Which laser and which skincare products to support the time/money spent?

Dr. Irwin
February 17, 2021
Please tell me what you know about the DEKA laser. I am 63 years old. I have healthy skin but am showing signs of laxity on my cheeks and jowls, have wrinkles around the eyes and across the forehead; I have some veins at the nasal entrance I want to go; some largish pores on the nose; and dark chin hair and lower jawline peachfuzz that has gotten heavier with HRT. I have done microneedling twice and Fraxel once in the past but think it is time to investigate a stronger laser. Am I looking at the right product? How this laser different from Fraxel. Will using a laser do more to improve my skin than trying microneedling with RF like Profound and one of the others? I am hesitant to do a facelift. I use a PCA retinol, Vit C and B, Neocuits eye cream and serum; and moisturize with Skin Ceuticals Triple Lipid and AGE along with a good zinc oxide based sunscreen daily. I wash with Cetaphil or CeraVe twice in the evening and once in the morning.

You ask a ton of good questions!  Did you know you can also ask questions on Instagram at @drbrandith_skin?  Okay, I’m going to tackle because I think a lot of consumers are wondering the same things.

What lasers/RF can and cannot do for you.

  1.  Veins around the nose.  These can absolutely be improved and almost vanquished!  Look for a Vbeam or an IPL with a Nd:YAG head.  We use the latter because it’s more versatile, but Vbeams work well too.  You may need 2-3 treatments depending on the size.  You will get more of these and some of the old ones will come back, so expect to need a treatment every 1-2 years.  Sometimes for very stubborn, large ones, we will inject a drop of concentrated glycerin, but experts only on this.
  2. Large pores on the nose.  Honestly, these are oil glands that are large on everyone.  In my opinion, no laser or microneedling makes enough difference to be worth the money.  Keep them very cleaned out with a retinol or glycolic product, a good facial, and occasional microdermabrasion or Hydrafacials.  Ok…or a gentle squeeze…gentle is the key word.
  3. Hair removal on the face.  The dark hairs will respond to laser hair removal treatments (usually diodes or YAGs).  The blond (vellus) hairs won’t.  Have you tried Vaniqa prescription cream or dermaplaning for the lighter hairs?
  4. The nonsurgical facelift.  10 years ago, this was not possible, now we are getting quite close by combining the deep RF microneedling with fractionaed CO2 (we use the DEKA).  Depending on how much laxity/jowls you have, you may need 2-4 treatments over 1-2 years to achieve your goals nonsurgically.  Also, if you have a fat pocket under the chin, that may need to be addressed with Coolmini, Kybella or targeted liposuction.
  5.  Fraxel is a fabulous laser for pigment, superficial texture problems and mild acne scarring.  It doesn’t go deep enough to tighten.

Skincare products to maximize

  1. You’re doing a great job on your products….keep it up!  You may like our MadisonMD Zero Irritation Retinol, or Eye Rescue Cream.  Please make sure your sunscreen has 10-20% zinc depending on how much time you are outdoors.

Hope this helps,

Dr. Brandith Irwin

Dr. Brandith Irwin, MD

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Hi, I’m Dr. Irwin. I believe that consumers deserve a medically trained and unbiased skin care advocate.

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