Q.

Just a quick basic question. I have bought (and returned) so many products to moisturize and reduce wrinkles on my face especially around my eyes. I don't see any difference at all. My grandmother used to rub olive oil (don't laugh) on her face and it always looked great at 80 years old. Can you recommend something that REALLY makes a difference- I am 40 years old but want to do what I can before thinking about surgery. Thanks for your time. Janet

A.

Many studies have been done that demonstrate that Retin-A™ is an effective cream to improve frown lines around the eyes. The same active ingredient is in Renova™ cream. You will need to see a dermatologist to get a prescription for this. Non prescription creams may be good moisturizers, but none is as effective in reducing fine lines. Sometimes glycolic acid creams can remove dead skin flakes which can accentuate wrinkles.

If your lines are deeper or related to smiling or squinting, you may be a candidate for Botox® treatments. Most importantly, use a sunscreen daily to prevent the lines you have from getting deeper.

Q.

I'm interested in microdermabrasion, or any other methods to remove stretch marks. Do you specialize in these areas?

A.

Our office does perform microdermabrasion. Repeat treatments can sometimes improve stretch marks. Also, newly developed stretch marks have been treated effectively with Retin A™ while others can respond to our Photoderm™ treatments.

I recommend making an appointment for a consultation to see which of these treatments is best for you.

Q.

Just wondering, will microdermabrasion help reduce the redness or previous scarring.considering that I have very fair skin.and will I be able to see results with just one treatment?

A.

Microdermabrasion can help to improve shallow, depressed or minimally elevated scars. Unfortunately, it will not reduce redness. Red scars can often be improved with Photoderm treatments or topical creams. Microdermabrasion works best when performed as a series of treatments. In my experience, one treatment would not produce marked results.

Q.

I have been having problems with ingrown hairs in the bikini area. I use waxing in this area and if I do shave, I go with the direction of the hair. I use loofas and my facial person sold me the Peter Thomas Roth body cream to use in that area. All of this may help for future prevention, but what do you do about the ingrown hairs that are already there? They don't seem to go away on their own. Does a facialist or dermatologist have to remove them? Please advise. Thank you!

A.

Ingrown hairs that are already present and visible should be loosened and clipped at the skin surface. Plucking and waxing will temporarily remove the hair but when it grows back it will likely become ingrown again.

You may want to consider laser hair removal to your bikini area. Such treatments can permanently destroy unwanted hair follicles and prevent hair regrowth. The effectiveness of these treatments for permanent hair reduction will depend on the color of the hair and the background color of your skin.

I recommend a visit to a dermatologist skilled in laser surgery that can further discuss this option with you.

Q.

What is your recommended treatment for facial "spider veins?" Also, what are common associated side effects of the procedure used?

A.

Facial "spider veins" can be treated with the PhotodermT Intense Pulse Light source, a laser like device, or with sclerotherapy. The type of procedure we chose depends on the size and number of veins you have. Rarely, we still use the hyfercator (commonly known as an electric needle.) but it has a higher chance of causing scarring for larger lesions.

Common effects of the procedures include temporary swelling and/or redness. Occasionally, bruising can occur.

Q.

Hi, my name is Eric. I'm trying to find a place to get a tattoo removed. The tattoo is on my left hand, middle finger. On the inside of it are three dots. How much would this cost?

A.

Most tattoos, especially those with blue, black and red colors, are effectively treated with the Nd- YAG laser.

Multiple treatments are the rule and depend on the type and amount of tattoo pigment in your skin. While some tattoos can be removed in 2 treatments, we've had to treat others 10-12 times. Of course, if the tattoos are small enough, as might be the case with "dots," they could also be cut out very easily with minimal scarring. This would be a very rapid approach to the problem.

Cost of course, depends upon the size of the area to be treated, but for tattoos measuring about 3" x 4", costs are about $225.00-$350.00 per treatment.

Q.

I visited your website and wanted to know if you had any procedures to clear up light to mid craters on the side and cheeks area of the face.  Please let me know.  If you do have such a procedure what will the average price be and do you have any type of payment plans. Need your help. Thank you.

A.

Scars on the face can be treated by dermabrasion or laser resurfacing.  Both procedures are designed to permanently smooth the surface of the skin. Some deep pitted scars are not very improved with these techniques and must be surgically removed for best results. The cost depends on the size of the area to be treated and which technique is felt to be the most useful. Fees may range between $2000-$3500 and we would determine the fee during your consultation visit.

Q.

I would appreciate if you can let me know what does hyaluronic acid do to facial skin.  Thank you.

A.

Hyaluronic acid is an important component of our skin.  It has very important biological functions.  When applied topically it acts to hold water in the skin and as a result, it is often present in different moisturizers.

Q.

Are you using Botox® injections for the treatment of axillary sweating or can you refer someone who does?

A.

Yes, we have used Botox® since 1994, for all the varied indications including hyperhidrosis.  Frankly, patients with hyperhidrosis are amongst the most gratified ones we treat.  The treatment is very effective and actually lasts longer than the treatment for hyperactive muscles - usually 6 to 9 months.  One drawback is the expense.  Botox® is expensive and a substantial amount of medicine must be used to treat the areas.

Q.

At first I have to apologize for my English.  I hope I express myself correctly (I am German).  How much would it approximately cost to remove just one wrinkle, that vertical one between the eyebrows?  And how long would the results last?  Thank you very much for your answer!

A.

The crease between the eyebrows is caused by the over use of muscles that pull the eyebrows toward each other; these are called the corrugator muscles.  The most common treatment these days is to weaken those muscles by the local injection of a medicine called Botox®.  The results last 3 to 6 months.  The effects of Botox® are localized so that the nearby muscles are not affected.  Patients are typically very satisfied by Botox® treatment.

Q.

I'm an African American male with oily skin, with some acne scarring and dark spots. I would like to know what kind of procedures work best for my skin and how good of a result should I expect along with any side effects, such as discoloring.

A.

In African Americans and other people of color, it is important to control the underlying acne to prevent the development of additional dark spots (since they are the residual of previous pimples.)

Q.

I have been told by my current and past dermatologists to use Cetaphil™ cleanser. I am 36, use glycolic acid products, have normal skin, and wear a lightweight foundation. I do not think Cetaphil™ adequately cleans normal skin of make up and residue, as evidenced by my clogged pores every time I go back to this product. Am I right, and if so, what types of cleansers work best for normal, over 35 skin?

A.

Cetaphil™ cleanser is often recommended because it is gentle and non-irritating. However, it is usually not sufficient to remove make-up and does not leave a "squeaky clean" feel to the skin. In general, liquid cleansers are best if you tend to get clogged pores.

If your skin can tolerate glycolic products, I would recommend a glycolic cleanser. You can try one in the brand you currently use, or one such as MD Forte™ Glycare Cleansing Gel, which does take off make-up and leaves the skin clean. Be careful around the eyes, as glycolic acid can sting if it gets in your eyes.

Q.

I have a friend whose skin on her face (on upper lip) is turning a dark color and gets darker when she goes out in the sun. What can she do about this?

A.

There is a skin condition called melasma, one that produces dark discoloration of the upper lip and often the cheeks and forehead, as well.

The condition is often produced by the combination of hormonal changes that may occur with birth control pills or pregnancy and sunlight. The most important thing to do is use a sunscreen (at least SPF 15.)

We prescribe a prescription strength bleaching cream. Sometimes, chemical peels can help to lighten melasma. They should be followed by constant use of sun protectors such as hats and sunscreens.

I recommend a visit to a local dermatologist who can prescribe the best treatment for your friend's condition.

Q.

I am an African-American female, I have adult acne and it leaves scars regardless of what I do.  I am totally unhappy with the results of medicines like Melanex™, which takes forever.  I am interested in Microdermabrasion for the removal of acne scarring.  Please let me know what the results are.

A.

Microdermabrasion is useful for mild acne scarring.  Deeply depressed scars and ice pick scars will not really be helped.  It sounds as if you have active acne and the most important issue at this point is, in my opinion, to control the acne.  In this way at least you won't be developing new scars and discoloration.  Repeat microdermabrasions and light peels would be useful for improving any discoloration and superficial marks. I'd suggest an evaluation to discuss medications to control your acne.

Q.

I am interested in getting erbium laser resurfacing.  I have some acne scars that I really would like to get rid of.  I have read about erbium laser resurfacing that is an excellent procedure for darker skin tone like me.  Do the doctors at Mid Valley perform this specific laser treatment?  If so, how much does it cost?  I would like to know some ideas then I can come in for consultation.

A.

The erbium laser typically is used to produce superficial resurfacing.   Often this depth of treatment is not satisfactory for acne scarring.  C0₂ laser resurfacing and dermabrasion remains the most useful technique for acne scars.   Its true skin pigmentation can be affected by the treatment, but this doesn't happen in all cases.  We have treated Asians, Hispanics and Blacks for acne scarring in the past.   Sometimes a small test treatment can help to predict the likelihood of discoloration. 

Q.

I'm really confused if "keloids" can still be removed.   I have searched the net but I got contrasting answers.  So, I hope you can give me clear information about this. Thanks.

A.

You may be getting different responses to your question because keloids on different parts of the body respond differently to treatment.  In some instances keloids can realistically be improved but not removed.   In some cases, for example on the earlobe, it might be practical to attempt to surgically remove the keloid. On the other hand, keloids on the torso and extremities will usually return when surgically removed. For this reason, non-surgical approaches are usually used on these areas. These include cortisone injections and special dressings.