Question: I’m 33, female, and I just got laser skin resurfacing treatments three weeks ago. I know I’m supposed to wear sunscreen constantly, but when I’ve put it on to go outside, the skin has gotten red and itchy, so I’m embarrassed to go out. Why is the sunscreen irritating my treated skin?
Answer: Certain sunscreens can be irritating to very sensitive skin and due to the fact that you have had a laser skin resurfacing, your skin is very sensitive. I would recommend a physical block style of sunscreen that has titanium dioxide and zinc oxide. These mineral-based sunblocks do not irritate even freshly lasered skin yet provide an excellent protection against the UV radiation of the sun.
Question: I have heavy sun damage on the back of my neck and my shoulders. In the future, I will be more proactive about wearing sunscreen but what can be done to improve the look of my neck and back now?
Answer: We can treat the neck and back area with broadband light, which will target the abnormal pigmentation in these areas and help the neck and back look much better. This usually requires a few treatments, but we can use this broadband light in a rather intense way to greatly improve these areas with only a few treatments. Another option would be ProFractional laser treatments, which essentially lasers tiny, little holes in the skin and this healing process causes some new collagen deposition, which tightens the skin and can reduce apparent laxity or wrinkling in the skin. This can be safely performed in areas off the face, but I would highly recommend seeking out someone who has significant experience with this; otherwise, the new Ultherapy device, which uses microfocused ultrasound can also be used on the chest, neck, and back if we are trying to improve laxity in these tissues. A personal evaluation would be necessary to determine which treatment would be the most appropriate and in many of our clients, we perform combination treatments where we will combine broadband light, ProFractional laser resurfacing, and Ultherapy to give them the ultimate result.
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 am a 40-year-old man who had a melanoma removed last year. Short of staying away from the sun altogether, what sort of precautions should I be taking to make sure I do not have any followers sprouting up?
Answer: Everyone should be protecting their skin from the sun using a physical block-type of sun protection. This would be products that have zinc oxide and titanium dioxide in them. These completely block the UV rays, both UVA and UVB, and these products do not degrade in the sunlight like other products can. Unfortunately, melanoma is a rather unusual skin cancer due to the fact there is some who believe that there are other factors involved in causing a melanoma other than the UV radiation from the sun. In fact, many feel that some of the other wave lengths that are even in visible light can put someone at increased risk of a melanoma. For now though, we do recommend a good physical block when you are outside, whether you are in direct sun or not. Other helpful things are wide-brimmed hats and sunglasses and wearing clothing to protect the remainder of your body.
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.
The best way by far to lighten dark scars is to prevent them from getting dark in the first place by wearing sunblock on any sort of injury or incision until it has completely matured, which typically takes six months to a year. If you already have a dark scar, there are several treatment options one being broadband light, which will injure the pigment in the scar and the body’s own natural processes then absorb this pigmentation and lighten the scar. A second option that can be performed in conjunction with broadband light is ProFractional laser resurfacing. This is an erbium laser that vaporizes small tunnels into the skin. These injure the deeper dermis and cause a significant collagen remodeling. This will improve the overall appearance of the scar and in conjunction with the broadband light sunblock and skin care regimen that included hydroquinone, one can expect a very nice improvement in the overall appearance of the scar over approximately a three-month period.
Absolutely, the skin will still tan after intense pulsed light. If a patient is having intense pulsed light treatments due to pigmentary issues, I obviously would then highly recommend that they not try to tan as the pigmentary issues will just recur and worsen. If patients are having intense pulsed light treatments for vascular lesions, I also again would recommend that they try to avoid the sun, but if they did end up getting sun exposure, they should tan in a natural way without any difficulties or influence from the IPL treatment. We all know the damaging effects of the sun’s rays and I counsel all of my patients to wear sunblock on a daily basis and should they desire any sort of improved or darker color to their skin that they consider some high end bronzing agents as the newer products that are available including the products that we have at Quintessa Medical Spa can provide a very natural appearing tan-like quality to the skin without the damaging effects that come with the actual exposure to the sun.
Depending on what type of laser is used for the hair removal, it is definitely not uncommon for freckles to turn darker. Most laser hair removal systems target the pigment that is within the hair shaft and because they target pigment, they can have the side effect of treating freckles or other darker skin lesions such has lentigines. Once the freckle turns darker, it typically essentially flakes away slightly one to two weeks after the treatment and is now a lighter color. There is typically less darkening with each successive laser hair removal treatment as the freckle itself is actually lighter in color. Should you end up getting sun exposure between treatments resulting in darkening of the freckle, this will once again be treated by the laser hair removal system and resulting darkening will again occur. We therefore highly recommend patients that are undergoing laser hair removal treatments to wear sunblock so that this does not happen.
The easy answer to that question is avoidance of significant sun exposure. I highly recommend that patients wear a sunblock as opposed to a sunscreen due to the fact that a sunblock will prevent damage from the sun’s ultraviolet radiation where as a sunscreen continues to let a small amount of these damaging rays from entering the skin. Once a person has broken capillaries and brown spots and loss of collagen, they need to essentially consider a rejuvenating treatment such as laser resurfacing, ProFractional treatment, or any other treatment modality that will increase the collagen within their deep dermal tissue.