Blog with Dr. Irwin

For my lines and blotchiness on the chest, what would help?
Hello, My chest area has several issues: hyperpigmentation marks from acne scarring when I was younger, untreated melasma and wrinkling from sleeping on my side. My dermatologist mentioned that the chest area is delicate and easily prone to scarring and discouraged laser treatments. Could you suggest which procedures or treatments would help all of these issues in the chest area? I’m 50 years old and female. Thank you.
I think a lot of progress has been made over the past 5 years or so to improve  skin on the chest.  It’s never been an area where surgery has been a good option.   And………for those of us who tried...
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A wedding, reunion, an event…..what can I do to look better?
I'm 67, have marionette lines, some sagging of the jowls and neck AND a need to look a bit "refreshed" when my daughter gets married late September. I use decent skin care on a regular basis and think my skin is generally OK (although, as an Australian, I had quite a lot of sunburn as a child). I was thinking of getting HIFU treatment but someone has suggested that because of my age and fair skin, it probably wouldn't work to regenerate collagen production. I'm not keen on fillers (on the basis that if I "fill" something, it will shrink again and probably look worse). What are your thoughts on HIFU and any suggestions for what I could do to look better before the wedding? Thanks, Lee.
Hi Lee – We hear this a lot and it’s based on age somewhat, as you point out.  A 30 y.0. getting married needs something different than a 65 y.o. who’s mother of the bride.  Congratulations to you! Maybe the...
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When is it too much filler, tightening, Botox/Dysport, and……..?
Hi Dr. Irwin, I'm 49, and over the last 8 years I've had two Thermage treatments, Ultherapy (on my forehead), and an overzealous injector who put far more filler in my cheeks and clown lines than I wanted (which is still wearing off after almost two years). The result of all this is that the shape of my face doesn't look anything like it did when I was 41 years old. It looks fuller and shorter than it did, and my chin looks smaller. My question is, if I wait long enough and the filler dissolves and the tightening wears off, will my face go back to normal? I know I will have aged, but will it take on its prior shape so that I'm once again recognizable as me?
Thank you for sharing this.  I completely hear you.  We see this frequently at our clinic. People coming in for help with problems created by too much, or wrong placement, or odd asymmetries. We know now from MRI studies of...
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Fourth of July sun protection and …..why I use different sunscreens.
Hi Dr. Irwin, I was wondering why you list 2 different sunscreens in your morning skincare regime? And is this your current routine? (2019) Thank you, Sandy
As the weather gets warmer, we’ve all been seeing a lot more sunburned people.  Of course, what our staff thinks when spotting a sunburn is…..oh no…possibly another melanoma.  Melanoma can be life threatening. Why you don’t want a sunburn. Sunburns...
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Those little red bumps on the backs of the arms, cheeks and legs. Keratosis pilaris.
Hi, my daughter who is 14 as keratosis pilaris on her cheek and upper arms. She has that since she was young. We have try Amlactin cream and other moisturizers but it is not working. There is also redness around the bumps on her cheeks. A dermatologist told me that this her skin's DNA and there is nothing to do except moisturize!!! Is there really anything we can do to get rid of those bumps especially the one on her cheeks? Is this condition worsen with age or there is a chance that when she gets older this will disappear?? Should we use exfoliant every week?? Is there any cream out there?? Thanks
Who named this disease anyway??  🙂  Most derms just call it KP – short for keratosis pilaris. And what causes it?  Your dermatologist is right.  It’s genetic and about 10-20% have a form of it at some point in their...
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Which foundations help or hurt you? 4 ideas!
I just turned 60. I follow your recommendations for products(my skin is normal now - it used to be oily) but I have never seen any recommendations for foundation. I live in the deep south, it is hot and humid and I sweat my makeup off. I am so tired of having a sweaty face. I would appreciate any recommendations for foundation.
I love your question, precisely because I wouldn’t have thought of it!  But it matters because we want great skin, and this is another way to help ourselves. First, I see some foundations now that are promoting “active” ingredients.  Forget...
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When the facelift doesn’t go as planned.
I had a facelift March 26, 2019. I now have a drooping salivary gland under my right jaw that is quite conspicuous. I’d read that Botox could help reduce it & recently had that done, but, don’t notice a significant improvement. The doctor that injected it said it could take a couple of months to see a difference. What is your opinion? My plastic surgeon isn’t willing to operate because apparently that area has a lot of facial nerves. If Botox doesn’t help (I’m simply looking for improvement, not perfection), but, it is bothersome enough that I will try to find a plastic surgeon who has experience in tacking it up or shaving it. I live In Biloxi, MS & a facial plastic surgeon in Alabama that is world renowned performed my facelift, but, there may be someone in New Orleans, LA that could help. Can you recommend anyone if I choose that route? I was REALLY hoping Botox would help. Thanks
It would be very frustrating, after all that time, money and effort spent, to have your facelift not be successful. Can you go back to the doctor who performed the surgery, and ask again, what your options might be?  Was...
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Scars after picking or acne the skin on the face, neck and chest
Good morning Doctor. I was born in 1979 and i started developing dermatillomania since 1996, it has not stop totally yet but i am so much better and most of the time i keep thing under control. The year that i stopped with it was recently in 2014. So i always had combination to oily skin , pimples and some breakout in mu face, but not cystic acne. But my dermatillomania has left scars in my face, neck , chest.Most of them are white (because of the years i thinks) , they are not deep, they are almost flat (Also i remember that the wound scratch that i made to myself were like 3 mm of diameter and 1 mm deep i think). And i have some red and some brown, I decided to make a laser treatment, so here i my country i went to 2 different laser centrs. In the first one they advised me the fractional laser co2 for about 4 sessions. In the second one they advised me the fractional laser for my face and the fractional laser co2 for my chest and part of my neck. In the second one they told me that they find that the fractional laser (without co2) is ideal for my skin because my skin is not thick and is a little sensitive and something about my capillaries, and that i have open pores as it not goes so deep than the fractional laser co2. My question is this. I am afraid to decide for the fractional laser for my face and in the future it wont be as effective as the fractional laser co2. Because the session of both have the same cost. My fototype skin is between a 3 and a 4 , like 3.5. I am already eating very healthy (as i always tried because of my skin type) but now more taking care of the vitamins and all of that. Can you help me please? I know that you have to see and touch my skin to give a certain opinion but, i would appreciate your orientation, which one should i use, how should my skin be to decide for one of these? (and how should i prepare it, it is little dry right now) Thank you very much. Please ask me as soon as you can, I am going to make the treatment the 7 of June. Thank you very much again.
My heart goes out to you on this.  And it sounds like you’ve done an amazing job with a difficult health issue.  Kudos!  I love that you’re eating healthily. We sometimes tell our patients at the clinic that everyone picks...
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