were several good points that were made. ... more Is IPL, Botox or filler okay with these medical problems?Posted in IPL and Photorejuvenation, IPL, Fillers, Botox, 2012 on Feb 08, 2012 | Permalink Dear Dr. Irwin,
If one has RSD (Reflex Sympathetic Dystrophy)and/or fibromyalgia, are there any additional risks to having IPL? What about Botox or the filler injectables?
Thank you for your time.
Carrie
All three of these treatments are generally so safe that they are compatible with most medical problems. It is important though to check with your doctor - in your case probably your... more
Will IPL leave me with a completely pale face?Posted in IPL and Photorejuvenation, IPL, Brown Spots, 2012 on Feb 08, 2012 | Permalink i am scheduled for a cutera ipl procedure on my face next week to remove large brown spots, broken capillaries, etc. i've always had alot of freckles and don't mind them....andeven though i wear a hat and use sun block, i also don't mind when my face gets a little tanned. my question is, will ipl leave me a 'pale face'? i'm worried about this because think i look better with a little color and don't like wearing make-up during the day. I'm 63.
The short answer is , no it won't. It's almost impossible to remove all color from someone's face and even when you wear sunscreen, some light gets through to stimulate that melanin... more
What about the new Clear & Brilliant laser treatment?Posted in Peels, Lasers, Fraxel laser, 2012 on Feb 08, 2012 | Permalink What do you think of the new Clear & Brilliant laser treatment?
I think that if you are 35 or under and have very little sun damage you might be happy with this. Even so, a peel like a light TCA or beta hydroxy Rejuvenize might be more cost... more
Is Cosmelan a good product for pigmentation problems?Posted in Skin Care Products, Skin Care, Pigment problems, Asian skin, African american skin, 2012 on Feb 04, 2012 | Permalink Dr,
I am planing to get Cosmelan. I did my research and found out that Cosmelan has a new formula with Hydroquinone. It seems like the old formula was the best, and new formula has mixed reviews. Can you please advise on new Cosmelan.
Thank you
I hope I'm wrong, but I'm very suspicious of this company - Mesoestetic. First, it's difficult to find out much about them. Their website constantly asks the user for information while... more What can I do about uneven cheeks?Posted in Juvederm and Restylane, Cheeks, 2012 on Feb 04, 2012 | Permalink I am 31 years old male. I have very uneven cheeks like a squeezed mangoo and my face does not look fresh. Could you please tell me which cosmatics procedure is suitable for me and where can I can go for the treatment, I live in London Ontario Canada?
At the age of 31, it's unusual to have cheek uneveness so I'm wondering if you had this as a child? Look at pictures of yourself when you were younger, do you have that even at age 10 or... more Can I continue to use Retin A if I have rosacea?Posted in Rosacea, Renova Retinoids and Vitamin A Creams, 2012 on Feb 04, 2012 | Permalink I just found you web site & it is great. I am 65 yrs. old & just developed a mild case of rosecea. I have used retin a for 30 yrs, first to clear up bumps & continued for aging. I have tolerated the retin a well & my skin looks 15 years younger. I am using metrogel 1 x day. Should I continue using the retin a with rosecea. Thank you so much for your help.
Yes! For many years dermatologists recommended against this afraid it would cause more irritation. But, a few years ago, several studies were done which showed that Retin... more
WHAT I LEARNED AT THE EUROPEAN CONFERENCE (IMCAS)Posted in Skin Care, Lasers, 2012 on Feb 04, 2012 | Permalink In the next few weeks, I'll be sharing some of the information and new tips that I learned at the Paris conference this past week. Stay tuned! Topics I'll be discussing include pigmentation problems, how to find good doctors in Europe, Asia, Middle east, etc., new information on lasers and various products. Dr.... more
Are Juvederm and Botox safe for african american skin?Posted in Juvederm and Restylane, Botox, African american skin, 2012 on Feb 04, 2012 | Permalink Hi Dr.Irwin, i'm a afro-american woman 59 years old i'm looking into having Juvaderm done for smile lines and botox for my forehead do women of color have often have these procedures done? will smoking affect the outcome i'm really trying to quit.
thanks
Linda
The short answer is yes! In general, pigmentation problems or any problems (other than the usual - see links to Botox and Juvederm), make these products very safe for African American... more
Does metal, particularly braces, cause a problem with Thermage?Posted in Thermage and Radiofrequency Devices, 2012 on Jan 21, 2012 | Permalink Hello, I am considering having thermage but I wear orthodontic braces. Is this a problem? If so, once my braces are removed I will have a permenant wire behind my lower bottom teeth, would this still be a problem? Thank you for your advice. Kate
Generally, as long as the grounding pad is placed properly, other metal in the body or on the body is usually not a problem. But.......have your doctor call the MD only line that
Why no answers right now? I just want to let all of you know that I'll be gone until February 3rd. I, and several other members of our office, are going to Paris for the Dermatology/Plastic Surgery conference there... more
I recently ordered Retin A and was given desonite cream. Are they similar drugs? I am using it for wrinkles.Posted in Wrinkles, Skin Care Products, Skin Care, Product safety, Cosmeceuticals, 2012 on Jan 18, 2012 | Permalink I recently ordered Retin A and was given desonite cream. Are they similar drugs? I use it for wrinkles.
You bring up a good point and no, they are not the same, at least in the U.S. Did you order this off the web? In most countries, if you buy a product like Retin A (generic name is... more Can you recommend a good office in Southern California for Thermage?Posted in Finding a Good Doctor, 2012 on Jan 18, 2012 | Permalink I'm interested in Thermage treatment and live in Souther California. Can you recommend a couple of providers in the Santa Monica California area who are Thermage experts?
Thank you.
I'm giving you two links on the site - the first to our Regional Guide, and the second, to the article on how to find a good doctor! These should help. Dr.... more
Hi Dr. Irwin,
I have cleft lip and I was wondering if I could get lip filler done to balance out the asymmetrical lip ???
As I am very upset with the symmetry of my upper lip.
Thank you
Generally, a cleft lip must be corrected with surgery. Fillers can sometimes make the cleft look worse. Hopefully, you can find a good surgeon near you and, there are international... more
I bought device that seems to be making my skin worse?Posted in Thermage and Radiofrequency Devices, Thermage, Radiofrequency systems, 2012 on Jan 18, 2012 | Permalink Hi Dr Irwin, I bought biopolar radio frequency unit and when I did on my forhead my wrinkles become more visible, it was ok on my face and I looked more slim like an old lady, not like a healthy slim type? What did I do wrong?
Please don't try to do this yourself at home. I'm guessing that you bought this off the internet. You really don't know what your getting. Some radiofrequencies used incorrectly can... more
Are two Sculptra treatments for the initial series enough?Posted in Sculptra, Fillers, 2012 on Jan 15, 2012 | Permalink Dr. Irwin,
My dermatologist recommended 1 treatment with 2 injections of Scupltra. I have been reading that normally there are 3 treatments so I am wondering if 1 treatment would be sufficient.
You didn't tell me your age! So it really depends a lot on that and also where your body weight range is. Low body weight women tend to need more. And, the older we get, the more is... more
Is there a good doctor for aesthetic services in Anchorage, Alaska?Posted in Finding a Good Doctor, 2012 on Jan 15, 2012 | Permalink Okay - I have to confess I accidentally deleted your question but I remembered it! I truly wish I knew absolutely great and trustworthy board certified dermatologists and plastic surgeons for cosmetic services in every area. I'm sure there are wonderful doctors out... more
How do I sort out a complex product problem and acne?Posted in Skin Care Products, Skin Care, Acne, 2012 on Jan 08, 2012 | Permalink Dear Dr. Irwin, If you had to make the best between 2 bad choices, which would you choose? the choice is no daily sunscreen with less acne, or daily sunscreen and large horrible cyctic acne and blackheads? I am so exhausted battling acne (had accutane 2x in my 30s), every sunscreen brand makes me break out worse (ive tried dozens including some your recs.) And i figure superficial sun damage can later be fixed with lasers? I'm careful never to "bake" on the beach, i wear a wide brimmed hat, and use sunscreen everywhere except the face and chest in the summer and on sunny holidays (most of the year i live in foggy, rainy north europe). I work indoors, but enjoy being outdoors a few hours a day with my kids, regardless of weather. I'm 43, type 3 skin, some rosacea and lentigoes. Recently iv'e switched to a minimal routine which seems to control the acne: scrub (clinique), organic argan oil, plus Differin (adapalene) only on the problem areas (jawline/chin), and a multivit high in B5. Retinol facecreams and benzoylperoxide just makes the acne worse. I remember you saying, use retinol if you can tolerate it, else don't beat yourself up about it if you cant. I am hoping to hear the same thing about daily sunscreen! Or do your really think its nonnegotiable?
Also, any suggestions for fading the red/brown acne scars? I have no pitting, but though hydroquinone 4% reduces the brown age spots it dosn't reduce my postacne redness. Thanks so much for your great website, and wishing you a succesful new year!
Petra
Petra - thank you for writing and I hear your frustration on this. A couple of general thoughts that may help and then some specifics. Remember that while products can make certain... more Melasma and Asian skinPosted in Melasma, Asian skin, 2012 on Jan 08, 2012 | Permalink Dr. Irwin, I'm Asian with skin type 4 and also suffering from melasma. What cream/moisturizer that you can recommend for my skin that can help with my melasma? My skin is also sensitive. I've been using the sunscreen you recommended and love it. Thanks!!
Melasma is one of the most difficult problems that Dermatologists face today because, at this point in time, as you all know, there is no true cure for it. There is just good... more Is this a Botox mistake?Posted in Botox Mistakes, Botox, 2012 on Jan 08, 2012 | Permalink Hello Dr Irwin,
I could really do with your advice. I have recently had botox for the second time. Both times my eyebrows have dropped! Help! I'm 34 years old and just had botox between my brows and above them, but not up into my forehead. Above my eyebrows is now smooth, but the brows have dropped and are 'crowding' my eyes. Both my eyes are very hooded making me look tired and angry! I went to a good doctor and the second time he did two less injections than the first to avoid this. Why has this happened, and am I just a poor candidate for botox?
Thankyou Claire.x
Usually with Botox, it's a placement and/or dose problem. What's tricky about Botox is that we are all individuals and our facial muscle activity is not always the same. That's why it... more Is this a problem with Botox dosing?Posted in Botox Mistakes, Botox, 2012 on Jan 08, 2012 | Permalink Dr. Irwin,
I received my first Botox injection about 4 weeks ago. My first injection was about 25 units spread over my forehead and 11 lines and 3 on each of my crows feet. I returned because My 11 lines were still very prominent as were some other wrinkles in my forehead. This time I received another 30 units. After two weeks I couldn't tell a difference and returned today where she says she injected another 30 units into my forehead, but said she couldn't do anything about my 11 lines. 90 units of Botox seems excessive to me as I am only 35 years old. Do you think she is diluting the Botox or is this normal to take this many unit to correct my lines?
Generally, and I'm sure other Dermatologists would say this also, the first dose of approximately 25 units is quite reasonable and will be in the ballpark for many younger women for the... more |
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