Question: Do I need a prescription for Latisse?
Answer: Yes, Latisse is a prescription-only product and depending on where you live in the United States you may or may not be able to purchase this from your doctor’s office directly and if this is not an option then a prescription would be given to you to have it filled at a pharmacy.
Question: Does microdermabrasion improve fine lines at all?
Answer: Microdermabrasion will definitely improve fine lines, but it is a very small amount of improvement compared to some more aggressive modalities such as laser resurfacing or wrinkle fillers; nonetheless, I feel that microdermabrasion, due to its complete lack of any downtime, is a very important part of a patient’s skin care regimen since it will allow their skin care products to work better and penetrate the skin easier. Many patients only need a handful of treatments a year but early on in their rejuvenation they may require monthly microdermabrasions to get the maximum result.
Question: I am female, 33 years old, and have hairy forearms. I removed the hair using abrasive pads once but the hair has come back even thicker and actually longer. After laser hair removal treatment, is the skin more sensitive to the sun? If so, I just have to plan the procedure some other time after vacation.
Answer: Hair removal lasers can definitely be used on the forearms and it will make you slightly more sensitive to the sun for a couple of reasons. Initially, the skin is slightly irritated from the actual laser treatment and you need to allow a few days for this to normalize. Secondly, with reduced hair the skin of the forearm is actually exposed to the sun more intensely than when it has the actual hair protecting it. Ultimately, at the Quintessa Aesthetic Center, we always recommend patients wear a good sunblock anyway. So after the first few days have allowed the skin to normalize, you simply protect the skin with sunblock and you should be fine on your vacation.
Question: I will be getting microdermabrasion treatments to my face and upper chest. Do I need to purchase special moisturizing creams for after the treatment? Will I need to stay out of the sun and, if so, how long?
Answer: Well, you should be able to continue to use your current skin care regimen and that should include a moisturizer if necessary, but you do not need to use anything special after microdermabrasion. But, do remember that your skin care products will typically work a little better after microdermabrasion, and you may want to use smaller quantities. Regarding the sun, you should always wear good skin protection. So, even after a microdermabrasion, you should not necessarily have to stay out of the sun, but you should continue to protect the skin with sunblock as you would any other day.
Question: I have heard of something called photo facial. What is this and what does it do?
Answer: A photo facial is an intense pulse light treatment that can be performed in a variety of ways. Most places perform a single pass of intense pulse light treatment and this light energy targets pigment and vascularity on the face, but can also be used on the body as well. It injures the pigmented and vascular structures and then the body slowly resorbs these structures and it essentially clears these abnormalities from the skin in a way that creates no downtime. Frequently, several episodes or treatments are necessary to create the desired effect. At Quintessa Medical Spa we perform a photo facial in a little bit of a different way in that we treat the face with several passes of this intense pulse light all at one time, creating a much more significant effect, which will greatly improve the result and decrease the number of episodes or treatments that are necessary.
Question: Can permanent damage be done to the skin with laser hair removal?
Answer: Yes, permanent damage can definitely be done with laser hair removal if it is not performed in the safe and appropriate manner. If the laser device is set to too high of a power setting and the patient has darker skin type the energy can be absorbed by the skin as opposed to absorbed by the hair follicle and this can cause blistering and ultimate scarring or pigmentary issues of the skin. Fortunately, these are seldom permanent, but theoretically in worst case scenario scarring could be permanent. That is why I always recommend that people seek out a reputable facility with extremely experienced providers so that they end up getting the result that they desire while nearly eliminating the risk of any sort of complication.
Question: I am a lifeguard and even applying sunscreen regularly has not shielded me completely from the sun damaging my skin. After I have a chemical peel to correct my sun-damaged skin tone, when can I return to lifeguarding?
Answer: The answer to that question really depends on what type of a chemical peel or laser peel you have performed. If it is very superficial, you can most likely apply a sunblock and go back to lifeguarding the following day. If it is deeper and requires a period of time to heal, then you need to wait until the healing process is complete before you can apply the sunblock and then go back to your lifeguarding. For instance, some of our chemical and laser peels require a good three days of the use of a greasy-type occlusive emollient as, during that time period, there tends to be some weeping and oozing from the skin; we do not want this to dry and crust.
After those three days are up, we can then apply a sunblock and you can resume your activities outdoors. Other even deeper peels can require six to seven days of downtime, during which you would not be able to be outside lifeguarding. Even after these deeper peels heal, you may even want to take one more week off due to the significant sensitivity of the skin before you go back outside. Even after you return to lifeguarding, you are going to want to wear a wide-brimmed hat and a very effective sunblock to prevent any unexpected and unwanted pigmentary changes to the skin. So, in essence, depending on which chemical peel or laser peel is performed, you may or may not have any downtime or could even have downtime up to two weeks.
Ultimately, we provide rather detailed postoperative instruction sheets for patients, and we discuss these issues prior to the actual procedure so that they are fully prepared for any downtime that is going to be expected.
In my opinion, no, you should not discontinue your Retin-A but you should be wearing a very good sunblock that has zinc oxide and titanium dioxide in it. You should also be wearing sunglasses and a wide brimmed hat. Furthermore, you should only be using your Retin-A before you go to bed at night and, by doing all of this, you really should not have any significant difficulties with using Retin-A even in a sunny location. However, if you are one who does not routinely and consistently use a sunblock and you will be out in the Hawaiian sun for a significant amount of time, then I would recommend that you discontinue the Retin-A but would also note that you will most likely cause a significant amount of sun damage to your skin and will reverse some of the helpful effects that your skin care regimen has provided. I would therefore strongly encourage you to go ahead and wear a good sunblock on a daily basis and, that way, you should be able to continue to use your Retin-A in the evenings without any difficulties.
About the only aftercare that I recommend for patients who have had Juvéderm injected into their lips is to ice the lips continuously for the first 45 minutes after the injection and then ice them on and off for another hour or so. I also recommend that they keep their head elevated for the first night to prevent any additional swelling and should they have any early bruising, I would recommend Arnica Montana to hasten the resolution of the visible bruising. After the first few days if they feel that there is some irregularity or bumpiness, they can then massage the areas to smooth this out though this is rather uncommon as we tend to massage the lip right after the injection to assure that it is quite smooth before they leave the office or medical spa. Ultimately, the far, far majority of patients only have some mild swelling in the lips that lasts for one to two days and then they can enjoy the enhancement of their lips over the next six months or so.
No, unfortunately I really cannot recommend a cream for deep scars as there really is nothing topical that is going to make a significant impact on an established scar; however, if your scar is immature or a relatively fresh scar and still has pinkness to it, silicone gel has been shown to improve the appearance of scarring over time. Kelo-cote is a product that can be applied as a thin film of silicone gel. Makeup can be applied over this if desired and this is essentially left on the skin on a daily basis and can help prevent enlargement or thickening of scars. If your scarring is secondary to acne scarring, then this treatment will most likely not improve these nor will any other topical application or cream. The massaging action of applying a cream to the skin can, however, improve the overall appearance of surgical or traumatic scars and I will certainly recommend that my patients try some vitamin E gel rubbed into the scar two to three times a day. However, I truly feel that the action of the massage is more important than the actual vitamin E substance that is rubbed into the area. With that said, if you do have a mature scar that is unsightly, I would recommend an evaluation by a board certified facial plastic surgeon, so that all of your options can be discussed. An exciting relatively new technology that has been extremely successful in reducing the appearance of scars is ProFractional laser resurfacing. Typically three treatments are required and we usually have to treat the skin relatively deeply so that there is some oozing of some fluid from the area for a few days, but the overall downtime is relatively minimal. This has essentially replaced dermabrasion and deep erbium laser resurfacing as my gold standard for acne scarring, traumatic scarring, and surgical scarring treatment.