Ask Dr. Garcia - The Archives

• # # Hello Dr. Garcia, Have you seen any successful scar revisions in dark skinned patients using excision? I have a small linear hypertrophic scar (very small and thin) on my face (left cheek;near side-burns). I was hoping, to get it excised and stitched up with botox to relaxe the area. And also, do you think electrolysis can work on dark skin without scarring? Thanks

  Answer:  as to the electrolysis, what I have seen is that it leaves small darker spots. As to the Botox, I am afraid that any effect from that is shortlived and in time, as the Botox wears off, what was going to happen without the Botox still happens. As to the results from a scar excision and revision, it is all a matter of skin tension, if the skin is loose, it might leave a good degree of improvement. If it is tight upon closing the wound, then the result might look exactly the same as what you have at present. JG 7.1.09

• Hi Dr. Garcia, What kind of peels do you do there? I am thinking about one and want to remove dry skin, discolorations and some fine wrinkles. What do you suggest? I don`t want to do anything to drastic. Thank you CW

  Answer:  I think a chemical peel alone will not correct all of that, and there are so many different types that I think you would need to be seen in person, sorry. JG 7.1.09

• Dear Dr Garcia! Is there any skin care regimen or treatment (retin-a & glycolic acid combined? peptides? laser? peel?)that can be used to effectively reverse sun damage and aging skin on the body? such as spots, fine wrinkles on the belly, neck and arms? From what I understand CO2 laser is a not OK below the neckline? Thank you again for your great service/Anders

  Answer:  all that you mention will to some extent reverse some of the damage, but nothing will reverse it completly and nothing will stop it from aging in the future. JG 6.29.09

• I`m planning to have Aluma Aesthetic for my sunken looking eyes and wrinkles, would you recommend this? How effective it is? Thanks.

  Answer:  I would not recommend it and I think the only thing it will do is make your wallet flatter. JG 6.29.09

• Hello Dr. Garcia, Have you seen any successful scar revisions in dark skinned patients using excision? I have a small linear hypertrophic scar (very small and thin) on my face (left cheek;near side-burns). I was hoping, to get it excised and stitched up with botox to relaxe the area. And also, do you think electrolysis can work on dark skin without scarring? Thanks

  Answer:  if the skin is loose, yes, as to the Botox, it is a waste of time as the Botox will wear off and what was going to widen will widen. As to the electrolysis, it might leave dark spots where the hair was. JG 7.1.09

• Hello, what`s your opinion about Aluma laser which is an anti-aging procedure to combat eye wrinkles? Thanks.

  Answer:  I personally would not offer it to patients nor have it done on myself. JG 6.29.09

• Hello Dr. Garcia. Does power peel help in diminishing fine lines and wrinkles? Thanks.

  Answer:  very mild effect, but yes. JG 6.29.09

• Hello Dr. Garcia. Whats the difference between the diamond peel and power peel? Which one is better? Thanks.

  Answer:  essentially the same thing, just marketing. JG 6.29.09

• Dr. Garcia, I went to an even at a PS offce last night and they demonstrated fillers and talked about lasers. It was interesting and I feel informing. They demonstrated Botox and the vendors were there so we could ask questions. Dysport rep was there and touted it as the next best thing that has bgeen used in Europe for over 18 yrs. It was just recently approved for use in the US by the FDA. Is this true? Is it the same company as Botox? Will this new competition for Botox drive prices up or down? Will you be using it with Botox or as a stand alone or just dump Botox in favor of Dysport? Thanks for helping with all of my questions and sharing your knowledge. You are a gem...bless you.

  Answer:  it is a diffferent company and is not the smae product. I feel Dysport is better then Botox, it works faster and lasts longer. I will be switching my patients to Dysport as they come in. Best of luck.

• Does water retention make the skin look better or worse?

  Answer:  might decrease wrinkles but can also make someone look bloated or too round, so no clear answer. JG 6.23.09

• Is differin just as bad as tazorac while tring to concieve? what ovt product can you use for acne while trying to get pregnant to maintain clear skin and anti age?

  Answer:  it has never been studied so I suggest not using it. JG 6.23.09

• Hi Dr.G...I recently had Candela Laser to remove spider veins on my cheeks...I read onsite that you said that Retin-A or AHA may cause these...should I refrain from using Retin-A or facial scrubs as to not have them return?..Thanks for any advise you may have!

  Answer:  I would say yes to that. JG 6.23.09

• I just ordered your copper peptide. Can I still use the Renova with it? Thanks

  Answer:  yes, apply the Renova first and then wait ten minutes, and our cream is a peptide, but has no copper in it, I only use copper peptides when there is an acute injury, like a laser. JG 6.23.09

• oops. typo. meant to say L-ascorbic acid and Copper Peptide together in same serum. Thanks.

  Answer:  got it.

• Hi Dr Garcia, IS Clinical has a new antioxidant serum that contains both L-ascorbic acid Copper peptide. I had always been told never to use the two together, but now I see them both in the same serum. Is it OK to use?

  Answer:  I normally do not use them together. JG 6.23.09

• what are your thoughts on hydroxatone?

  Answer:  save your money. JG 6.23.09

• Dr Garcia I am 55yrs old, thin skin, and have been using Renova with copper peptide and emu oil. Would you suggest anything else or keep using what I have been? Also which of your products would you suggest thanks

  Answer:  you can continue those or switch to our peptide cream and sunblock of course, our peptide cream would take the place of all three. JG 6.23.09

• Hi there I am going back to the clinic a appearance medicine clinic as I am not happy with some moles I had removed by radiofrequency. They are not flat I had one done by someone else 3 years ago and it was a different kind of mole but that is completely flat and no mark. So my question is if I don`t feel secure they can do them again or confident in them should I go to a plastic surgeon or dermatologist because the two are on the lower part of my cheek on my face. Thanks once again.

  Answer:  I would go to a plastic surgeon or a dermatologist, yes. JG 6.21.09

• Hello, What ist the best type of peel to use for large pores and blackheads? I have tried 30% glycolic acid which seems to help and does not irritate my skin. I have been using this once a week - is it ok to use it more often? What would you recommend? Thank you.

  Answer:  I think 30% glycolic peels more than every 2-3 weeks might give short term improvement but not long term, your skin will become irritated, as to other peels, nothing will last very long, there is no long term control of large pores, sorry. I like IPL or microdermabarasions for the pores. JG 6.21.09

• Dear Dr. Garcia, Have you had any personal experience or know of anyone who has been using Boots No 7 serum from the U.K. or is too much hype? It has been touted as the next best thing in O Magazine.

  Answer:  save your money, do you wonder why their cast-iron medica proof is nowhere to be found except in their claims. JG 6.21.09

• Dear Dr. Garcia, I saw a ps gove an oxygen facial on tv last week. Both he and the recipient gave it glowing remarks. I am only interested in things to give long term effects due to money and time constraints. What is your feeling on this if it is not just for a special occasion to look better? I always value your honest opinion. Christine

  Answer:  it does not work, oxygen cannot be absorbed through the skin, if it could, it could also come out through the skin, and if it did that, you would die, the improvement was likely due to all else that was applied and a little wishful thinking, sorry. JG 6.21.09

• Dear Dr. Garcia, I hope you are having a wonderful weekend. Thanks for all you do. What is your feeling on Chella products? I want a mask and exfoliater for someone with good normal skin. I use your peptide cream but you don;t have a mask or exfoliater yet :( .

  Answer:  Sorry for the delay in getting back but I was out of town, I think trying the Chella products is OK, just go slow to make sure they do not irritate your skin too much. Best of luck. JG 6.21.09

• Dear Dr. I am a 47 year old woman. I use RetinA once a week, as my skin can`t take more then that. What would be best for my skin, DMAE or Peptides? Also, between the vitamin C or Alpha Lipoic Acid is best for aging, sun damaged skin? Appreciate your time, Thanks

  Answer:  likely the peptide would be better. The alpha lipoic is good but it is hard to tolerate around the eyes. JG 6.21.09

• Hello Dr. Garcia, since I have extremely oily skin - blackhead prone skin, my Dermatologist recently prescribed Tazorac Gel .1 since my Differin gel stopped working (been using it for 1 1/2). I`ve heard that Tazorac CREAM is helpful in reducing fine lines. Does the Tazorac GEL have the same benefit, or is it only with the cream? It would be a great bonus if this new gel not only helps with the blackheads, but lines as well :) Thank you, and have a great weekend!!!

  Answer:  the effects of Tazorac with that are implied as it is similar to Retin-A, but the long term effects of Tazoarac for wrinkles is not as well studied as for Retin-A. The gel and the cream would be equally effective if it is going to owrk for that. Best of luck. JG 6.21.09

• Is there any reason not to do a microdermabrasion and/or a microcurrent shortly after or some time after having Restylane or Radiesse injections? Also, you recently did not recommend microcurrent as a an effective method to improve overall appearance. Just curious why not? Thank you.

  Answer:  I do not think either will affect the Restylane but I think waiting a few days between is best, as to microcurrent application, it might help tone the muscle but that is not the problem in aging faces, and more muscle flexion causes more wrinkles, that is why people use Botox, to get the muslce to flex less, not more. JG 7.1.09

• I asked a question about my skin and it wasn`t answered. Here it goes again. What can you do for large pores and a lot of texture.Thank you!

  Answer:  a CO2 laser will help with the texture, or for milder cases just Retin-A. For the pores, Retin-A will help along with microdermabrasions and IPL, but the results for the pores is short-lived, it needs to be kept up. JG 6.12.09

• Hello, What would you recommend for bluish/gray discoloration. I have a spot approximatly 2cm round area on my cheek. It is similiar in appearance to dark under eye circles; however it is on my check above the jawline. I have seen a dermatologist and it is nothing medical etc. Is there anything that may be effective to treat this area? Thank you.

  Answer:  hard to say how to treat it without seeing you in person and knowing what it is or what is the cause, sorry. JG 6.10.09

• Hello Dr.Garcia, I`ve heard of Aldara for the possible use for hypertrophic scarring. Is this for use after when the scars are already present or to help prevent the scarring from occurring in the first place?

  Answer:  can be placed on the wound after the sutures are removed but its effects are not seen in all patients. JG 6.11.09

• What can be done for large pores and a lot of texture. I am using Retin A 0.5 % every night. I have had this problem for over 20 years. Thanks!

  Answer:  IPL an microdermabrasions. JG 7.1.09

• Dear Dr. Garcia, I use your peptide cream at night. I Use it first then retin-a and obagi blender mix over a brown spot. If I want to use retin-a , as you have mentioned several times is a good help for fine lines, do I apply this over your cream and before or after the mixed blend? 2nd question During the day I use your peotide cream 3-4 days a week followed by sunblock. The sunblock is thick. white and takes a while to blend in and dissapear. Is this okay or am I losing the peptide beneifts? It`s expensive and I want to maximize my money`s worth and results. Thanks in advance for sharing your knowledge. Just wanting to clear up some confusion :)

  Answer:  appply the Retin-A first, wait ten minutes, then the other creams on top of it. As long as you wait about ten minutes after the peptide cream to apply the sunblock, it is OK. JG 6.10.09

• Dr. Garcia, what is the difference between your neuropeptide cream and your cell matrix peptide or are they the same?

  Answer:  it is the same, the cell matrix is the new one with the penetrator for added absorption. JG 6.8.09

• How do you feel about doing a series of micrcurrent and microderm to improve skin tone and overall appearance?

  Answer:  microdermabrasion, OK, microcurrent no. JG 6.8.09

• Hi there. Pls explain what you mean by overkill. I am trying to maintain some youth and prevent some early aging? What should I be using tehn??

  Answer:  at your age you likely just need sunblock and a moisturizer. JG 6.8.09

• what exactlyy will your peptide cream improve for a 28 yr old?? And csn I use with tazorac and acne pone skin??

  Answer:  I think it is overkill for someone your age, and Tazorac is likely also overkill but can be used in acne prone skin. JG 6.8.09

• are there any procedures that have no downtime to help firm skin/produve collagen other than micro??

  Answer:  Retin-A. JG 6.8.09

• Hello, What is the most effective treatment for scars with rough-textured edges and slightly hypopigmented? Would you recommend lasers, peels, or microdermabrasion? If lasers, which type? The scare is on my face and I am very fair-skinned. Thank you for the adivice!

  Answer:  CO2 laser is what I would recommend. Best of luck. JG 6.8.09

• oh and regarding the question below about the allergic reaction, is there anything I can apply to speed up the moisturizing

  Answer:  could try a copper peptide cream too but as you have not used it, there is a very small risk of you not tolerating it. JG 6.8.09

• I had a terrible allergic reaction to an ingredient in a very expensive eye cream. My eyes were swollen shut, the bottom lids were the worst. My doctor gave me steroids, and I have been taking them along with applying cold milk compresses. Anyway after day four of the steroids it appears most of the swelling is gone. BUT now the skin under my eye is DRY...kind of looks like the skin on a dried apple...it is puckered and looks distorted. Will this correct? I am 44 and worried that the skin will not heal? Please help!

  Answer:  it will correct but using a good moisturizer that you know you are not allergic to will certainly help. JG 6.8.09

• Dr.Garcia is it true, if you use the same cream for long time your skin gets use to it and cream does`n work as good? For how long do you recomend to use your peptide cream? Thanks.

  Answer:  some people do become refractory to some creams and switching around is not a bad idea in those cases. I suggest taking a break whenever you see the improvements have leveled off, in the case of Retin-A I suggest three months per year off due to the irritation, but no need to wait that long with the peptide cream as there is no irritation. JG 6.7.09

• Hi Dr G. Wondering if there is anything you can recomend for very tight eyelids due to a Gemini Laser being placed near the corner of the eyes ? Thanks for your help and site.

  Answer:  I am sorry, but only time. JG 6.7.09

• hello how do you feel about tanda light therapy by sephora?

  Answer:  save your money. JG 6.6.09

• Hi Dr. Garcia. I`m really loving your peptide cream -- first time I`ve ever truly noticed a difference with a facial cream. I was using retin A as well, but I dropped it in favor of the peptide cream. Any benefits I`m missing out on by dropping the retin a?

  Answer:  you only need to use the Retin-A if you have some brown spots, otherwise you do not need it, glad it is working well for you. JG 6.6.09

• any thoughts on skin genesis multi later strenght treatment??

  Answer:  very mild therapy, nothing dramatic, needs continued treaments. JG 6.6.09

• what is the best most potent face serum to use for a 28 yr old in conjunction w/tazorac??

  Answer:  my peptide cream on my shopping cart. JG 6.6.09

• How soon after having some spot treatments for growths with erbiurm laser, is it safe to have pulse dye for the redness from the erbium? As always, thank you for your help.

  Answer:  2-3 weeks or so. All the best. JG 6.5.09

• Hello dr Garcia, Is an antioxidant cream (vit E, ester C, lecethin, etc) more effective if it is used twice daily? Or does it max out at once daily dosing? Thanks for your generosity. I really appreciate this.

  Answer:  yes, twice daily is better. JG 6.5.09

• Dr Garcia, If I apply an antioxidant cream at night then wash it off the next morning, is my face still being protected by the antioxidants during the day? Even though I have washed off the cream?

  Answer:  they have been absorbed and whatever their effects might be they will stil be working as by then they have been absorbed inside the cell. JG 6.5.09

• Question regarding Retina Micro and Differin. I have used Retina, and find it migrates out quite a distance from the spot it was originally applied. Does Differin act in the same manner? Thank you.

  Answer:  potentially the same. JG 6.3.09

• you know how they have false eyelashes, do they have anything like that for eyebrows that are thin?? If not, what is a good product to help stimulate brows to grow??

  Answer:  I am sorry but I do no have any good solutions. Sorry. JG 6.2.09

• Hi Doc, Thanks for your reply. I just got off the phone with the dr`s office (spoke to a nurse). I told her that I did not want another injection and that as far as the locoid lipocream, I`d prefer he give me a prescription for an antiobiotic instead. She proceeded to tell me that the Dr. said to try the lacoid on my butt first for a couple of days, and if I did not get a reaction, that it would be fine to use. Now what????? I feel like I am getting nowhere, and after a month have the same problem!!!! I am totally frustrated and am having sleepless nites cause of it. I have been to this dr. several times about 3 yrs. ago for IPL`s and Thermage. I am not a new patient. I always paid my fee in cash all the time. Don`t know if I should get a second opinion or not. JoAnn

  Answer:  yes, second opinion time. Locoid is used for allergic reactions or dermatitis and you do not have that. JG 6.1.09

• Hi Doc, Had a ingrown zit on the side of my nose which was present bout 3 wks. when I decided to go to a dermatologist who proceded to inject it with a steroid I presume. It is now 4 days since ( he said it should go down within 48hrs.) I went to see him today cause to me it is red, and looks like a tiny blister. He told me to give it 10 days more and gave me lacoid lipocream to apply to it twice daily, if that does not work, he will re-inject me. I highly respect your opinion, is why I am asking you, I only wish I lived in Vegas. Thank you ever so much for replying to my request. JoAnn

  Answer:  have him give you some antibiotics, stop the injections and stop the cream, they will cause more harm than good, like broken blood vessels in the skin and tissue atrophy that can lead to dents in the skin. Best of luck. JG 6.1.09

• Hello Dr. Garcia. I was wondering if there is something that can be done for oil glands ? Most of them are on my forehead. Thanks for your time:)

  Answer:  Retin-A will help,and Boox can also in small doses. JG 6.1.09

• Hello Dr, Garcia..Have you heard of Spa Milk Salt whitening product w/ milk formula.. Is it safe to use in the face? Thanks.

  Answer:  never had any patient use it, cannot say, sorry. JG 5.31.09

• Is there a cream that fades red marks on the face?

  Answer:  none that are reliable. JG 5.31.09

• Also, is it OK to use my nighttime antioxidant cream over triluma? (antiox cream has olive oil, ceramides, tetrahexydecyl ascorbate, green tea, vitamin E). Thnaks for your advice!!

  Answer:  should be OK to use both. JG 5.31.09

• Hi Dr Garcia, I am a 33 year, fitzpatrick 3 with mild melasma on much of my face. I have an event in 8 weeks for which I want to look nice. I plan to start triluma cream tonight and use for the next 8 weeks. I also want to do a series of 3 PCA peels over the next 8 weeks. Does this sound like a reasonable plan or should I just use the triluma and forget the peels?

  Answer:  I think all sounds reasoanble to try, but do not forget the sunblock. Best of luck. JG 5.31.09

• when putting on latisse, does it actually have to touch your eyelashes up top or just the skin?

  Answer:  I would suggest you use a different prodcut duer to the side effects of Latisse.JG 5.30.9

• Dr.Garcia, what brand of sun block for the face will you recomend Thank you.

  Answer:  Fallene Total Block. JG 5.28.09

• 2 questions. what is the cheapest procedure to help stimulate collagen for a 28 yr old? Also will the pructs like latisse or revitalash ruin or damage the lashes you already have?

  Answer:  Retin-A for the collagen, I do not think those products should hurt your eyelashes. JG 5.27.09

• Is there really a facial mask that can clean out pours? All claim to deep clean pours but is there one that can really deliver? Thank you

  Answer:  I do not think there is one that is better than the rest, all pretty similar. JG 5.27.09

• Dr.Garcia, I used your old peptide cream, now I got the new one. What is the difference between them? Also, the new cream is more like a lotion or serum and feels sticky. Thank you.

  Answer:  the new one has a penetrator that helps it absorb quicker, otherwise all the same. The tacky feeling is part of the penetrator but should go away in time so you can apply make up easily and not rub the active ingredients off. JG 5.27.09

• Hello, Just wondering what is the most effective treatment for red marks (left from blemishes) on the face? Thanks.

  Answer:  YGA laser or VBeam laser. JG 5.27.09

• What is the difference between the rhytec and co2 laser...what circumstances would you reccommend one over the other?

  Answer:  CO2 is much stronger and for more sever wrinkling correction. JG 5.27.09

• Just wondering if Chemical Peels and Microdermabrasions are safe for hispanic skin. I have melasma and heard they might help with my condition.

  Answer:  as long as they are done lightly they can be safe. The problem is that light ones might not be enough to correct the melasma. That is an extremely difficult problem to correct in hispanic skin. JG 5.24.09

• HAVE ANY OPINIONS ON lOBE wOUNDER FOR STRECTED PIERECED EARS? aLSO IS IT TRUE THEY CAN PUT FILLER IN TO STRECTED EARRING HOLES?

  Answer:  fillers will not fill in stretched ear lobes, they need surgery. JG 5.24.09

• im so sorry. can u recommend a toner thats anit age thats inexpensive that i can use because my beauty fund is pretty much used up with fillers, tazorac, prevage and lipfusion..lol.

  Answer:  toners do not have any antiaging effects, sorry. JG 5.24.09

• can u recoto use, that is not expensive as recommed a great anti age toner that is inexpensive as my fillers,tazorac and prevage take front seat?

  Answer:  please repeat your question.JG 5.23.09

• Hello, I also forgot to ask how much Emu Oil one should apply to the skin (facial area) at a time?. Thanks

  Answer:  as small an amount to cover the face is all. JG 5.23.09

• what would happen if i put tazorac .1 cream on then prevage night cream over it. Too much?

  Answer:  nothing bad would happen. JG 5.23.09

• Which is better to use on face ... tazorac cream or Retin A? Thank you!

  Answer:  I prefer Retin-A. JG 5.23.09

• Hi Dr. Garcia, what are your thoughts on 100% pure Emu Oil as a moisturizer for the skin? I have rosacea and have read a lot about this helping the skin in cases of rosacea, eczema as it is an anti-inflammatory and also helping with anti-aging, boosting collagen production. What are your thoughts on this? I always get nervous at the thought of putting oil on my skin, fearing it will make my skin oilier and cause breakouts? Thanks for your time!

  Answer:  it helps in many cases. JG 5.23.09

• Hello there Dr. G. Like some of your other posters here, I have early stages of Rhinophyma. Is Retin-A (Differin) ok to use on the nose in early stages of Rhinoipyma or in Rosacea in general? I have read conflicting reports, some say that Retin-A can help elimiante small spider veins and helps Rosacea, while others warn against it. I was on Accutane for 8 months which really did help reverse the Rhinophyma but now since being off it has returned, which is why I was thinking Differn on the nose, as it is Accutane in a bottle according to some derms. Thanks

  Answer:  I think Retin-A will likely aggravate Rosacea and Rhinophyma in many cases, but not in all. Under no circumstances will Retin-A ever improve broken spider veins. JG 5.22.09

• Dr Garcia, what is your opinion of DIY cosmetics. As in use a base lotion and add active ingredients one prefers. www.skinactives.com offers such an option.

  Answer:  sorry, have not had anyone I know use them. JG 5.20.09

• Dear Dr. Garcia I use your neuropeptide cream in the evening every night. Sometimes I also use it during the day. If I use it during the day and use Sunscreen, do I need to wait after applying the screen ( I assume that I need to use the sunscreen first) before using your cream? What about if I want to use a sunblock? Also, is this true for any moisturizer that you want to put on after sun protection? As always, thanks for your great advice. Have a great day. Christine

  Answer:  sunblock and not sunscreen, and the sunsblock always goes on last, over the peptide cream and you should wait ten minutes in between the peptide and the sunblock. Most sunblocks and sunscreen have enough of a moisturizer that an additional moisturizer is not needed on top. JG 5.20.09

• No7 Protect & Perfect Intense Beauty Serum any comments????

  Answer:  sorry, have not had any patients use them. JG 5.21.09

• Hi Dr Garcia, I use retin-a .05% every night. I am going to have a PCA pumpkin peel done on my face. How many nights prior to the peel do I need to stop using retin-a? Thanks.

  Answer:  2-3. JG 5.20.09

• do you think astringent/toner can help before using matte makeup which is non oily to get rid of the oiliness onmy face... ive seen some pics of myself lately and my face is so oily, and im not using anything oily to my face only retina for moisturizer

  Answer:  it will be very temporary at best. JG 5.20.09

• I have very dry heels, they are also discolored and the bottom of my feet i have spots. Is their any type of surgery that can fix this problem?

  Answer:  sorry but no surgery for that. JG 5.19.09

• Hi Doctor, You may remember me, I posted a few questions about a red spot of faint capillaries on the tip of my nose after being on BP 10% gel and one day being in a bitingly cold wind. It`s been 3 months and over the past few weeks, it has started to fade quite a bit. Now, even if you look closely, I can`t really see any capillaries. And thought the redness has faded, the area is still a bit residually pink. It has definitely gone down rapidly over the past few weeks all of a sudden, but it is still pink. Do you think that pinkish area will fade to my normal color eventually, too?

  Answer:  yes, all in due time, glad all is getting better. JG 5.19.09

• Dear Dr. Garcia, what do you think about AHA cream 12%, can I use it in the morning and retinA or your peptide cream in the ivening? Thank you.

  Answer:  OK to use that way. JG 5.19.09

• Dr.Garcia, I use your peptide cream and for sun protection I use moisturizer SPF 15. It gives me protection? Thanks.

  Answer:  I think you should use SPF of 50 at least. JG 5.19.09

• what is the name of the peptide cream that you sell? thanks

  Answer:  neuropeptide cream. JG 5.19.09

• Hi Dr Garcia... would it be okay for someone my age (24) to start using your peptide cream? and if so what benefits would i get from it?

  Answer:  OK for you to use it, I think in general it helps maintain your skin and stabilizes cell membranes along with enhancing your skin`s ability to replenish itself, no harm in using it a younger age, still need your sunblock though. JG 5.16.09

• Hi Dr Garcia, I know you are not a fan of topically applied hyaluronic acid as it is not absorbed into the skin. However, I am thinking of using an antioxidant serum that contains a lot of well researched antioxidants in high percentages. The problem is, the base of the serum appears to be water and hyaluronic acid. I do not mind at all if the hyaluronic acid is not beneficial, but my question is this: Will the hyaluronic acid in the serum prevent the other active ingedients of the serum from being absorbed by my skin? Thanks for your opinion and have a great day.

  Answer:  no, it will not counteract the absorption but does give the skin a very temporary feeling of smoothness which helps the sales. JG 5.16.09

• which is better-renova or retina-a cream?

  Answer:  I prefer Retin-A. JG 5.16.09

• Hi Dr. Garcia. What is the best way to improve thin crepey skin under the eyes. I`m afraid of Retin-A because my under eye skin gets worse with harsh products. Thank you.

  Answer:  might suggest my peptide cream, sold on my shopping cart, it casues no irritation. JG 5.15.09

• Hi doctor, I have age spot on my both skin and the doctor had prescribed locacid cream? What do you suggest, is it a good cream. or what is the effect of using locacid cream. thanks

  Answer:  will not help fade a brown spot, sorry, you need something like hydroquinone or Retin-A. JG 5.15.09

• I was perscribed bactrim ds from a dermatologist and i have been on it for 3 weeks and i just developed a rash all over my body. I am pretty sure it is an allergic reaction. I called my regular doctor for an appointment and they told me they have bactrim as a drug i am allergic to, which i didnt know. I cancelled the appointment because they told me to just take benadryl. The last time a took the bactrim was the night before last. I am just wondering how long it usually takes for the rash to go away? also is there anything i can do to help soothe it or make it go away faster? thanks

  Answer:  might take a few days for the rash to go away, you can use benadryl cream too. JG 5.14.09

• Hi, Dr. Garcia. What is your opinion regarding the best topical regimen for increasing elasticity around the eyes - or the entire face and neck for that matter? Thanks!

  Answer:  either Retin-A or my peptide cream.

• I have red sensitive skin that i am having IPL treatments for and i also get clogged poors that turn into breakouts. Not rosacea. I am wondering what i can use to unclog the poors and help the breakouts while not irritating my redness or being too harsh? Its so frustrating.

  Answer:  that will be hard because the pores are due to plugged oil deposits deep inside and the things that help, like microdermabrasions and Retin-A will irritate your skin. JG 5.12.09

• Dr.Garcia, I want to take Arnica Montata before cosmetic procedure. What dose is better? It comes in 6, 30 and 200. Thanks.

  Answer:  6X. JG 5.11.09

• Hi there again I was the one who had the 4 moles shaved off it has been 4 weeks since the scabs have come off and just wanted to ask a quick question I brought some moisturiser not relising it had aha`s in it it was only a basic boots u.k brand so don`t think the levels will be high and wasn`t very expensive is this alright to use while my skin were the moles were are still in the healing process i.e still hoping the red or pink is going to fade. Thanks so much again

  Answer:  should not cause any damage. JG 5.11.09

• Hi dr. Is it safe to use prescription strength retin A on skin one night and then a gylcolic product the next day and so forth.Also when I used retin A regularly before, my skin itself got more papery/thinner although it is meant to increase skin thickness. So can you tell me how this is? Also I was told that only one percent of a medical product is absorbed by the skin. Is this correct? Also how often should I use retin A and for what length of periods? Thankyou doctor.

  Answer:  yes, OK to alternate. I cannot comment on why your skin got thinner, at the begining as it exfoliates the skin will flake off, and certain areas like eyelids are very sensitive, but the long term effect is dermal thickening. As to the percent absorbed by the skin, it depends on the product, commonly it can be quite higher and the amount absorbed also depends on where on the body it is applied. I suggest Retin-A be used for 9 months and then take a three month break. JG 5.11.09

• Hello Dr. Garcia, I had a crystal-like formation in my forehead. Very small, but embedded in my skin. It came out effortlessly as if it were simply a piece of lint caught on my skin. But when it came out it left a gaping hole in my forehead. It was a small hole but nonetheless it`s ugly and disfiguring. There was no blood and it looks as if this crystal-like formation was embedded in my skin. Any idea on what it is? Will the hole close? It doesn`t look at bas as it did on day 1 - it`s been 2 days since then. I`m really stressed out now...I feel like my face is simply falling apart...

  Answer:  should close on its own and fill in with time, I would not consider doing anything for it except keeping it clean and applying neosporin for now. JG 5.8.09

• I want to use a moisturizer without chemicals for my newborn child. Whzt do you recommemd? Thank you

  Answer:  almost all baby creams have no irritants. JG 5.8.09

• Do you have any comments on Hydroderm Beverly Hills Intense Oil Free Facial Moisturizer? will it help any with anti age?

  Answer:  would not recommend it, expensive for a so-so product, lots of hype though. JG 5.7.09

• O.k so I had these moles shaved off with radiofrequency and honestly they really don`t look any different than before. I went to a apperance medicene clini and the lady is a g.p but also is quailfied form the new zealand college of appearance botex, anti aging treatments etc... Do you think I should have gone to a dermotologist that she would have been better? She did say I can go back in three months when all healed and she would do again if needed? Do you think I should wait and do that or seek help somewhere else? I know nothing perfect when mole removal is involved and there will be a bit of a mark but that I don`t mind just wanted them flat? Please help just feeling like I am wasting money for no results

  Answer:  yes, I think her credentials are purchased, not earned. I think repeating a treatment that did not work the first time is likely not going to work any better the second or third time. Seek professional help from a dermatologist next time. JG 5.6.09

• any comments on caracol cream?

  Answer:  do not think it is worth it. JG 5.6.09

• Dr.Garcia, I use your peptide cream. Do I need to use sun block in a rainy day, when there is no sun at all? Thank you.

  Answer:  yes, the damaging rays go right through the clouds I am afraid. JG 5.6.09

• Hi Doc! I`m a 32yr old female who is considering going on Spironolactone for cystic acne. I take no BCP but I struggle with melasma and have for years. Do you think the Spironolactone is a good medication for acne? And do you think it will worsen my melasma? Just wanted your 2cents.. Thank you!

  Answer:  think it is worth a try and as long as you use your sunblock all the time I think worsening of the melasma should be controlled. JG 5.6.09

• Hi Doctor, how would you recommend using your peptide cream. I use Retin A nightly. Could I use it under my foundation through the daytime or alternate nights. Thanks

  Answer:  you can use my peptide cream either instead of the Retin-A or use the Retin-A first and then apply the peptide over it if desired. The peptide cream can be used under your foundation also. JG 5.5.09

• Is there better products than Pyratine Cleanser and Pratine 6 soft cream for a female in her 60`s that also uses Retin A every night? Want to use the best products possible. Should I be using additional products on my face and eyes? Thank you always for your quick response.

  Answer:  I am sorry but I am not familiar with those products and I think sunblock and a moisturizer would be nice, or take a break from the Retin-A and try our peptide cream instead. JG 5.5.09

• Hello Dr Pierce or Dr Garcia, How intense is the sun sensitivity while on retin-a? I am asking because I was on very high dose doxycycline for several years (double usual dose at 400mg per day) and had to wear gloves and long sleeves AND strong sun block in the summer which was miserable. I`d rather not do that again. Is the sun sensitivity dose dependent? I did not have to wear gloves while on 200mg doxy. I am wondering if retin-a at .01% or at .05% would be do-able in summer months. I have yellowy fairish skin, tend to burn the first time in sun and tan thereafter. Yes, I do know to apply retin-a at night. Thank you very much for your time :)

  Answer:  as long as you wear sunblock you should be OK. JG 5.5.09

• Hello Dr Pierce or Dr Garcia, I recently tried some very strong copper peptide serum (skin bio CP serum)for 4 weeks. Even at a very dilute rate and switching to every other day it seems to have caused damage to my face. It is not a temporary getting used to it reaction but a real concern. I now have more wrinkles and sag. I am 49 years old. Does this mean that I should stay away from copper peptides or do you think only this brand or type? I did have very good results with olay regenerist which has palmitoyl pentapeptide-3 in it. I guess I was a bit spoiled as I started to use an OTC estriol cream which made my face even better but the cream was discontinued. So I tryed CPs. What could you recommend that would help my face heal? And are there other peptides which are effective? I have another question and will post again so it`s not too much at once. Thank you for your kindness in taking the time to answer questions.

  Answer:  more likely the brand, they probably have some irritants or exfoliants in it. I would suggest using squalene oil from the health food store until the skin hels. As to peptides, everyone responds differently depending on their skin so there is no one single one better than others. JG 5.5.09

• what brand of peptide cream do you recommend? Can you use retin A with it? I have fair skin with large pores and some sun damage. Thanks for the advise!

  Answer:  I recommend my peptide cream on my shopping cart and if desired the Retin-A can be applied first and the peptide over it. JG 5.5.09

• Hi there I was the one that had the moles removed. I had two little ones beside my mouth which were raised I went back for a follow up at the clinic as it has been three weeks since the scab has come off and is still quiet red but is still raised were the moles were. She said there may be a bit of scar tissue still there and it might flatted a little bit but best to wait 3 months for the skin to heal and assured me it would fade more in this time. I it is still raised or grown back which I think it isn`t flush with the skin she will do it again free of charge. What do you think? I am scared it will just be a red raised lump now? Or the moles will come back and look worse than before as they were only two little ones together as it was?

  Answer:  I cannot say whether she will do it again free of charge, that is up to the doctor. Unless the moles are cut out and you trade them for a scar there is always the possibility that in time they will grow back, no way to predict how long that would take though. It is unusual for them to grow back worse than what they were. JG 5.4.09

• hello doc.Im had a sever allergy after a botox injection around the eye.i was treated with prednisone.The swollen had almost gone away but for a small portion on my chin.i didn`t finish the treatment yet. Will it completly disappear. Thankyou

  Answer:  it should completely disappear, yes. JG 5.3.09

• Dr. Garcia, Is your old peptide cream still available for purchase or only the new one?

  Answer:  yes, we still have some of the older one here. I am going to be making some container size changes for the new one though after further negotiating with the manufacturing company so we will be offering the new peptide cream in the same 1 oz container at the same price as the old one, I just had to do some arm twisting. JG 5.1.09

• Can you use Retin A all around the eye area (upper and lower lids)? I am trying to address crows feet and sagging upper lids. Will applying Retin A in these areas help? Love your website!

  Answer:  it will help some, yes but it tends to be a little irritating as that skin is quite thin, thanks for the kind words too. JG 4.30.09

• Can you tell me what kind of results you have seen in patients who have used your peptide cream? I use Retin A cream and would you say i might benefit from using both. Thanks, love your web sight! By the way I am 44 years old if that makes a difference.

  Answer:  in general they are very pleased, we now have the newer formulation with liposomes to increase delivery, thye feel the skin feels and looks smoother without the irritation and sun sensitivity experienced with Retin-A. I have some people that use both, applying the Retin-A first and then the peptide cream in an attempt to get better penetration of the peptide cream but it is for the most part not necessary to do that. JG 4.30.09

• Hi Doctor, I had a spot on my lip checked out and my doctor said it was a mole, is there a fade cream for this. Lipstick will cover it but not for long. Thanks

  Answer:  not likely to work well, but if you were going to try it, it is called hydroquinone, it is a prescription. JG 4.30.09

• What is the percentage of DMAE in your face cream and what is the quantity in the jar (it`s not noted in the shopping area).

  Answer:  5%, 1 ounce.JG 4.30.09

• I started dabbing retin-a creme under my eye on Monday night. I woke up this morning and the skin under my eye looks terrible...seems like it is more saggy then usual and the wrinkling is more noticeable. Why is this? I use the gel on the rest of my face. Should I just use the gel under there too.

  Answer:  it is due to the skin being thin and the effects of Retin-A come from skin irritation, that is normal and will get better with time and continued use, You can use a moisturizer over if if you wait 10-15 minutes first. JG 4.30.09

• what is the best otc peptide cream to help a 27 year old just to tighten a bit, but more preventive?

  Answer:  the one sold on my shopping cart. JG 4.30.09

• HI DR. GARCIA, I HEARD THAT THEY ARE GOING TO COME OUT WITH A RUB ON BOTOX CREME, HAVE YOU ANY INFORMATION IF THIS IS TRUE? THANK YOU!

  Answer:  well, the thing is if it does work, it will be a drug so it will be years, there are lots of OTC creams out there that make those claims but the science behind it is scarce and if it were true it would be classified as an unapproved drug and taken off the market. JG 4.29.09

• PS--what kind of results have you seen in your patients who are using your peptide cream? Thanks again.

  Answer:  in general they have been very happy, and an even better response from the new formulation. JG 4.29.09

• Hi Dr Garcia, it`s me again w/ the questions about the peptides (Palmitoyl Tripeptide-5, palmitoyl pentapeptide-3). You say the research is sketchy. Is this because research about peptides in general is sketcy, or just those peptides? As for your peptide cream on your shopping cart, is there established research for the peptides you use? Or perhaps peptides are too `new` in general to really know? Thanks for your time.

  Answer:  those peptides, but there are so many new peptides that are being developed that the amount of research and the years of experience with them is short. The peptides I have placed have some research, yes, it is short lived, but we have been having good response with our cream, I am constantly tweaking the formula is the issue, so what we sell now is I feel differnt yet likely better than the older one, the product is in constant evolution. JG 4.29.09

• Hi Doctor, About 4 months ago, I got a little too happy on 10% Benzoyl Peroxide gel and also face wash. Since I have olive skin, my nose got slightly discolored. It`s hard to notice, but in certain areas, the skin is slightly darker and you can see clean jagged lines where the darker skin and lighter skin is. It`s weird. Anyways, I still use the 10% BP but quit the salicylic acid and face wash. The discoloration is still there. Again, hardly noticeable. My question is, if I lower the BP to maybe benzaclin strength (5%), will this stuff eventually fade? It`s been a few months already through winter. Or do I need to completely quit the BP. Either way, do you think it`s permanent? I can`t explain the jagged lines though where the skin gets lighter. Can you??? Is it just stripped skin? It never did burn.

  Answer:  it might, might also need a bleaching cream like hydroquinone to help fade it and you also should be using sunblock too. Should not be permanent though. It is reactive hyperpigmentation from the irritation, it does not have to burn to cause that. JG 4.29.09

• Good morning Dr Garcia, Which is the better peptide? Palmitoyl pentapeptide-4 (Matrixyl), or Palmitoyl Tripeptide-5? Thanks for your generosity in sharing your advise/opinions with us. And by the way.....LOVE the ALA/DMAE cream.

  Answer:  there is no definitive answer for that question I am afraid, they are both heavily promoted and ther is a small amount of study of each, but I cannot say one is any better than the other, sorry. Glad you like my little cream too. JG 4.29.09

• what is Nouri-cell tns recovery skin care?

  Answer:  TNS skin care is a long standing skin care company that has a new made-up name of Nouri-cell MD that is claimed to be a group of growth factors, but they have no studies on it and do not disclose the ingredients. Kinerase has growth factors and it is a good cream, but it is hard to say about Nouri-cell at present. JG 4.28.09

• Hi Dr Garcia, Thanks for responding to my follow up. If the pinkish area of capillary redness on my nose does end up resolving on its own, how long could this entire process take? 5 or 6 months? longer? Also, do you perform any laser yag or v-beam procedures? I will be in vegas quite a bit over the next several months.

  Answer:  could take up to one year. We do perform YAG laser treatments. JG 4.28.09

• Hello Dr. Garcia. Can I use you neuropeptide cream under my eyes and crows feet area after having botox? Thanks.

  Answer:  yes, OK to do so. JG 4.28.09

• Hello Dr. Garcia. Can I use virgin coconut oil as a facial moisturizer or is it too oily? Thanks and God Bless.

  Answer:  everyone responds differently, you can try it and see. JG 4.28.09

• DO U NEED A SCRPIT TO GET TRILUMA?

  Answer:  yes, all topicals that will help lighten it will require a prescription, anything less than that will likely not work at all. JG 4.27.09

• WHAT IS THE BEST CREAM TO LIGHTEN A BIG BIRTH MARK ON MY LEG? hYDROQOTIQUIN?

  Answer:  probabaly TriLuma which is a retinol and hydroquinone mixed together, but topical lightening creams do not have a dramatic effect on birthmarks, YAG laser might be more effective. JG 4.27.09

• Hello again, I`m trying to get a general idea of the difference between a punch Incision and Excision as I`m confused as to which is better. I`m not sure if I have the right term when I say punch incision so please correct me if I`m wrong. I heard an Punch Incision is a small cut in the middle of the scar which is then lifted to even with the surrounding skin. The extra skin is then removed in the center of the scar and stitched closed. Is this true and do yourself perform this type of procedure? Thanks.

  Answer:  a punch excision is where a round punch cut is made and sutured closed, if a float is done, then the center of the punch is not removed but pulled up flush to the surface of the surrounding skin and then sutured in place. If the scar is small then an excision is best, if it is wider, then a float is better. We do perform that type of surgery, yes. JG 4.27.09

• Do I still need to use my regular moisturazer and a night cream on a peptide cream? Will I need a sunblock. Thank you very much, dear Dr.G.

  Answer:  no, the peptide is enough of a moisturizer. Still need sunblock though. JG 4.27.09

• Dr.Garcia, how to use neuropeptide cream: 1 or 2 times a day? Can I use it under the eyes and then use eye booster cream for more benefits. Do I need to use moisturiser and night cream over it, and how long to wait between aplications. Thanks.

  Answer:  the more the skin damage, the more you should use it, so if mild at night alone, if worse, then twice daily. The eye booster will not be needed if you are using the peptide there already. JG 4.27.09

• Hi Dr Garcia, I asked you a question last month about a pink area on the tip of my nose with some faint, deeper looking capillaries that formed after being in a very cold wind (coupled with the fact that it was sensitive already from some peeling from using Salycilc acid and BP 10%). Another practicioner, a PA-C, zapped the spot with a gentle yag and made it worse if anything, although I think it has settled a bit since then. Anyways, you said it was a likely a vascular effect that may heal itself with time (as did another dermatologist) and not to do anything to it. I was concerned that the Gentle Yag zap may have burned the lesion in or something and would keep it from healing itself now. Though it kind of looks the same. Does that make sense? Or is that not how the laser works? Can it still heal itself over the next few months even though it was zapped with the gentle yag? I may have asked a similar question last month but I`m still trying to figure it out. I would hate to think that I destroyed my chance to let it heal itself because it was zapped with the gentle yag. Thanks for the advice.

  Answer:  the lasers work by irritating the veins so they clot, that is the normal response. It can still heal and will heal more over time. Laser treatments commonly make it look worse in the short term though, and it usually requires a series, not a single treatment. JG 4.27.09

• Dear Dr.Garcia, can I use your neuropeptide cream and DMAE eye booster after I had filler injections and I have a lot of bruising and marks from needles all over my face and under eyes. May be I need to wait? Thanks.

  Answer:  yes, they can be used on toop of the filler, no problem there. The bruising will not be affected for better or worse with my creams. JG 4.26.09

• Hey there I am getting a bit depressed, I was the one that wrote and had 4 small moles removed by radio frequency cost me $250 dollars it has bee two weeks` now since the scabs have come off but they are all still raised not heaps as they weren`t massive before but still are red is this normal? I am starting to think should have left them alone I am not going to be left with a red mark there ah it should fade they said 4 to 6 weeks what do you reckon

  Answer:  the redness is normal, as to how flat they are, there might still be some swelling present. You might need further treatments though. JG 4.26.09

• Dr. Garcia, what can a liquid facial wash containing lactoserum with pH 3,5 do to our face skin, if we use it everyday?

  Answer:  since a facial wash is on your face for so short of a period of time its long lasting effects are almost none, but it will irritate your skin more than one closer to your normal skin pH. JG 4.25.09

• what is a better filler radiesse or sculptra and which is tolerated better cna either one be used all over the face? mkj 4/24

  Answer:  they are meant to be injected for different things so I think in many cases you can use them both, they are not interchangebale as some docotrs promote. Sculptra is for deeper tissue loss and Radiesse is for more superficial injections. JG 4.25.09

• Hi Doctor, Could the ND:Yag laser be effective in the removal of nasal telangiectasias?

  Answer:  yes, in many caases it can. JG 4.25.09

• Hi Doctor, I forgot to mention in my last post which you graciously responded to about the vbeam on my olive skin. My skin type is Type III in color. Thanks!

  Answer:  just pretreat before and use sunblock after and you should be OK with the setting suggested. JG 4.24.09

• Hello Dr.Garcia, I noticed you say punch techniques are a better way to go for acne scarring rather than lasers. However, it seems to be much tougher to find physicians who do these procedures. Do you yourself do them or can you recommend anyone in Nevada who does? Thanks.

  Answer:  I do perfrom punch excisions and in many cases will laser the skin after that, rarely does punch alone take care of the problem. JG 4.24.09

• Hi Doctor, Another quick follow up question. I am a little paranoid. I have very clear medium-to-lighter-medium indian/middle eastern skin tone. A small area of red capillaries visible on the tip of my nose that looks like a circle/spot. Derm said he can use vbeam-595 pulsed dye on non bruise mode to be conservative. Do you think in this case, there is still a high risk for post treatment hyperpigmentation? What is your opinion of this approach? Would you do something different? Thanks so much.

  Answer:  I think it would be low risk, just pretreat with some hydroquinone for two weeks before if you desire. JG 4.24.09

• Dr. Garcia, to prevent fine lines, darkcircle and puffiness around eye area, what ingredients in an eye cream that i should look for? I dont want to use tretinoin / retinoid cause its too strong for my under eye area, and my goal is to prevent that. I use sunblock in the morning under eye area, and i am looking for something to put on at night under eye area. What ingredients should i look for?

  Answer:  there is no single cream that will treat all of your concerns, we have a cream that helps reduce the dark circles and another one for the fine lines without Retin-A but for the puffiness, there is not much that is very effective. The creams are on the shopping cart of this website. JG 4.23.09

• Hi Doctor, A follow up to a previous question. I have olive skin. If the doctor uses the pulsed dye laser (perfecta 595) in NON-BRUISE mode, would it decrease the risk of hyperpigmentation?

  Answer:  likley, yes. JG 4.23.09

• Hello, I have lines directly under my eyes on the inner corner of the lower eyelid. These are not due to age because they have always been there. What are these and is a dermal filler safe to correct those? Are there any creams that will actually help fill them in? Thank you.

  Answer:  they are from the skin folding when the eye blinks or closes, fillers there can look lumpy and creams such as Retin-A will likely help some, yes. JG 4.23.09

• What is your opinion on applying vitamin e oil in eye skin area to prevent fine lines? is it a good thing or you prefer an eye cream instead?

  Answer:  likely too oily for that, better to use a cream with Vitmain E in it if you want to use that, but the prevention of fine liens with Vitamin E is is small at best. JG 4.23.09

• Dr. Garcia, which one you prefer for washing face, liquid face wash with pH 5,5 or liquid face wash with pH 3,5 containing lactic acid?

  Answer:  5.5 pH. JG 4.23.09

• What treatments do you recommend to remove sun damaged pre-cancerous, actinic keratoses. Any lasers or Photodynamic Therapy? AK are basically all over my body (back, legs, arms neck, etc) I have many so I am concerned about the treatment used so that I have no scars.Unfortunately, I was a sun worshipper & now regret it!!Thanks Doc!

  Answer:  topical Efudex cream, I think you should see a dermatologist though first to make sure none need a biopsy before you start. JG 4.22.09

• I have a sun burst scar on my the top of my foot. About a quarter size. I got the scar from an accident in 9/2005. The scar never faded & is pink/red & very noticeable. Is there any way to improve color to make it more like the color on my foot. I used mederma & did not work... Please help.

  Answer:  maybe a YAG laser or VBeam laser will help fade the redness. Best of luck. JG 4.22.09

• exactly how many days do you need to be off tazorac before attempting to concieve? Also how do u know what face creams, washes, acne creams, etc to use while trying to or becoming pregnant? Any website u know of that may help with all that?

  Answer:  I would say at least two weeks and then you cannot restart until the breast feeding is over. There have not been, not will there ever be any studies done on pregnant females and skin creams so the rule of thumb is anything with Retin-A, retinols, retinaldehydes or things like Retin-A should certainly be avoided, all other irritants like alpha hydroxy glycolic aicds, no one knows. JG 4.22.09

• Hi Doctor, What is your opinion of the safety of using vbeam pulsed dye 595 for an area of capillaries on my nose. I have light/medium olive skin (mixed blood/indian-middle eastern). My concern is permanent hyperpigmentation. Doctor said we can take it conservatively and do a few light zaps rather than one strong bruise. Thank you

  Answer:  pretreat with hydroquinone for 2-4 weeks before and again after and it should decrease the risk of hyperpigmentation. JG 4.22.09

• there is a product just out (from reputable company) that claims it can now boost genes` activity and stimulate the production of youth proteins. Is this possable? Thank you for your time

  Answer:  not sure what prodcut they are referring to in order for me to say. I think there are many things that can be taken orally or topically that can induce some changes. JG 4.22.09

• My dermatologist said that dairy products have the male hormone in them, which can cause acne. I was wondering if you know if soy milk has that hormone in it? I was thinking of switching to soy. Thanks

  Answer:  soy will not have hormones, but I think what thay are telling you is not true, think about it, male cows might have testosterone, but they are called bulls and do not produce milk. Female cows are the ones that produce milk and giving them male hormones would stop their ability to produce milk as you need female hormones of pregnancy to produce milk and not male hormones, not what a dairy farmer wants to do. JG 4.21.09

• I have a lot of redness and some viens in my face and my dermatologist said that if i am not careful i could develope rosacea. He said products with alcohol can irritate it. I have been looking for face washes and products without alcohol and i am having a hard time finding any good face washes or face products. Can you recommend any? I also have a tendency to breakout. i am using cetaphil face wash and retin A and i am on Bactrim DS. I noticed cetaphil face wash has alcohol in it. I am just wondering if there is a better one to use and if the other medications i am on could cause more problems. I really dont want to develope rosacea. Thanks

  Answer:  maybe baby products.The Retin-A will aggravate the redness and veins quite a bit, could consider some IPL laser treatments to control it too. JG 4.21.09

• Dear Dr.Garcia, what brand of tanning lotion you`ll recomend? Thanks.

  Answer:  the honest truth is I do not, I do not advise tanning, sorry. As to self tanners, I have seen nice results with Clairins. JG 4.21.09

• Dr.Garcia, is it save to use a tanning lotion, or any other way to get sun tan without being on a sun? Thanks.

  Answer:  self tanners are safer than a real sun tan, just remember to wear your sunblock on top of it. JG 4.21.09

• Hello Dr, I have recently noticed that I am losing a facial fat from the side of my nose leading into my cheek which appears like a dent when I smile. Could this be from a Thermage treatment I had which was over a year ago now as this has only started to be noticeable in the past month? Thanks

  Answer:  it could be, it can also be part of the normal aging process. Usually Thermage fat loss starts to show in the first few months though, not this late. JG 4.21.09

• I have had melasma for about 2 years. Basically, I have white circles around my eyes, as if I fell asleep in the sun w/ sunglasses on. I have tried Retin-A, Hydroquinone, lycopene, I wear sunblock. Would oral supplementation of melatonin help?

  Answer:  sorry, but it will not help your scenario. JG 4.21.09

• Hello, With all the hype, I just have to ask, what is the best skin firming cream for the body?(if any?) Thank you.

  Answer:  as you would expect, no skin cream firms body skin, if the skin is damaged from a recent sun exposure, it might help hydrate is about all you are going to get. JG 4.20.09

• Dr i have just bought a cream on guerlain.intensive serum guerlain i want to know it is a good cream? Please suggest thks

  Answer:  cannot say as I cannot find out what the ingredients are. JG 4.20.09

• Dr. Garcia. I am a medium skin tone African American and I shave my head bald regularly. I shaved my head on Friday with a hair clipper I have been using since late 2006 and it left 3 small scabs on the back of my head. Will this leave temporary or permanent marks on the back of my head after the healing process of the scabs?

  Answer:  usually the scalp heals well and the residual should be almost imperceptible. JG 4.20.09

• Is 5% dmae the highest concentration that works well, or is the cream 5% for safety reasons? I ask because I wondered if adding a little dmae bitarate powder to the cream would be okay.

  Answer:  not sure you can get more of it to dissolve evenly in the cream and more is not necessarilly better. JG 4.18.09

• will levulen light treatment help necks or just face and chest? Is there alot of downtime, can you be in the sun?

  Answer:  I am sorry but I do not recommend Levulan for the treatment of wrinkles, it is an attempt to take two products to improve skin texutre but it removes all of the safety margins that each product has and nas never been approved by the FDA for that application. JG 4.18.09

• what is the best filler for around and under eyes not botox and what would be side effects under eyes if any thanks mkj

  Answer:  I normally use Restylane. The potential side efects would be short term bruising and lumps if too much is deposited. JG 4.18.09

• Have you heard of ANTARCTICINE, a`survival` molecule – or a good bacteria – helps to restore the breakdown of your skin`s collagen and elastin? True or Nonscence? Thank You

  Answer:  I have no personal experience of a patient that has used it, sorry. JG 4.18.09

• Hi Dr. Pierce. I`m at the end of my rope here. I`m 45 asian male and have these dark brown blotches around my cheek. I tried Hydroquinone 4% and TriLuma......all no effect. So recently I tried IPL or Laser (not sure) but it made a clicking/stinging feeling and then the spots turned really dark, like a scab which peeled off after a week. Wow, I was so happy, for one week only though, cuz in one week it came back. Now I ordered some Obagi Serum 20% and used it for a week and a half now, spots still there. The person doing the IPL said they`d help me do it again in a month. Dr. I`m about ready to use clorox bleach if I have to cuz these spots are terrible looking. Any advice? Should I still use the Obagi?

  Answer:  I think pre and post IPL or YAG laser treatments will help and the laser treatment will never work after one session, it is a series, so be prepared. JG 4.16.09

• I have some pinkness with a dark border left over from a scab on the side of my face. How long before the color blends in? should I use something to speed it up?

  Answer:  sunblock, can also use Mederma or ScarGuard, but it can take up to one year to fade to its maximum. JG 4.16.09

• Hi Dr. Thank you for answering my previous question. To increase elasticity, you recommended that I cut out prevage and Relastin Emolliant and use the Retin A twice a day. Three questions 1. I use the prevage to protect against free radicals, if I cut out the prevage what product should I use to protect against free radicals during the day? And If I opt not to cut it out, can I use the retin-a under the prevage? 2. If I cut out the Relastin at night, I still need a mosturizer because the Retin-a drys my skin, what do you reccommend? 3. Lastly, what do you suggest I use during the annual 3 month break from Retin-A? And why is it important to take a break from using it? Thank you. sorry about all the Questions

  Answer:  I think the evidence for the effectiveness of Prevage is very slim, I suggest maybe a Vit C serum along with sunblock of course. You can use the Retin-A under the Prevage, yes. As to a moisturizer, if you can avoid it at night so as to not dilute the Retin-A effects, that would be best, I do not think Relastin is any better than many less expensive ones, so that is why I said that, Oil of Olay or others are just as good for less money. I suggest the three month break from the Retin-A because there is evidence out therre that continued skin irritation can lead to accleration but not cause of superficial skin cancers. JG 4.16.09

• Hi Dr. Garcia--I had an additional question. I`m, almost 28 Currently, I use retin-a .05% at w/ Relastin Ultra Emolliant for firming at night. Daytime, I use Prevage and sunscreen. Relastin claims that based on scientific studies it increases skin elasticity, but I wanted confirmation from you. So here`s my question, I want to increase skin elasticity what products/ procedures/ regimes should I use or cut out of my regimen in order to increase skin elasticity? Thank you.

  Answer:  skip the Relastin and Prevage and use the Retin-A twice daily. JG 4.16.09

• Hi Dr. I was wondering what, if anything, do you know about Nia24 products and thier effectiveness? Thank you

  Answer:  I have not been impressed with the results in people who have used it. JG 4.15.09

• What is the difference between your DMAE and neuropeptide cream? How many ounces in the DMAE jar? Which would work better on my slightly (so far...) sagging neck? Would you be able to say how much DMAE is in your product? Thanks so much for answering my questions.

  Answer:  they are different produucts, the peptide is for more mature skin, they are both in a 1 oz container. Neither will fix sagging skin though, no cream will do that honestly. Our DMAE is 5%. JG 4.14.09

• Hi Doctor, I have a dark spot on my lip that is a mole or a frekle. Is there a fade cream i can use to make it go away. i have had it 8 months now.

  Answer:  I think it best to get it checked out by a dermatologist to make sure it is not something that needs a biopsy. JG 4.14.09

• is there an over the counter cream for ance i can use while trying to get pregnanat and then discontinue when i do that wont cause and damage like the tazorac? i want a babay but if i leave my skin without help i will for surely breakout, i am very oily still at 28.

  Answer:  well, I will be honest, there have not been any studies I am aware of that have been done on pregnant females, so I cannot say 100% for sure. JG 4.13.09

• Sorry meant to say they sort of look raised still.

  Answer:  I figured.

• Hi there again I had four moles removed by the shave method as they were raised but small. Its the tenth day and all the scabs have come off and I obviusly have a red mark that hopefull over time will fade she said 4 to 6 weeks. Could you tell me though they sort Will this flatten in time or do you think she hasn`t shaved done far enough? Thanks so much.

  Answer:  too early to tell, btu most likely you stil have lots of swelling and they wil get flatter than they are at present, hang in there. JG 4.13.09

• Hello Dr Garcia and Happy Easter! This is a question for my mother. Unfortunately she has to take oral steroids permanently for an ongoing collitis condition. This unfortunately means her skin is very thin. Is there any creams you recommend to help thicken the skin whilst on this medication or any vitamins which would help? Thanks

  Answer:  Retin-A will be the most effective, best of luck. JG 4.13.09

• Dear Dr Pierce, i have just bought a cream in Guerlain :orchidee imperial white - serum and i must say its quite expensive. could you tell me more about the cream: its it a good cream for brown spot etc.... thank you

  Answer:  hard to find out what the ingredietns are but prescription hydroquinoen is likely much stronger and more effective for a fraction of the price. 4.13.09

• Hi Dr Garcia, Would using a 5% BHA serum 2-4 times per week be as effective as using a 2% BHA serum daily to decongest pores?

  Answer:  might be, only trial and error will tell. JG 4.12.09

• Is it true that if my facial product contains too much hyaluronic acid that the other active ingredients of the product will not be absorbed into my skin? If so, how much hyaluronic acid is too much? Thanks for your help.

  Answer:  I personally feel that hyaluronic acids in topical creams does not work, it is not absorbed through the skin and they are just trying to capitalize on the hyaluronic acid fillers effects and trying to let pateints think it works the same way. JG 4.12.09

• have u heard of resVpro? any comments?

  Answer:  likely not enough in there to see a result. JG 4.12.09

• while trying to pregnant what creams can u use for antiaging and acne?

  Answer:  not things like Retin-A or retinols for safety. JG 4.12.09

• ok, so since they recomend i dont carry out this pregnancy because of tazorac use, i wana try again, o is differen or becycline category x as well. I scar easily so micro`s wont work??? im desperate, i want a baby but dont want to breakout like i do either?

  Answer:  there are no studies documenting the safety of any of those drugs while pregnant, but I will say that usually acne gets better while pregnant as the hormones help settle it down. JG 4.10.09

• if tazorac is so dangerous to a baby how can it be any safer for us???? what would it do to a fetus that makes it so dangerous?

  Answer:  the danger is in the tissues in the fetus that are developing and are much more susceptible to things than adults are. JG 4.10.09

• Hi. I was just wondering what you think of the proactive products? thanks

  Answer:  in general, pretty goods products. JG 4.10.09

• i have been using tretinoin cream 0.05% and melquin hp 4% cream for the past month and have not experienced any peeling at all. Ive heard that i would have flaky skin and redness but none of these side effects are happening. I do, however, use a exfoliating cream 2 a week plus a mud mask and I do a light exfoliation every day. Do you think the tretinoin cream is not strong enough. Should I continue using all of this and I also, want to start monthly microdermabrasion. By the way I am 62 years old.

  Answer:  you can try increasing the Retin-A to a stronger strength, 0.1% and see, but peeling is not needed to get the benefits. JG 4.9.09

• OK, I got that, but what about if u used it w/o knowing u were pregnant,? What are the chances you did some damage, before you go ahead and have it? they just said its a category x and u have no choise?.....

  Answer:  there is no way to tell if it did anything bad. JG 4.9.09

• using tazorac for about a yr and found I was one month pregnant. my ob advised me to have an abortion because i used it for 3 weeks while, i was. is this true??? I just read women have used it while pregnant and never knew? do u have any advice? also is there something u can use to control acne incase i try again to get pregnant????

  Answer:  well, it has never been studied so no one can say for sure. I think Retin-A and Tazorac should be avoided while trying to get pregnant and stick with microdermabrasions while pregnant. JG 4.9.09

• Hi Dr Garcia, I have been using a 2% salicylic acid treatment every night and it has cleaned my pores and smoothed my skin very well. A clinician at the PCA skin center tells me I could come to thier clinic for weekly treatments(20% salicylic acid treatment) instead of applying 2% home product daily. For concenience, I would much prefer the stronger weekly option, but only if it is likely to produce the same/better benefit as the weaker daily option. What do you recommendation?

  Answer:  the 20% might be too irritating and will likely give you some donwtime to heal. JG 4.9.09

• Thanks Dr. Garcia for that answer. So what kind of time frame would I be looking at for it to heal? RE: Dear Dr. Garcia. I have a serious question. I am a medium skin tone African American and I have had acne for some time now that has left brown spots on my face. I had a 10% tca peel March 23 at the doctor`s office and now it has made my skin a little bit smoother but has lightened my skin around the corners by my nose drastically. Is this permanent and what do i do to reverse these changes? Answer: it is temporary and with a little time and sun it will all come back. JG 4.7.09

  Answer:  well, it is healed now, it just needs to repigment, that time will vary depending on your skin and the amount of sun exposure, no way to tell. JG 4.9.09

• Dear Dr. Garcia. Is there anything or any product which will take away or improve old white stretch marks? How about different lasers or a cream called strivectin which is suppose to improve stretch marks? Have you heard about that cream? What is youre opinion about that cream? Thank you

  Answer:  sorry, but not that I have seen be effective. I think Strivectin at present is no better than many other creams out there and is more expensive than their competition. JG 4.9.09

• you cant use tazorac while pregnant either right? what can i use to control my acne then?

  Answer:  it has not been studied so I would avoid it for fear of damage to the baby. I think you can use micordermabrasions and likely light glycolic acid washes. JG 4.7.09

• Sorry one more thing is it better to keep them moist or let dry a bit have been told to use foban cream twice a day and don``t need to be covered now?

  Answer:  if you are using the cream just leave them open to air. JG 4.7.09

• Hi there I have just had bout 4 little mole removed raised ones with radiofrequency. I have been using a antiobotic cream twice a day and have been told to use for a couple more then scabs normally start coming off on about the 10th day. My concern is that the one one my cheek looks darker than before but don`t know if that is because it is still forming a scab and that one bleed a bit more and the two by my cheeck look a bit raised still but don`t know if that is just the scab. What do yo think? Also do you reckon I could use conceler over the top now it will be 6 days tommorow. Thanks lots of quetions I know

  Answer:  not uncommon from the bleeding and the scabbing, just continue doing as you are for now. I would not use the concealer until the scabs are off. JG 4.7.09

• No question this time....just wanted to say that I`ve been using your neuropeptide cream and I really like it. My skin looks great. Got anything new in the works?

  Answer:  as a matter of fact, yes, we are going through the trials as we speak, stay tuned. JG 4.7.09

• Dear Dr. Garcia. I have a serious question. I am a medium skin tone African American and I have had acne for some time now that has left brown spots on my face. I had a 10% tca peel March 23 at the doctor`s office and now it has made my skin a little bit smoother but has lightened my skin around the corners by my nose drastically. Is this permanent and what do i do to reverse these changes?

  Answer:  it is temporary and with a little time and sun it will all come back. JG 4.7.09

• What is the difference between the MedLite laser & the IPL? Which is safer & most effective for Asian skin; to remove freckles & age spots on the face? After treatment with the MedLite does it scab over like the IPL? The IPL doesn’t seem to do much for wrinkles & collagen improvement is the Medlite better for that? Thanks for any other information you can give me!

  Answer:  Medlite is a true YAG laser while IL is a light amplification device, like a weak laser. I think IPL is safer and at the same time not as effective, but understand that Asian skin is risky with both as to be effective it takes higher energy which can cause dark spots to appear, and no matter what you use, there will never be complete removal and it is temporary. Neither one should normally scab although it does happen at times. Medlite will also not do much for wrinkles. JG 4.7.09

• Dr.Garcia, you recomend emu oil. What it does? Thanks.

  Answer:  good moisturizer that is similar in fatty acid make up to the fats in normal skin. Some people report it helping in acne control. JG 4.6.09

• When looking for a good vitamin E serum/cream. What percentage of vitamin E does it need to contain to be effective? The one I am looking at contains d-alpha tocopherol. Thanks!

  Answer:  no set amount, it is fat soluble so it is easy to be absorbed. JG 4.6.09

• Dr Garcia, I wear my antioxidant serum at night while sleeping. Is it better to wear it in the day time while actually exposed to sun/environment? Or does it make a difference? Thanks.

  Answer:  better at night. JG 4.6.09

• I have deep red pigmentation under my eyes (tear trough) that is not from bags or allergies. I had two IPL sessions and there is a definite improvement, although some pigmentation remains. Since the IPL had an affect, does that suggest that the pigmentation is caused by leaky blood vessels? If so, would your dark circle cream be of any benefit for me? Thanks!

  Answer:  our dark circle cream is mostly for brown and blue, not red, sorry. JG 4.6.09

• Dr.G, about retin-A, please, tell me how to take it and what dose? You`re the best. Thanks.

  Answer:  need to start low and work yoru way up once tolerating it, I suggest 0.05% at night and then increase dosing and strength to 0.1% over time. JG 4.6.09

• Dr.Garcia, you recomend retin A and peptide cream for neck. It can be used for the face as well? And where can I buy this cream, what brand is it? Do you sell it? Thanks.

  Answer:  the Retin-A is prsecription and we sell our peptide cream on our shopping cart. JG 4.5.09

• Hi Doctor Garcia, There is a small area on the tip of my nose that became very red in the cold about 7 weeks ago and then faded into a light pinkish spot over the course of a few weeks. If I look closely, there seem to be three or so pore sized reddish/pink dots with very very faint and deeper branching .. from a normal distance, it just looks like a soft pinkish area. It won`t go away. What could this be? I have medium olive skin (indian/persian). Also, could you suggest a possible treatment? Thanks so much.

  Answer:  broken capillaries, could try IPL or a YAG laser to control it. JG 4.4.09

• have u heard of Pre Fill HA skin firmer? Also what do u think of Chanels firming Ultra Correction?

  Answer:  sorry but no personal or patient experience with either one. JG 4.2.09

• retin a for firmimg, does that include tazorac?

  Answer:  potentially yes but it has not been studied as extensively as Retin-A for that. JG 4.2.09

• Dear Dr. Garcia, Does emu oil serve well as a nightly moisturizer? Also for the under eye area? I use it and by the a.m. time it is not at all present on my skin.

  Answer:  some people swear by it. It is easily absorbed and a good moisturizer should be absorbed, not just sit on your skin to be felt. JG 4.2.09

• what is the BEST FIRMING cream you can reccommed. A cream that will help at all?

  Answer:  Retin-A. JG 4.1.09

• Hi Doctor hope you are well. You seem to not like the candela gentle yag much for redness/capillaries. But from what I read about it, that`s one of the things its made for. Do you just think its ineffective?

  Answer:  I think for broken capillaries it is OK, I just feel that for most people, it will not tighten skin, which is also what it is marketed for. JG 4.1.09

• Hi Dr, I find the Obagi range a bit confusing. Which range (Nuderm or Proderm) would be the best for a 42 year old with fair skin and fine wrinkles and which of these products are essential. Thanks

  Answer:  just use the Retin-a and either of the cleansers, is all you need for that. JG 4.1.09

• Dear Doc....PLZ tell me whgat you found most sucessful treatment for enlarge pores besides laser and Chem-peel because I am skin 5 and have enlarge pores on nose and cheeks.I have miro dermabrasson crystals.Does daily exfoliation HELP? Any products,mask OR treatment you suggest most effective.How to treat my skin on daily basis??PLZ HELP.

  Answer:  exfoliation does help, Retin-A should help also. JG 4.1.09

• IS THERE ANYTHING I CAN USE THATS LIKE BOTOX FOR BETWEEN BROW? I HAVE A LITTLE LINE AND IM ONLY 27 AND AM AFRAID OF BOTOX. ANY SUGGESTIONS?

  Answer:  you can inject a filler if the line is there at rest, otherwise, not much. JG 3.31.09

• yes i know both prevage and cindy;s cream are not as strong as tazorac, I am just confused about what is a good night cream just to help mortutieze and hope that it is giving that little extra for anto aging...any suggesstions. I am addicted to beauty products but cant seem to fond the best night cream to use that will help in the lng run....

  Answer:  just use Oil of Olay, and I think they are good products that are less expensive. JG 3.31.09

• Hi Doc, You suggested I use copper peptide, neo cutis is what u use in your office. I cannot find it on line only neova nite therapy with CP repair. Is that o.k.? Thanks Again, JR

  Answer:  OK to use, NeoCutis is only sold in doctor`s offices, and you need to see the doctor in person to purchase it. JG 3.31.09

• Hello Dr. Garcia, Why does hair have to be shaved before laser hair removal?? Should this be done day of or a day or two before?? Thanks so much!!!

  Answer:  I suggest leaving a smal amount of stubble, not too much as you want the shaft to acccept the energy, the day before should be enough. JG 3.31.09

• my doctor wants to perlane on my cheek area os that a good product or will it give me lumpy chipmunk look? Is there a better product for that area and would it be better to inject more on the sides toward hair line rather than in cheeks just to get a lift is that apossibility?

  Answer:  if injected deeply it should not cause lumps but it might take quite a bit to fill and lift the area. JG 3.31.09

• HAVE U EVER HEARD OF PEPTO BISMAL AS A PEEL MASK? ANY COMMENTS???

  Answer:  no, I have not, cannot say what it could do than any other mask cannot though. JG 3.31.09

• HI, I SUE THE STRONG TAZORAC CREAM AT NIGHT TO HELP KEEP SKIN CLEAR AND HOPEFUULLY FIRMING. i WOULD LIKE TO PUT A NIGHT CREAM OVER THAT BUT WOULD i LOOSE THE EFFECTINESS OF TAZORAC. ALSO OUT OF THE 2 WHICJ I KNOW U ARE NOT FOND OF WOULD U USE PREVAGE NIGHT CREAM OR CINDY CRAWFORDS NIGHT CREAM?

  Answer:  wait tne minutes and then the Tazorac should have absorbed enough the other cream should not dilute its effects. As to Prevage or Cindy Crawford, I would not use either to be honest, and both are weaker than the Tazorac.JG 3.31.09

• Hi Doc, Thanks for being u, and for helping out.I had genesis done on my face, so I asked my dr. if she could remove the broken vessels I had on the sides of my nose, and she replied yes, but used the same instrument she had done the genesis with which I thought was too wide for the sides of my nose. Well, on one side of the nose I developed a sore which scabbed, and when it fell off, I have 2 small, but noticable indentations there,almost look like holes. I brought this to her attention and she told me to use retin-a for a while, and that it should help it heal. Can you recommend anything else that could help me? Would really appreciate your input. Much Appreciated!! JR

  Answer:  might suggest some copper peptide cream, we use NeoCutis, best of luck. JG 3.30.09

• Hi Dr Garcia! I just read an article saying that micro current/muscle stimulating facials are essential after having botox to keep the muscles stimulated as when the botox wears off, you will not be left with weak muscles and thus a sagging face. Surely, these types of facials would speed up the rate in which the botox wears off as it is encouraging the muscles to move and on the contrary should be avoided? What is your opinion Dr? Thanks

  Answer:  I do not recommned the, muscle atrophy is minimal and if it does occur it then makes the future Botox injections last longer, I do not think the micro-current machines are worth it, they cause muscle flexion which is what you are trying to combat with Botox, they do produce a short period of swelling that makes things look better. JG 3.30.09

• I have a chance to participate in a test (no coast to me)for the NU SKIN and the GALVANIC II by Nuskin. I know you think it`s hype. but as it`s free I thought I`d try it. BUT do you think there is a chance it could harm my skin? I trust your judgement, thank you for your time

  Answer:  I do not think it will harm it. JG 3.27.09

• Then is it ok to use your Peptide cream with an ABA/BHA product? Will the acids break those peptides? And what about peptides like Matrixyl and Palmitoyl Tripeptide-5?

  Answer:  apply the AHA/BHA first, wait ten minutes, then the peptide, that will decrease the chance of inactivation. JG 3.26.09

• is there a product which actually lightens your skin I am caucasian with fairly light skin now M 3/26

  Answer:  only ones that remove sun damage. JG 3.26.09

• Dr Garcia, Is it true that when BHA/AHA products and peptide creams are both used, that the AHA/BHA breaks down and inactivates the peptides? Thanks for your advice.

  Answer:  it depends greatly on the peptide, the term peptide is used generically, but in truth, it is a term that encompasses many different potetential substances, some are fragile and can be damaged by the hydroxy acids, but some are much stronger and do not break down. Not all peptides are the same. JG 3.25.09

• Have you seen the new products containing nanosilver? The claim is it’s an anti-biotic. Will this work on moderate acne? Thank you for your time

  Answer:  I am not sure it will help, sorry. JG 3.25.09

• Dr Garcia, If my 2 % BHA product is a thin liquid, and my tretenoin is the thicker cream, is it ok to apply the BHA 1st, wait 10 minutes, then apply the tretenoin?

  Answer:  yes, best of luck. JG 3.24.09

• Dr peirce, I have used tretenoin cream .1% nightly x 7 months with nice improvement in lines/wrinkles. However, the surface of my skin is not as smooth as it was using 2% BHA. I read that tretenoin works at deeper layers of skin and BHA/AHA on the surface. If this is the case, is it ok to use 2%BHA (salycilic acid) simultaneously with tretenoin? Thanks for your advice.

  Answer:  you can, as long as you skin can tolerate it, yes. JG 3.24.09

• What is calcarea sulphurica? I have a friend who has begun to take this three times a day for acne. Should this work? Thank you

  Answer:  have not heard of it nor had any pateints try it. JG 3.24.09

• what is the difference between sunscreen and sunblock what would be a commonly used sunblock

  Answer:  sunblock blocks all of the sun, and sunscreen ony partially blocks it. Sunblock is better. JG 3.23.09

• can I use retin a three nights a week and still work (my job is outside) and I am also into many outdoor activities.Would neutrogena sunscreen be enough or will my skin always be ittitated? M 3/23

  Answer:  OK to use on that schedule as long as you wear sunblock and not sunscreen. The skin irritation from the Retin-A usually gets better after 4-6 weeks. JG 3.23.09

• can you use retin A 3 nights a week and still be out in the sun I live in florida would neutrogena 55 or 70 be ok?MKJ 3/22

  Answer:  as long as you use sunblock, yes. JG 3.22.09

• Hi doctor, which cosmetic brands is the best to use for sensitive skin: guerlain,clarin or clinic and why? if not, which creams would you suggest me to use. thanks

  Answer:  I am afraid that I cannot answer that as every person`s response is different. JG 3.22.09

• Hi Dr. Pierce, I`m a 31 year old, African American women with very fair skin. I`ve finally found a wonderful solution for clearing my acne... NO MAKEUP! However, I still have a dozen recent acne scars. I`m using a 3% over the counter hydroquinone cream with octisalate (3%) and although the spots don`t appear to be getting darker (they were brown), they look red, and irritated. Will this cream really help to fade my scars or should I try another treatment, or time? Is the redness a part of the fading process? Please let me know. Thanks!! I`m also using a face wash that contains 10% benzoyl peroxide, could it be irritating the fade cream?

  Answer:  the bleaching cream will help fade the brown but it can itself cause some redness, which normally goes away when you stop it, the cream will not fade redness. JG 3.22.09

• Hi I have a few pockmarks on my face as well as scarring that is indented in the skin. I am of Indian skin and was wondering if collagen induction therapy would work to help raise the pockmarks and fade away the scarring. I am interested in the Roll-CIT fine needle roller physicians use to roll over your skin. I am also wondering if the risk of post secondary hyperpigmentation the same as fraxel treatment. And are there are any other treatments to my skin colour without doing surgery or using lasers?

  Answer:  I have been very disapppointed by the results from those technologies, you will look better right after while swollen but the degree of long term improvement is almost non-existent. I think the risks of hyperpigmentation are small and I know of no new lasers that would be safe for darker skin. JG 316.09

• Hi Dr. Garcia. Is there a difference between Atralin and Differin? I`ve been using Atralin to improve facial skin tone, and pharmacy switched me to Differin cuz insurance no longer covered Atralin. Thanks!

  Answer:  well, to be truthful, the supposition is that Differin works like Retin-A did, but it has not been approved for facial wrinkles by the FDA like Retin-A was, but Atralin is essentially the same as Retin-A. I would use old-fashioned generic Retin-A and save your money. JG 316.09

• What can you tell me about Meg 21. I got a sample from my ps and it was quite nice but very expensive.

  Answer:  I have not had any patients that have tried it, but I am always doubtful when the company says that 100% of patients report dramatic improvements, the only thing 100% certain is death. JG 316.09

• i am miserable. does melasma ever go away? i use retain a and melanex and spf 60. i have had fraxel(made it better at first but then worse) and ipl (looks good at first) however as soon as i ski or even run outside for a second it comes back worse. is there anything new that i havent tried. i am afraid to even experiment with other things because i don`t want it to come back darker. what about cutting something out of my diet?

  Answer:  not entirely in most cases, and even if improved, will likely come back with sun exposure. You have been experiencing the usual issues of Melasma treatmetn, nothing out there that will be any better I am afraid. JG 316.09

• dear dc. thinking of using vaniqa for facial hair removal. Am i wasting money and time.

  Answer:  it does work, slowly, and will never remove all of the hair though. JG 3.15.09

• I think I read a post where you said that the neck cannot be treated as aggressively as the face..did I read that right? And what does that mean...this is in regards to wrinkling. Thanks so very much!

  Answer:  that applies to treatment options like lasers or chemical peels, the skin there cannot tolerate as intense of a treatment, therefore the results will never be as dramatic as one can see on the face. JG 3.15.09

• Have you heard of HTY Gold products? If so,what is your opinion of these products? Do they work! Thank you

  Answer:  I have heard of them but I have never had a pateint try them and report to me their repsonse, sorry. JG 3.15.09

• Dr. Garcia, After a year of horrific grief and stress, I am noticing effects on my face. I got off my renova and c&e ferullic acid regime for eight months and used nothing but olay regenerist. I notice that my skin has red splotches (from trying home microdermabrasion possibly). I am afraid to use Renova again because of the redness. Do you still recommend the dmae and peptide rather than renova and c&e for 59 year old stressed out skin.What would I do for the brown spots that are starting to appear? The renova company told me that when they reduced their formula, it is no longer effective for brown spots. For years my derm has prescribed alternately renova, c & e, and prevage md but had to stop prevage because of rash. I don`t mind paying for a few good products if I am sure they are the right thing. When I went to your product page, I was amazed at how reasonably priced they are. I am scared to let go of Renova completely because it is so highly recommende. THanks and sorry this was so long.

  Answer:  I still suggest the peptide cream and might suggest some bleaching creams like 4% hydroquinone for the brown spots but it can irritate the skin some. Renova alone will likely not remove the brown spots. You can use the Renova and the prptide together the Renova goes on first. Best of luck. JG 3.15.09

• I`m using AHA 10% and DMAE. Which should I put on the skin first? Also, when I add C into the mix in the morning, can I just mix that into the DMAE? Thanks so much!

  Answer:  AHA first. You can mix the DMAE and the Vitamin C together, not sure how well it will mix tough. JG 3.15.09

• Would you recommend using your neuropeptide cream on the neck?

  Answer:  it certainly can be used there too. JG 3.13.09

• Dr. Garcia, I am a 63 yr old, asian, female living in Hawaii. I would like to know if I can use 4% Hydroquinone and a 0.05% Tretinoin Cream at the same time and what would be the effects and what kind of results do you think I will achieve.......thank you

  Answer:  yes, you can use them as long as you avoid sun exposure and use sunblock, the results will be some reduction in brown spots and a mild reduction in the fine lines. Best of luck. JG 3.13.09

• Over the years and sun exposure the skin on my arms have developed white dots. The are fairly small but as I get more dots I`m afraid it will take over my whole arm. I am also developing them on my legs but not as many. They are quite visible because I am fairly tan and darker my nature. What can I do to help with these white spots?

  Answer:  might want to see a dermatologist, sounds like some pigment loss from superficial fungal infectiosn. Best of luck. JG 3.12.09

• Hey Doc, What product is good for undereye dryness, and peeling. Over the past few days, my eyes seem to be very dry under the eye area a peeling. Do you have a treatment for that? Thank You

  Answer:  just a good moisturizer, can try squalene oil from the health food store. JG 3.12.09

• One of the lady asked you earlier about the skin care products making.I went through on this website by chance (makingcosmetics.com)....PLZ if you get time visit on this website .I feel its fishy...what do you think?

  Answer:  not sure if it is fishy or not, but in general, think about what you are doing, especially if you intend to sell, them if there is a problem with a patient that buys it, you are going to get sued, not worth the hassle I feel. JG 3.12.09

• Dr G---Iam also interested to make skin careproducts.I own a small spa.Would you mindtelling me doineed to read books or go any short course?I know about all the ingrediants and willing to start & try on me ,family and then use in my spa.Kindly HELP and advice and any course/ book recommendation.What would be really helpfulto get in skin care formulation.PLEASE DR ADVICE ME COZI THINK YOU CAN BE BEST PERSON TO ASK.THANKS IN ADVANCE.

  Answer:  Honestly, I think unlless you go to school to learn how to make the products, you are likely asking for trouble. Most of that can be learned in pharmacy school, I do not recommend it to be done without extensive education. JG 3.12.09

• Thank you for your time, Dr Pierce. I started using Obagi system, with .05% tretinoan, 11 days ago; using the tretinoan only at night. I am 51 years old and have had rosacea for about 15 years, and have controlled it with prescription Finacea 15% topical gel twice a day for many years now. (Metrogel stopped working for me.) I stopped using the Finacea when I started the Obagi, because I did not know if they should be used in conjunction. Can you tell me if I should use this at the same time, and if so at what step do I include it in my regimen and how many times a day? Thank you for your help.

  Answer:  can try applying the Finacea first and then applying the Obagi ten minutes later, I am afraid there are no compatability studies though. JG 3.11.09

• Thank you for your time, Dr Pierce. I started using Obagi Condition and Enhance system 11 days ago. I am 51 years old and have had rosacea for about 15 years, and have controlled it with Finacea 15% topical gel twice a day for many years now. (Metrogel stopped working for me.) I stopped using the Finacea when I started the Obagi, because I did not know if they should be used in conjection. Can you tell me if I should use this at the same time, and if so at what step do I include it in my regimen and how many times a day? Thank you for your help.

  Answer:  put the Finacea on first and wait ten minutes before applying the Obagi products and see how it goes, no studies have been done to show their compatability though. JG 3.11.09

• Is there any real effective way to get rid of dark circles under the eyes so I don`t have to keep using concealer which just seems to accentuate fine lines. Thank you.

  Answer:  we have a cream in our office that helps about 70% of users to some degree, that is a difficult area to improve. JG 3.11.09

• which is better Olay Regenisrst Micro Scuplting or Olya Prox Hydra Firmining Creme, for me at 27, oily skin, concerened about fullness and sagging..?

  Answer:  I like Oil of Olay but it will not change fullness or sagging. JG 3.11.09

• Dear Doctor.You suggested the website(www.dnpint.com) for purchasing skin care products formulation ingrediants.I am looking on the website it doesnot have products need for making products.PLZ can you suggest me where to purchased quality ingrdiants speacially L-AscorbicAcidPowder.Iwanna make serum for myself...plz helpme DOC...THANKS

  Answer:  http://www.lotioncrafter.com/store/L-Ascorbic-Acid-Ultrafine-pr-16426.html

• DOC.Is 10% vit-c serum good for 52-aging skin and dark pigments.Iam also using 4% HQ Can i use both and which one apply first.THANKS for any Help.

  Answer:  Vitamin C serum will help some with the wrinkles, not sure it will be too effective in lightening the darker pigments though, but the 4% hydroquinone will, I would apply the hydroquinone first and wait ten minutes then apply the Vitamin C. Best of luck. JG 3.10.09

• I have a tube ($175) of Renova that I just found. The expiration date was July of 08. The company says it won`t hurt you, but they can`t vouch for its effectiveness. Would it be better to get new or give this a try? I hate to waste time on something that has no effect. Thanks and last question for a while!

  Answer:  well, I agree the effectiveness is likely less, you could try it and see what happens, the worst is likely that it just will not work as well, likely low chance of anything negative happening. Just might waste some time. JG 3.10.09

• Adorable and good with numbers. thanks!

  Answer:  no worries. JG 3.10.09

• So, if I`m wearing moisturizer that`s 15 SPF, and I put mineral makeup over it that`s SPF 15, am I wearing SPF 15....SPF 30...or something in between? Bad with math lol.

  Answer:  15 and 15 equals 30, divided by 2, is 15, so you are back where you started, 15 SPF. JG 3.10.09

• I had IPL on July 2008 the first 3 treatments and my spots did not go away and the doctor did another 2 treatments more intense and my spots got worst, then he did a cosmelan treatment and my spots clear but still darker than before I got treatment and now my face have a tiny red veins all over my face I am still using the cosmelan treatment but I don`t what to do.

  Answer:  at times some of the products used to treat hyperpigmentation, like Cosmolean and Retin-A and Hydroquinone cna irritate the skin and cause worsening of the red spots, these might need a laser to correct, but you have already seen what lasers can do at times. Don`t forget the sunblock too. JG 3.10.09

• Dr.Garcia, what will you recomend and what will be helpfull to improve the skin on a neck, make it more tighter and thicker? Thanks.

  Answer:  I am afraid the neck is a risky area to treat with laser as it does not heal easily, so aggressive lasers, which is typically what is needed to get thicker skin and tightening are not able to be used on the neck. The lasers out there used on the neck provide a very short term improvement that does not last much longer than the swelling does. JG 3.10.09

• Hi Dr.G. My son is 15 years old and has had very bad acne. After many medications and different doctors, we finally found something that works. He`s been on Sodium Sulfacetamide 10% & Sulfur 5% lotion in the AM and Tazorac 0.1% in the PM for about 2 months now. Wow, what a change! He`s still very flakey and is looking for a face cream that will help with the flakes but doesn`t make your face shiny or sticky. Can you please recommend a cream to use. Thank you !!

  Answer:  might suggest squalene oil or emu oil from the health food store, used very sparingly. JG 3.10.09

• Have you heard of Mederma causing a scar to become firmer and lumpy? Thank you.

  Answer:  I have not heard that, no. JG 3.10.09

• what do u think of anew derma full?

  Answer:  no better than all of the other products out there that claim they fill wrinkles by applying it to the skin, it is very temporary at best. JG 3.10.09

• Hi Doc, hydroquinone 4% undereyes, is used for what purpose? Does it help with darkness under the eyes, or what is its purpose?

  Answer:  it will help brown spots but not the dark circles. JG 3.7.09

• Can hydroquinone 4% be used for under eyes?

  Answer:  on the skin, yes. JG 3.9.09

• what is a great sc system i could buy in store or online for someone with oily skin and worried about volume loss. I am 27 and dont have any loss yet but would like to help prolong it. I also use tazorac and juverderm.thx

  Answer:  I think Oil of Olay Regenerist for OTC is good. JG 3.7.09

• what do u think of murad resurgence?

  Answer:  I have not had any patients that have used it so I cannot say. JG 3.7.09

• what do u think og meaningful beauty by cindy crawford?

  Answer:  likely not much different than most other products out there. JG 3.7.09

• Hi Doctor, A quick follow up. You said that the light zaps of the gentle yag probably slowed the healing process of some capillary redness I had on my nose that appeared to finally resolve itself. Why would that be so? I thought gentle yag laser is used to treat this sort of thing in the first place? Also, will it still heal itself or did I ruin or completely stop the healing process? Thank you.

  Answer:  it will heal itself in time and I think the postive effects of the GentleLaser are grossly overexaggerated. Best of luck and give it time. JG 3.9.09

• Hi Dr. Garcia, I had asked about the SmartXide Dot laser for fine lines around the eyes. I am using Retina-will this help with fines lines? Will anything help?

  Answer:  I think the SmartXide will do little. JG 3.9.09

• Hello Dr Garcia, I would like to know what I can do to remove brown spots that were supposed to crust over from ipl /photo derm treatment. I still have the really dark spots (coffee spots) & its been 2 days. I was told they would fall off within 24 hours. They wont come off when I wash my face. It really looks much worse than what I had. plus other areas were darkened however no crusting just obvious brown spot that were NOT there before. I am olive complexion. Do u think there may have been a prob wit this treatment? Any info you have would be appreciated... Thank you I rather not call clinic about outcome if there is no need for panik.

  Answer:  no need for panic, just use your facial wash and let them flake off, it can take a few more days in some cases. JG 3.8.09

• I am 37 yrs old and have had chemical peels in the past and currently using retina. I have fine lines under my eyes that I was told botox would not work on. My dermatologist just got the SmartXide DOT Laser. Would that be my best option? What are realistic expectations?

  Answer:  I think the results will be mild at best and short lived, but low risk with that. JG 3.8.09

• Hi Doctor, This is a follow up question of another question I asked you a a couple of weeks ago. For the past month and a half I had a red spot on my nose that appeared to be dilated capillaries. Last week, all of a sudden I noticed it started to improve quite a bit like it was healing on its own. I had a dermatologist appt a few days ago and he decided to give it two very light zaps with a GentleYag. Instantly it was a little redder. It`s been two days and I can`t tell if it help it or if it hurt it. My question is: If the area was healing on its own, and the doctor zapped it with two light zaps of the gentleyag, could that have interrupted the healing process? Or if anything, would it have just helped? Right now it seems slightly pinker after 2 full days.

  Answer:  I do not think the Gentle YAG will help and it has slowed the healing a small amount but it is a weak laser so it will not have negative effects for too long. JG 3.8.09

• Dr. Garcia, I am having vbeam laser soon. In the past, the doctor has marked areas of my face. Some areas get missed, and some get zapped and don`t need. What kind of pen do they use that can`t be seen by the naked eye? Is there a place I could purchase one, and premark my face where I want the laser zapped? Thank you.

  Answer:  the doctor should have a surgical marker in his office he can use that will not affect the ability to perform the VBeam. JG 3.8.09

• I am a 62 year old white female. Can I use Retina A at night followed by hyology base lotion and in the morning use Serum Vitamin C Physician`s complex, once again followed by hyology base lotion. Want to do the most with my skin.

  Answer:  should be fine to do. JG 3.8.09

• Dr. Garcia, Could you please give your opinion on Radiesse.What kind of injectable filler do you feel gives a good result, for lifting, smoothing wrinkles and extra fullness to the face? T.I.A.

  Answer:  filler is used for deeper folds like nasolabial folds, it does not last as long for deeper fills like fat atrophy of the cheek, and does not work well for small superficial wrinles. JG 3.7.09

• Dr. Garcia, I don`t know wether this question has been asked before, but what is your opinion on Bridge Therapy?Thankyou.

  Answer:  I am not a proponent of Bridge Therapy. JG 3.7.09

• By using copper peptides and emu oil-is this a good thing for the skin?

  Answer:  they are good, yes.JG 3.7.09

• Sorry Doc mean 2% ALA(not 20%) cream enough to use or more concentrated cream is good.THANKS

  Answer:  that`s more like it, I suggest going to 4% and seeing what happens. JG 3.7.09

• Hello, Iam 52 yrs old lady and would like to know if 20% Alpha Liopic Acid cream is enough tou se or do i need more concentration.PLEASE suggest.THANX.

  Answer:  I would start there are see what happens. It might cause some irritation at that strength and might need to be decreased. JG 3.7.09

• DEAR DOC.I am skin therapist and interested to try making some skin careproducts for myself,family and then for my clients if it comes up good. Can you plz recommened any website to purchased the pure and high quality ingrediants.I know its out of subject but i need your help.Where to buy L-ASCORBIC ACID Powder? PLZ DOC HELP I WILL REALLY ASPPRECAITE YOUR EXPERIENCED SUGGESTION.THANKS in advance.

  Answer:  Try this but be careful, not knowing how to formulate can cause bad reactions. http://www.dnpint.com/products/index.htm. JG 3.7.09

• When the face starts peeling from Retin A, is it better to continue usage, or discontinue until peeling stops? Assume that the peeling is not uncomfortable (just a tad unsightly). Thanks!

  Answer:  no, it should be continued and the skin uusually stops peeling after about 4-6 weeks. JG 3.6.09

• OK one last question on retin a micro....does it interact with any oral medications?

  Answer:  I am not aware of any. JG 3.6.09

• i was usin retin a micro for a while and after a while I statred getting alot of dizziness and tightness in my chest. could it have been too much vit a, or am I going crazy. the doctor couldnt find nything wrong and diagnosed as anxiety. could it have been too much though

  Answer:  I do not think Retin-A would do that, you could apply the entire tube and the amount of Vitamin A absorbed would still not cause that. Sounds more like an anxiety attack if all else has been ruled out. JG 3.5.09

• I have uneven skin tone-something that has developed in the last two months because of a burnt hydroquinoine patch on my face, sunburn etc. I want to know what cream I should apply to get an even skin tone again?

  Answer:  Retin-A , maybe some Kojic Acid, and sunblock. JG 3.5.09

• I use a mild form of retin-a nightly and recently used a10% glycolic product that has left certain areas of my skin irritated for over a week now. Approximately how much longer could it possibly take to return to normal? I couldn`t have pemenantly done something wrong? It`s the skin mainly on my upper cheeks under my eyes.

  Answer:  do not think there will be permanent damage but it can take 2-4 weeks, all depends on how irritated it is. JG 3.5.09

• Dr. Pierce, I am 39 and have combination skin with occasional eczema. Also, I occasionally get cystic acne on my chin, and use Retin-a to control it in addition to lessening the appearance of wrinkles. It seems like a lot of individuals have posted about issues concerning Retin-a causing fine lines under the eyes. I have also experienced this. Should I stop using the Retin-a under my eyes, or should I keep up with it? Can it damage the skin under the eyes in some people? Is it simply a stage one may go through due to Retin-a drying the skin? I am a bit confused on the matter. I don`t want to damage the skin under my eyes. Do you believe that Retin-a is more helpful than harmful?

  Answer:  might want to apply it to the lower eyelids and then apply a moisturizer about ten minutes later to combat the dryness that is likely the cause of the small fine lines. JG 3.5.09

• My doctor recommended that I use renova not retin A due to skin sensitivity. What do you think of renova? Also, if I used renova for a period of time and then used Retin A would my skin be better prepared for the Retin A?

  Answer:  good product and does not irritate as much as it is in a different base. The Renova might make yor skin better able to tolerate the normal Retin-A, yes. JG 3.5.09

• Would it be beneficial to apply your neuropeptide cream 30 minutes after applying Renova?

  Answer:  yes, that would be a reasoanable option. JG 3.5.09

• So.....what do you use to keep your skin young looking? :)

  Answer:  I use Botox and also my pepetide cream and sunblock. JG 3.4.09

• which is better to help prevent age, firm skin for 27 yr old? Tazorac or Retin A? and what is the excat precscription o ask the derm for/

  Answer:  either one, I prefer Retin-A at 0.1%. JG 3.4.09

• Can you recommend a good face cleanser?

  Answer:  Oil of Olay or Lancome. JG 3.3.09

• Hello Dr.Garcia, have you heard of K-II skin products,I believe originally created in Asia. If so, you thoughts? Thank you.

  Answer:  sorry but I have not had any patients that have used it. JG 3.3.09

• Is there a natural cream that I can use on some spots on my hand and a spot on my face instead of carac cream? My dermatologist recommended carac cream, but after reading the side effects I am scared. I am interviewing for jobs and do not want to look hideous. Thanks so much

  Answer:  Retin-A and hydroquinone will work better with less irritation for plain brown spots. JG 3.3.09

• Ten years ego I burned with hot water. After that doctor made me surgery, two times. But still I have scars on my hand and chest. Is it possible to fade these scars off ? / keloid scar /

  Answer:  the keloids might be able to be improved with kenalog injections so they are more flat but there will always be scars. JG 3.3.09

• Are you familiar with Arbonne products and if so, would you recommend them?

  Answer:  overpriced. JG 3.2.09

• Could you tell me I have had just three little lessions I suppose come up sort of flat tiny. Or I am hoping they are pimples can something like that come up like in a couple of nights or could they be pimples or a blackhead? Also sorry I did ask before but forgot should I see a dermotoligst for the removal of small black but raised moles or a plastic surgoen? They are on my face I. Thanks so much again

  Answer:  cannot tell what they are without seeing them, so I suggest seeing your dermatologist. JG 3.2.09

• What oral supplements, if any, are proven to benefit the skin? Thanks!

  Answer:  the best one is Omega 3 fish oils. JG 3.2.09

• Hi Dr. Garcia. Will DMAE cream provide an incremental benefit if I am already using Retin A? I am a 44 year old woman with pretty good skin. Mostly concerned with crepiness under eyes. Thanks!

  Answer:  to a degree, yes, use it after the Retin-A has been applied. JG 3.2.09

• PLease your recommandation for a 34 with issiues with brown spots some redness mild rosacea (little bumps). I have olive complexion (hispanic descent) I just would like something to brighten even out & remove spots. Can u please tell me your fisrt choicce in a peel (brown spots) & then 1st choice in laser or cream. SO I can have different options. Thank you for what you do for us all. It is really handy & quite incredible of you!

  Answer:  IPL or a YAG laser is what I would do for that combination of issues. Chemical peels and creams will help the brow spots but could aggravate the Rosacea. Best of luck. JG 3.1.09

• Hello Dr. Garcia, this may be a question for a derm. but you have such a knowledge about skin issues I thought I would ask: I`m a 36 year old female, been having acne issues the past year or two. I use retin a microgel 1x/day. Just started taking ortho tri-cyclen (been off the pill for 3 years now). I was told that this would help my skin but past couple weeks my acne is worse. Is this common? Will it improve over time as the horomone levels settle down? I`m hoping it`s case of getting worse before it gets better. Thank you for your time, I hope this question isn`t too far out of the norm for your forum.

  Answer:  it does not help all women with their acne, that is true. I think giving it a couple of months or more migth see it settle down some though. JG 3.1.09

• Hi - I have had a prescription for Renova, low dose, which was changed to Avage, .05, and then to Tretinoin, .05, (which I believe is a main ingredient in Avage). I don`t have wrinkles but slight crow`s feet, light lines on my forehead and down from nose and slight dark circles under my eyes. My skin is starting to give (a/k/a sag) somewhat. I`d like to perk it up but not sure which of these 3 products would be the best: Renova, Avage,Tazarotene or Dermapril SP, which someone mentioned. I`m 60 years old but am fortunate to have good family genes when it comes to wrinkles, etc. My backround is of Mediterranean ancestory (olive skin, tan easily,clear complexion,etc) Any information you can provide on these products and where they stand on fine lines/wrinkles and firming (or suggestions on anything else) is appreciated. Thanks for your time and help.

  Answer:  I think they will all have about the same effect. JG 2.28.09

• Hi Doctor, In your opinion, what is the safest laser/photo system to use for medium brown olive skin when treating a small spot of visible capillary? I`ve read that Gentle Yag is safer for darker skin but have not heard from a professional. Have you ever treated any darker skinned patients with any lasers and if so, are you familiar with any hyperpigmentation as a result?

  Answer:  I prefer a Q-swiched YAG laser for that in olive skin. JG 2.28.09

• Hi Dr. Garcia..Do you feel that a homemade vitamin C serum consisting of l-ascorbic vitamin c crystals and vegetable glycerin would be as effective as the expensive serums such as Hylunia Beyond Complex C? I can make it every 3 days or so to prevent oxdizing and it would be very economical. In addition, what are your thoughts on the Neocutis Bio-Restorative Skin Cream as an overall facial product for fine lines and wrinkles? Is this better than a Retin-A/Hdroquinone combo? Thanks so much for your valued advice!!

  Answer:  it should be OK, yes. I think in general NeoCutis has good products, not sure how well that particular product will fade blemishes though compared to Retin-A with Hydroquinone. Best of luck. JG 2.28.09

• Dear Dr, My Dr prescibed Atralin for my acne, What is the difference between it and retin a microgel. Also, my Dr sells the own retin a and said I could buy it from them if my Insurance doen`t cover my rx at the pharmacy. Is that normal? Do you think their retin a will work as well? Thanks!!

  Answer:  it is essentially the same thing. Some doctors sell Retin-A out of their office if they have a dispensing license, yes. In my experience it should work the same way. Most of us that do that can also mix other things in with the Retin-A at the same time, like bleaching creams. JG 2.27.09

• Dr. I was recently prescribed with Retin-A for discoloration in my underarms due to increase in weight after giving birth. Never got to try it due to insurance reasons but my question is, can Differin be used for the same purpose. Differin was prescribed to me for Acne issues not dark spots in my underarms. Can Differin help with this too

  Answer:  it will help also. JG 2.27.09

• Thank you for your previous advice, I had written to you about burning my skin with hydroqunoine last week. I waited it out and applied sqalene oil and the redness has subsided-theres a faint brown patch on my cheek now. Shall I continue with sqalene oil or move onto applying a skin lightener like kojic acid/ arbutin? The hydroquinoine burn is exactly ten days old now.

  Answer:  I would give it one month before switching to another bleaching cream as that one can also burn. JG 2.27.09

• Hi Dr. Garcia....HELP! I`m confused. I`ve written to you a few times on a few different issues and I really appreciate all of your input. I have been to several derms and I am being told so many different things. What do I do??? You would hope every derm would give you the same solution but that isn`t the case. I am half asian/hispanic with medium olive skin complexion. Everytime I break out I DO end up with a brown or red mark. I guess that`s hyperpigmentation? Anyways, for the most part my face is in good shape except for 2 areas of my face (both cheeks) where I broke out in cystic acne and it left scars. One derm said the scar was a rolling scar and the other said it was an ice pick scar....grrr. Well which is it? Anyways, one derm is saying I should do an erbium laser and the other derm is saying I shouldn`t do erbium b/c its too strong and that I should really do Fraxel. One derm says I won`t hyperpigment with the fraxel and the other says I might. I`m so confused. I just wanna get rid of these 2 scars with minimal risk. I`ve considered punch excision but I hear that can also leave a scar. It almost doesn`t make sense to exchange 1 scar for another. With all of the technology now, aren`t there any lasers out there that are safe for ethnic skin? I wouldn`t mind doing my entire face but I just want to know it is safe. My biggest fear is hyper or hypopigmentation. I`ve currently been doing the Aramis laser for collagen production and it seems to be working but it is working very slow and it isn`t cheap! Help and thanks!!!

  Answer:  OK, first to rolling versus ice pick scars, the rolling scars are like little undulations in the skin while ice pick scars are like big pores. No laser will help ice pick scars. As to getting hyperpigmentation from an Erbium or a Fraxel, if you hyperpigment from the acne, you will hyperpigment from the Erbium and the Fraxel too. I will tell you that as much as you want to improve the acne scars, I think the Erbium and Fraxel, while swollen will look like they did wonders and as soon as the swelling goes down, then it will either look the same or you will have hyperpigmentation, or worse, hypopigmentation which is the loss of pigment which is not easy to treat. As much as it would be nice to help your scars, I personally would never treat a mixed Asian/Hispanic with any type of laser, superficial, fractionated or not. I think the risk/benefit ration is not in your favor with your history. Punch excisions for the ice pick scars should look better, a small straight flat scar which is easier to hide with make up than rather than a hole. As to the rolling scars, that will not do well with punch excisions due to the amount of skin that is required to be removed. I am afraid there is nothing safe for your skin, sorry. JG 2.26.09

• I recently quit smoking, what improvements can I expect to see in my skin?

  Answer:  the only thing you will see is a slowing of the progression of the wrinkles, but no reversal. JG 2.26.09

• V-star on ethnic skin? Safe for the removal of old red acne scars?

  Answer:  higher risk than in paler skin.JG 2.26.09

• Do you think Erbium laser is safe for ethnic skin? I am medium olive complexion and am afraid of hyperpigmentation. I have 2 scars (1 on each cheek) that I would like to get rid of but I only want to focus on those 2 areas- I don`t want to do my entire face. The RN that I spoke to said that she can treat those 2 areas and kinda feather them off so they blend into the rest of my face. She also said that if I hyperpigment she can fix that as well. She gave me some hydroquonine pads. I`m wondering if I prepare my face with the hydroquonine pads first maybe I won`t hyperpigment? Nothing else is working b/c they are kinda deep and it appears that the erbium laser may be the final result. What do you think?

  Answer:  I do not think Erbium laser is safe for ethnic skin. Feathering scars I think will not work, even if the laser was safe to use, you typically need a broader area treated in order to induce enough tightening to see a visible difference. Pre-treatment is certainly more effective than post-treatment for the hyperpigmentation, I think the issue in ethnic skin though is not only hyperpigmentation, but also hypopigmentation, or the permanent loss of color which cannot be treated. Might consider having a surgical excision and then that will raise the surface to a more even point. JG 2.26.09

• In your opinion, what is a reasonable price for Steroid injection on a Hypertrophic scar?

  Answer:  $50. JG 2.26.09

• Hi Dr. Garcia, I would really appreciate your help. I am 41 yrs. old and African-American, and have had a surge of acne for the past 4 yrs. I have been to several dermatologist and still no relief. I am still on clindamycin as well as a compound with clindamycin,hydroquinone and salayic acid. The acne has subsided but the dark spots are not fading. Can you please, please give me some suggestions of what to try? I was told by one dermatologist that Retin A was now in a different form and not as potent. Please, I would just like some help as to what to try. Denise

  Answer:  might need to try some stronger beta hydroxy acid peels and some YAG lasers done lightly. JG 2.26.09

• Dr. Garcia, What do you suggest as the best treatment for significant crows` feet/wrinkles around the eyes? I am 57, physically fit, and have a very expressive face. I recently posted a question re. Retin-A .1% and wrinkles; however, you replied that this does not really eliminate wrinkles. Any advice is appreciated.

  Answer:  I would suggest a moderate depth CO2 totally ablative laser and Botox in conjunction. JG 2.26.09

• Hi Dr. Garcia, Had lots of syringomas under my eyes cauterised about 5 weeks ago, they all disappeared and looked great then reappeared about a week ago. They all reappeared with 4 days of using base to cover up the residual redness in that area, do you think the base is what has caused them to reappear in such a short time? What else can i do to combat them. I never used to have them at all until about a year and a half ago when i had a session of fraxel under my eyes. I also only started wearing base under my eyes after the fraxel, so I think they might be linked, what are your thoughts? Thank You!

  Answer:  no, they will come back even without the base. I am afriad there is not much else that can be done, they will persist and in time likely get more. It is a genetic thing, not due ot what you apply to your skin. JG 2.25.09

• Dr. Garcia, I have heard two different opinions about using Retin-A at the .10% strength...one that it will help fade sun spots and improve overall skin, and another that it is too strong for thin facial skin. I am 57 and very healthy; however, I have pretty significant crows` feet due to my expressive face, genes and outdoor lifestyle. I have used Renova (.02%)with very little result. Do you think that Retin-A at the stronger concentration is safe? I am hoping to get rid of a brown spot on my upper cheek as well as thicken my skin around my eyes where I have crows` feet. Thank you. I appreciate your help.

  Answer:  well, some people will get a lot of irritation from the Retin-A at 0.1% and others tolerate it well, I think the only way to know is to do a trial and see. I will say though, that likely you will not see anything dramatic in terms of your crow`s feet with Retin-A. I think the results will be minimal to moderate at best. It will help brown spots if relatively recent but in order for it to do that, you need to have the skin irritation as it needs to exfoliatate the top layers of skin. The longer the spot has been there, the less likely it will help, Also, if it does help, in time, the spot will come back due to sun exposure. Best of luck. JG 2.24.09

• This is a continuation of my previous question. I had two acne marks which I was trying to fade so I applied hydroquinoine 3% and woke up the next day with patches on my skin- bright red and burnt completely. I applied calamine to soothe the skin and waited it out for a week. The skin is still red and patchy. My skin used to be flawless and even before this and it stresses me out to see it bright red. I am currently applying retino-a at night since it is supposed to increase cell renewal and aloe vera gel in the morning. Shall I discontinue this? I am worried because the skin is abnormally lobster-red and very bright. Is squalene oil all I need?

  Answer:  well the Retin-A will make the redness worse but the Aloe might help some. I think squalene oil is all you need. JG 2.24.09

• I am twenty six and have screwed up my skin completely. I had two acne marks which I was trying to fade so I applied hydroquinoine 3% and woke up the next day with patches on my skin- bright red and burnt completely. I applied calamine to soothe the skin and waited it out for a week. The skin is still red and patchy. My skin used to be flawless and even before this and it strsses me out to see it bright red. What is the best way I can get rid of this chemical burn on my cheeks? Thank you.

  Answer:  just avoid sun, use no acids on your face in terms of cleansers or creams, that means glycolic or alpha hydroxy acids and use squalene oil to moisturize it and it should all heal in time with no damage, that is lower than the prescription hydroquinone we use and it is a normal reaction. JG 2.24.09

• Hi Dr. Pierce, thank you for answering my questions. I have a quick followup question. I asked previously which product would you recommend to protect against free radicals Obagi Professional-C Serum OR Obagi-C(R) Rx Serum, you answered that you thought either would be fine. However, each product addresses different issues, so which do you think is preferable to protect against free radicals? Thank you

  Answer:  the Professional-C will be better for free radical damage I feel. JG 2.23.09

• Hi. My skin changed dramatically in short order this summer. I was playing pickleball outdoors several times a week, totaling 6-7 hours. That is more than I had been in the sun as an adult. Could that have caused my skin to get looser and more wrinkled, or could it have been due to weight loss, hormone changes, or all of the above? I am 47, and am self-conscious for the first time about deep cheek fold lines when I smile. Is there a way to replenish the skin, and increase tightness without artificial ingredients? Thank you ever so much, Kathy

  Answer:  it can certainly cause the wrinkling, but not the looseness. I will say that weightloss will certainly cause the looseness though. Hormone changes will also cause skin looseness but not quickly like weight loss. Might suggest seeing about hormone replacement and also start avoiding sun and use some Retin-a too, should come back. JG 2.23.09

• I have recently purchased both the eye and face creams that your office sells. After using the creams twice per day, I noticed that my skin appeared dry and wrinkly. Should I use the product only once per day, or did I apply too much of the product? Should the eye cream be applied only under the eye? My husband has vascular rosacea on his cheeks, I would like him to use the facial cream, would it be safe to do so, without irriting his already present skin condition? Thanks.

  Answer:  might suggest to cut back to at night only, and the eye cream can be used on the face too. I think the facial cream is OK to use on the Rosacea with no aggravation of it. JG 2.23.09

• Hydroquonine 4%- on medium olive skin tone, does it act like bleaching cream? Looking to remove dark marks from old acne. I`ve tried bleaching cream in the past and it almost takes my natural coloring away. Will the hydroquonine take just the marks away while leaving my natural tone?

  Answer:  it will bleach spots from the sun but does not lighten skin that is naturally darker. It will remove the sun damage so you might have gotten used to a darkrer tone that was due to partially your normal tone and also to some degree of sun damage. JG 2.23.09

• What is the difference between fraxel and fraxel lite? Are both safe on ethnic skin?

  Answer:  the lite is even less effective than the regular. I would not do it on ethnic skin, but I would not do either on any type skin as I htink it is a waste of time. JG 2.23.09

• Steroid injection on a Keloid or Hypertrophic star- what will that do? Will it shrink it, take the redness out? Make it look less noticeable?

  Answer:  it will flatten it, it might help the redness a small amount. JG 2.22.09

• what is the best product to use on a very red face after cosmetic laser procedure? it`s been almost 4 days and my face is still very red, what can i use to calm it down?

  Answer:  squalene oil or NeoCutis creams. JG 2.22.09

• Hi Doc....is there a downside to using Lumigan for eyelash growth? any cautions or tips? thank you

  Answer:  just the precautions on the product insert in terms of side effect, but they are in general rare. JG 2.22.09

• Do you recommend Hydroquinone pads for dark pigmentation marks left after acne? I am asian/hispanic with olive skin tone. I`ve been told good and bad and don`t know what is best for my skin type. Do you sell these pads? Thank you

  Answer:  I prefer to use 4% hydroquinone cream .JG 2.21.09

• I have Keratosis Pilaris on both of my upper arms. What do you recommend to get rid of it?

  Answer:  alpha hydroxy acids will help but ntohing gets rid of it entirely. JG 2.21.09

• I believe I have a hypertrophic scar. It is on my belly received after piercing my belly too many times. What do you recommend to get rid of it? Steroid injection?

  Answer:  I would start with the steroid injection and them if that does not work it might need to be cut out. JG 2.21.09

• what do you recommend for a topical acne scar filler? What brand?

  Answer:  sorry but I do nto think anything appplied to the skin topically will fill in acne scars. JG 2.21.09

• Hello, I am a 28 year old half asian/half hispanic female with medium olive skin tone. I have a scar on my left cheek....not too deep but I think it is probably an ice pick type of scar. I have several of them in the same location on my cheek. My question is that I hae been doing the aramis for collagen production and med-lite treatments for dark spots left behind from old acne and have not really seen much results. I really hate the ice pick scars I have on my left cheek but the rest of my face is fairly decent. I was wondering if it would be wise to have the fraxel light treatment done in just that one area of my face? I have also been reading about punch excision and graphs and subincision and really don`t know which route would be best for me and my ethnicity. Any suggestions? Thank you.

  Answer:  I do nt tthink with your mixed skin type that any laser will help, I think the punch excision is likley what will be best in the long run. JG 2.21.09

• Dear Doctor, Would it hurt to apply Aloe Vera gel to an area of redness from visible capillaries on my face?

  Answer:  probably will not hurt. JG 2.20.09

• Hi Doctor Garcia, I had a nose job 2 years ago and my nose took forever for the swelling to subside. If I get a mild IPL treatment on my nose, what is the risk that the swelling could return and cause further scar buildup or just stay a long time? Thanks in advance.

  Answer:  should not casue any swelling I feel. No risk of scar tissue unless your skin were to get burned which is highly unlikely. JG 2.20.09

• is it ok to use prevage night creme with tazorac? what is the likelyness i will get a rash from prevage?

  Answer:  likely OK, I do not think Prevage does much good and the rash is probably rare. JG 2.19.09

• Hi, Dr. Garcia. One of the most attractive aspects of Rhytec Portrait was that the skin remained intact as a biological dressing and that healing time was two weeks or less. With that particular option in question now due to company`s bankruptcy, the next credible option seems to be a light CO2. What is the downtime with that procedure? Will it provide roughly the same benefits?

  Answer:  it will provide likely a greater benefit, downtime is about the same, but since it is different in the heat generated, the pinkness which is gone in one month with the Rhytec will likely take 6-8 weeks, but still able to be covered with make up after 2 weeks. JG 2.19.09

• Hi Dr Garcia, Well I went to the doctor today and he said that the red mark on my nose looks like visible capillaries. He said he wouldn`t quite jump into any laser work yet because that could cause a dark spot because I have tan olive skin. He said to see where we`re at at 6 months and go from there. My main question is: Is it possible for capillaries to just pop up and slowly fade a bit over time? Also what do you think about the laser or IPL causing hyperpigmentation in darker toned people? Thanks so much for the time.

  Answer:  they can fade but not all of the time. I think the laser and IPL can at times cause some darkening, but in most cases, it is short lived if it happens. JG 2.18.09

• I asked the dermatologist if any laser treatments would work to tighten the turkey gobbler skin on my neck. She said that all lasers only tighten a little. Do you foresee anything in the near future that might be developed that will give people an option besides surgery?I realize that the lasers don`t tighten as well as surgery, but is there some hope?

  Answer:  I seriously doubt than in the foreseeable futiure a laser or other external device will be able to tighten loose skin on the neck. JG 2.18.09

• I am 43 white female with medium tone skin. I have white spots on my arms and legs. The spots on my arms are spreading into each other and taking over my normal skin. My skin looks horrible. I am very depressed about being seen in public with my arms showing. I live in the South so long sleeves are not an option during the summer. What are these spots and is there anything I can do to get rid of them?

  Answer:  one of two things, either small fungal infections that are causing you to lose the pigment, that can be treated with antifungals and in time will improve, or it is Vitilgo and you would need to see a dermatologist about getting medications to attempt to re-pigment the skin with sun exposure and the medicines together. JG 2.17.09

• Hi there could you tell me what night cream of yours I should purchase. I am almost 35 have pretty good skin but are starting to notice those nasty wrinkles creeping in around the eyes. I have normal to dry skin sometimes can be sensitive but finding this is getting better with age. Also I am in new zealand do you delivery and how much extra cost it would be. Thanks so much

  Answer:  I think the ladies in the office can tell you the cost and shipping as we do mail there, email the office manager Sandie at Sandie@lvcosmeticsurgery.com. For your age I suggest the DAME facial cream and maybe the eye booster if you desire. JG 2.17.09

• what is the best thing to use for dark under eye circles without injections or lasers. my mom has them but cant afford to see a ps, plus prefers a cream or something u can easily buy.thanks

  Answer:  we have a new cream at our office that helps about 60-70% of patients, it is applied twice daily. JG 2.16.09

• what do u think of prevage? which would u reccommed the prescription ot non?

  Answer:  save our money. JG 2.16.09

• I would like to purchase your specialty creams. Should they all be used together and if I could only afford one which would be the best to use for slowing down lines and aging? Thank you

  Answer:  if you are using only one, use the peptide cream, that is the strongest. For younger skin we use the DAME face cream and for around the eyes we have our eye booster cream. JG 2.16.09

• Could you please tell me if you have heard of dr r.a. Eckstein skin products if so what do you think of them. What would be better to have a chemical peel or IPL to lighten up freckles and would it lighten up moles also. Also for removal of small moles I think you said to consult a dermotologist will they decide if they can be removed thanks so much.

  Answer:  I am sorry but I have not had any patients use those products. I think the IPL and chemical peels wil be about the same for lightening up the freckles and moles, but the color will all come back in time, no mater what is used. Seeing a dermtologist for the removal of the moles is a good idea, they can tell you if there is any appearance of cancer too. JG 2.16.09

• Would Mederma or Bio oil lighten red scars faster less chance of irritation? Thanks. KP

  Answer:  The Mederma might, or ScarGuard, they will help. I am not familiar with Bio oil. JG 2.16.09

• Hi Dr, I`m sorry I have one last question. I am the one with the red irritation spot on my nose. I heard that hydrocortisone can make visible capillaries worse. My doctor gave me Locoid Lipocream (a hydrocortisone butyrate) to use for a week on that area. If I do have a capillary issue, is that true it could make it worse? Thanks.

  Answer:  it can but only after prolonged use, one week would not be enough to be the cause of that. JG 2.16.9

• WHAT DO U THINK OF LATISSE EYELASH? IS IT BETTER THAN RIVITALSH. WHICH SHOULD I BUY?

  Answer:  we sell Revitalash, I think it is a good product and does not require a prescription to purchase, make sure yoru doctor has a dispensing license to sell it in his clinic, otherwise he is selling it illegally as it requires a prescription and a dispensing license. JG 2.16.09

• Hi Doctor, I asked you a question a few days ago. I had a sensitive area of my nose due to use of BP and Salicylic acid for acne treatment. I was out in the cold one day and it got more irritated and red. Since then it has just stayed red. One doctor said it was probably broken capillaries, another doctor said it could just be irritation and gave me Locoid Lipocream to use for a week. I`m on the 3rd full day of using the medication and it doesn`t seem to be doing much. I think the area has settled down just a bit, but not enough for sure. I looked at it with a magnifying glass and I just don`t see what looks like broken capillaries, it looks like just some bright pink dots that just look like red pores. They`ve been like this a week now. My questions are: 1. What do you think this could be? 2. How long would it take for Locoid to work if it was going to work? 3. How safe is IPL in the event this is broken capillaries? I`m afraid of discoloration from the use of lasers and such. Thanks so much.

  Answer:  hard to say what it could be but is likey irritation and the cream might not help for weeks, do not expect it to look better in just a few days. I think the IPL is safe though. JG 2.15.09

• Hi Dr.Garcia, I have been taking a low dose course of accutane and I am currently in my fourth month of treatment. I am happy with the reduction in oiliness and breakouts i have seen however, my skin tone and texture are terrible. Are there any products that are safe to use while on accutane that can help this problem(I think I have two months left)? Do you think that a facial would help my skin in this regard, and is it safe to have a facial done while still on accutane?

  Answer:  I think acids and Retin-A are likely to much just wait until you are off the Accutane to do more. JG 2.15.09

• Dear Dr. Garcia, Do you think a night cream with the following main ingredients sounds like a good cream: retinyl propionate (.2%); Glycolic Acid (7%), L-Ascorbic Acid (10%) and Glabridin (.1)? Thank you for your opinion.

  Answer:  pretty standard stuff nowadays. JG 2.12.09

• name is Mike. I am an African American with a medium skin tone and I have post-inflammatory hyperpigmentation from acne that happened late Sept/early Oct from a few acne cysts and from another dermatologist injecting these acne cysts with kenalog injections and using a blackhead extracter to squeeze out the sebum eventually leaving 5 brown marks on my face after they healed. My question is I am considering having a Vitalize or TCA chemical peel to remove these marks from my face so should I do this or what would u recommend? ......... OK so would a Yag laser be safe on me an African American with a medium complexion?

  Answer:  I think Retin-A and Hydroquinone are safer as the chemical peels themselves can cause PIH. JG 2.12.09

• Dr Garcia, i want to start taking vitamin for skin nutrition, consist of beta carotene 1500 IU, vitamin C 180mg, zinc oxide, selenium and green tea. The direction said to take it one tablet in the morning. I never have breakfast in the morning, so should i take it in the morning with empty stomach, should i take it after lunch?

  Answer:  better with lunch then. JG 2.12.09

• Ok then would those be my only options besides Retin A and hydroquinione?

  Answer:  a YAg laser too. JG 2.12.09

• My name is Mike. I am an African American with a medium skin tone and I have post-inflammatory hyperpigmentation from acne that happened late Sept/early Oct from a few acne cysts and from another dermatologist injecting these acne cysts with kenalog injections and using a blackhead extracter to squeeze out the sebum eventually leaving 5 brown marks on my face after they healed. My question is I am considering having a Vitalize or TCA chemical peel to remove these marks from my face so should I do this or what would u recommend?

  Answer:  I would saty away from chemical peels and stick with Retin-A and hydroquinone, you coudl get even more PIH from the chemical peels I am afraid. JG 2.12.09

• Hello Dr. Garcia. I am African American with pretty dark chocolate skin. I had a scar removed on my arm about a year ago but it formed a keloid. My doctor injected it with kenacott injection to flatten the scar. The injection spread outside the scar and caused the skin to become lighter / hypopigmentation. The color is gradually coming back. Is it true that shark liver oil helps the skin color to come back to it`s original state? What else do you suggest I do?

  Answer:  no, it does not, all you can really do is give it time, best of luck. JG 2.12.09

• Dear Doctor, I`ve been using BP 10% gel and Salycilic acid on my nose for acne and its been working well. Recently, a few weeks ago, i noticed some pinkness on a small spot on my nose. It just looked like irritated skin but I kept using the treatment even in that area because it didnt hurt. Over the past few days, its gotten slightly redder and noticeable. One dermatologist I went to, she said it might be broken capillaries. I got a second opinion and he said it might just be some irritation from the medicine and gave me Locoid cream (hydrocortisone?) to use for a week. If it does turn out to be broken blood vessels, can it be treated? I have olive skin/middle eastern. I always worry about scarring. Thanks so much for the answer.

  Answer:  it can be lessened with a YAG laser or an IPL. JG 2.12.09

• I should ask....what the heck do I use to improve texture, appearance, brown spots, and wrinkles?? I use to have gorgeous skin...now I feel like I have gross skin. Thank you

  Answer:  start with Retin-A and avoid sun and smoking. JG 2.11.09

• What do you think of the product Dermapril? It is being pushed along with Resveratrol as skin rejuvenator. Thank you for your time

  Answer:  I think any potential benfits of either are largely over-inflated. JG 2.10.09

• Hi Dr Pierce, What do you think of the Skinceuticals C + E Ferulic Acid Serum? I currently use 10% Retin A and hydroquinine combo and my skin reacts pretty well to that product. Just wondering if the serum would be a good addition :>) Thank you! Maybe

  Answer:  yes, good addition. JG 2.10.09

• Dr. Garcia, What is the best product to fade red scars on the front scalp from a browlift? Thanks, KP

  Answer:  Mederma or ScarGuard. JG 2.10.09

• Hello, I have several skin related questions: 1)What is the best way/treatment to fade post acne scars (red marks, not pitted scarring); 2)what is the best way/treatment to fade freckles (safe for eye area); and 3)What it the best way/treatment for large pores and blackheads? Thank for your time and assistance.

  Answer:  1)Mederma and ScarGiard are good creams, otherwise a YAG or IPL laser. 2) YAG or IPL laser but it will not last long and will take numerous treatments 3) IPL and microdermabrasion but again, short term improvements. JG 2.10.09

• I have this toner with active ingredient Mandelic Acid 3%. Other ingredients : Alcohol, Water, Glyceryl Laurate, Triethanolamine, Glycerin. Based on those ingredients, do you think this toner will function as an Exfoliating Toner or will it function as a Moisturizing Toner? Which action do you think it will do, more as exfoliator or more as a moisturizing?

  Answer:  exfoliating. JG 2.10.09

• Dr. Garcia, i bought this vitamin c serum product that is already in brown / yellow color eventhough it is new, it advertised also that way so i know that they make it in that color (it is flavo c made by auriga, a belgium company, and i already check the picture of the product at their web, the fluid is yellow / brown). Do you think it is safe to use it?

  Answer:  likely safe, but not sure how effective it will be. JG 2.10.09

• What do you think of the facemaster? It is a device that uses an electic current to contract musles on the face to firm them. Quack science?

  Answer:  save your money, if anything, you will get more wrinkles, that is why Botox is used, to weaken the muscles. JG 2.10.09

• What is your best recommendation for reducing pore size. Both my daughters seem to have this (they are a mix of Cuban and Italian heritage). I have never been plagued by large pores, so nothing I seem to come up with seems to help. The dermatologist called this globuos (not sure of that spelling) skin , but did not offer much help. They are in their late teens and have also been on accutane for acne. It seems that make-up makes the condition worse, as it seems to just slide right into the pores. Any help??? Thanks.

  Answer:  IPL and microdermabrasion, must remove their make up every night, might want to use some glycolic acid facial cleansers too, it will be a life long problem though. JG 2.9.09

• Is it okey if i buy a vitamin c serum with 8% ascorbic acid in yellow color? how can i tell if the yellow is still okey or it is already oxidize?

  Answer:  if it is yellow it is already at least a little oxidized. JG 2.9.09

• Will microdermabrasion work for tightening pores?

  Answer:  yes, but very temporary. JG 2.9.09

• I have had 3 Fraxel`s done. 2 of them have been the stongest my docter has ever performed. Because of this, my acne scarring has improved quite a bit. What I am noticing more and more now though is the many hypopigmented spots from the long gone acne that are still on my face. What if anything can be done to fix, or at least improve, these white spots? Thank you.

  Answer:  hard to say, in many cases the color comes back, but not always. Sun exposure can help at times, hard for me to say without seeing you though. JG 2.8.09

• Hello Dr. Garcia. Have you heard of copper oxide pillow case designed to iron out lines and crow`s feet? Is this true? Thanks.

  Answer:  save your money. JG 2.8.09

• Hello Dr. Garcia, regarding the question and your answer below. Why would the eyelid surgery procedure for hollow eyes not last for a longer period of time? Thanks.. Hello Dr. Garcia..Is it advisable to have an eyelid surgery for hollow eyes, wherein they stretches the skin below the eyes to make it firmer? Thanks.. Answer: the immprovement will not last long, maybe weeks to months. JG 2.7.09

  Answer:  because tightening the eylid skin and muscles will not fill in the hollows as that is due to loss of fat. JG 2.8.09

• Hello, I have some Celestone Cronodose suspension injectable which I will be using to treat my nodular and or cystic acne that I get from time to time. I know that you will probably recommended that a physician do this, however, since that will not be the case, do you have any suggestions, techniques, or guidlines other than what I may have already researched. Thank you in advance for any suggestions.

  Answer:  sorry, but I cannot give you that information. JG 2.7.09

• Hello Dr. Garcia..Is it advisable to have an eyelid surgery for hollow eyes, wherein they stretches the skin below the eyes to make it firmer? Thanks..

  Answer:  the immprovement will not last long, maybe weeks to months. JG 2.7.09

• Hello Dr. Garcia. What is the latest procedure in improving the appearance of hollow eyes and eye wrinkles. And how much does the procedure cost? Thanks.

  Answer:  nothing new besides lasers for the crinkled skin, for the hollow sof the eyelid itself, there is nothing reliable and new. JG 2.7.09

• Dr. Garcia, I posted a question earlier but it didn`t get through? I am scheduled to have Smart Lipo in a couple of weeks with a very good and qualified plastic surgeon that has very good success with this procedure. I had my consult and was told that not everyone is a good candidate for this,and that a skilled doctor is able to tell as to what patients will have success with it or not. It was also explained that only a small amount of fat is taken out and this gives a much better result. I feel confident with this procedure and didn`t feel that i was being sold on this idea of SmartLipo, just that this particular doctor is experienced using this particular method and that it his preference over other methods. I do see where a much finer cannula is used as opposed to a bigger one as in the other version of liposuction. From the videos i have watched, liposuction is liposuction,basically the same procedure throughout.

  Answer:  that is true, the claims of skin retraction being superior with SmartLipo is also not valid because the skin retraction from the laser has not been quantified, but if you remove only very small amounts of fat, the skin usualy shrinks well, SmartLpipo or regular. Best of luck. JG 2.7.09

• Dr. Garcia, What do you think of the Skin Medica products? Thanks.

  Answer:  good products. JG 2.7.09

• I have keloids on my chest.Dr. wants to use v-beam laser on them.They are like three small bulbous bumps.Will this do anything to eliminate them.

  Answer:  might flatten them out a small amount, will minimize the redness though. JG 2.5.09

• Hi Dr. Garcia, Is there anyway to prevent hyperpigmentation when getting a cut? Everytime I cut myself, even shaving or something like that....I end up with a dark spot that takes forever to go away. Is there anyway to prevent this discoloration on ethnic skin?

  Answer:  very difficult to do, you could use hydroquinone but it would need to be used for a few weeks before in order to prevent it. It can be used afterwards to help fade it faster too, but that is after the fact. JG 2.5.09

• Hello Dr. Garcia, after I had both of my kids I ended up with a brown line on my stomach, I think they call it linea negra. Anyways, I had 2 medlite procedures to try to lighten it up and it seems to be working but the procedures are pretty expensive. Is there anyway to speed the process of removing the line?

  Answer:  might want to use some Retin-A and hydroquinone inbetween the treatments too, all the best. JG 2.5.09

• What is the best way to get rid of crepey, crinkly skin under the eyes. I have dark circles. Concealer is great for the circles but only enhances the crinkly skin. I`d like to do a peel that does not require a lot of down time. Thanks.

  Answer:  I am afraid peels will do little, once the swelling goes away the crinkles are back,and I think if it is that bad, minimal downtime procedures are likely not going to help. If you want minimal downtime I suggest Retin-A at this time, but expect small improvements are slowly. JG 2.5.09

• Dr. Garcia, I have recently been diagnosed with Hashimotos Thyroiditis and the doctor says no treatment is necessary for this? I have the heart irregularities/palpitations also, which i am told could be Mitral Valve Prolapse, that often accompanies Hashi`s. What do you think about this? I have read on various websites that this autoimmune disease is treatable, and by all means it should be treated so that the patient doesn`t end up with full on Hypothyroid condition. All the controversy regarding this issue is very misleading and confusing!

  Answer:  irregular heart beats are certainly part of the thyroiditis and need to be treated in many cases. I would suggest you get a second opinion. The thyroid problem can be treated if the thyroid is a problem but at times the heart issues need to be treated and not the thyroid itself. JG 2.5.09

• Dr. Garcia, What do you think of SmartLipo as opposed to Cool Lipo? Are these treatments as effective as they say? I have heard people that have had this say they are very pleased with the results, namely for Smart Lipo. Thanks for your opinion.

  Answer:  I think they are both overhyped, I think the purported advantages are inflated and the results overall are not as drmamtic as they portray. I think in genral the smaller the amount of fat removed with any technique, the happier the patietn. I have had to correct too many problems from these procedures to recommend them, most of the problems come from doctors who are not plastic surgeons using the technology. JG 2.5.09

• Hi doctor, i an 40 and i begin to have age spot on my chin.I wanted to have laser treatment.could you tell me if there is any side effects like cancer etc.. thank you.

  Answer:  no side effects of cancer from the laser treatment, but in time and with sunlight exposure, the spot will return, nothing will be permanent. JG 2.4.09

• Dr. Pierce, I am currently using Strivectin eye creams for my under eye wrinkles and crows feet. Can I also use Retin A along with this? Thank you for your time.. Catherine Mesimer

  Answer:  I would start the Retin-A and stop the Strivectin, or just use it as a moisturizer. JG 2.3.09

• Hi Doc.. I have a few small depressions on my face from injections from cortisone shots for cysts. I have had many injections my whole life(I`m now 32) and I`ve had some depress but then later fill in. These few spots have been depressed(atrophy- I guess) for over 7 months now. My questions are 1. Do you think it`s safe to do a filler and what kind would you suggest? 2. Will it interrupt healing of the skin if it will ever fill back in own it`s own? Your advice is greatly appreciated. :)

  Answer:  afte 7 months a filler is OK to proceed with. I do not think a filler will interrupt the healing process. I do not think it will fill in if it has not done so by now. JG 2.2.09

• Olay’s new ProX products contains: Niacinamide, Palmitoyl Dipeptide-7, Palmitoyl Pentapeptide-4, Hexamidine and retinyl propionate. Are these “break through” ingredients? Thank you for your time

  Answer:  well, for an OTC product, it is good, as to grround-breaking, that is relative. JG 2.2.09

• Thanks you for your response Dr. Garcia. I have been going through blogs that Mederma may help upto an extent when it comes to scars. Can you please suggest on what should i be using which will help my cause along with time

  Answer:  I think it helps fade the redness and might flatten them out, but I think any lotion applied as the Mederma is suggested to be used will acheive similar results. I like Mederma though, along with ScarGuard, at least then I know they are using a helpful product and something that will not cause problems. JG 2.2.09

• Hi Doc! Thank you for helping me with this. I have a few questions about a sunken scar I have on my face. It is about the size of the top of an eraser and fairly deep. I just started using retin a but wasn`t sure if the peeling would cause the depressed part to be worse. Should I use a copper peptide on the scar area and if so what you would recommend? Will silicone sheets help blend the depressed part from the surrounding tissue or make it worse? I don`t want to use a filler at this point but would consider other surgical procedures. The scar is fairly new as well, it is still red and was hoping this would be beneficial in treating it. Thank you again.

  Answer:  Copper peptides and Retin-A will help with recent and fairly superficial scar, but not much for depressed scars. Silicone sheets will not help the depressed scar either. I think the surgical option migth be the best option at present. JG 2.2.09

• Hello Dr. Garcia, It has been like 6 months since i tried to cut my hands with a knife. I know that it is a stupid thing and selfish act but i just wasn`t thinking what i was doing. I have been using the cream Aclaro for while now. I will be visiting my parents soon and i cannot let them see me like this. Please let me know if there is a way to get rid of these marks for good.

  Answer:  I am afraid there is nothing that will permanently remove the scars, quickly or slowly. JG 2.2.09

• if we do cheek to cheek (like when girl meet girl, or on wedding event or birthday, to congratulate someone, we do cheek to cheek) with someone with very oily skin and full acne skin, can we get infected because we do cheek to cheek with that person?

  Answer:  no, that would not happen. JG 2.2.09

• Hi Dr Garcia. I am 25 and wanted to try a facial treatment,peel to correct my dull skin tone. Is there anything you can recommend that isn`t too harsh? This website is brilliant by the way! Thanks

  Answer:  stick with lighter glycolic acid peels to start, nothing over 30%. All the best and thank you for the kind words. JG 2.1.09

• Hi Dr Garcia, When choosing a products containing ALA, is it important that it be R-Lipoic? Or is the mixed isomers ALA just as effective?

  Answer:  R is stronger. JG 2.1.09

• Thanks for your response to my ? re hydroquinone. I mentioned I currently use Retin A. I am not sure I am using it correctly. I wash my face right before bedtime and immediately use the Retin A, followed by a moisturizer. Do I need to wait between each product? And if so, is it absolutely necessary? How do I incorporate the hydroquinone into my routine

  Answer:  well, applying the creams without waiting a period of at least ten minutes between can dilute the cream that was applied to some degree and potentially reduce its effectiveness. I usually have the patients mix a little hydroquinone and Retin-A in their hand and apply it already mixed together, it does dilute the medication down some but they enhance each other. After ten minutes you can apply the moisturizer if desired. JG 1.31.09

• Good Morning Dr Garcia, I use three serums in the AM, Peptide serum, Vit C, and DMAE serum. All three are very thin, water based. In what order should I layer them? Is 10 minutes between layers adequate? Thanks!!

  Answer:  no real issue with the order as one will not affect the absorption of the other with those ingredients. JG 1.30.09

• Dear Dr Pierce I am currently 5 months pregnant and using Retin A 0.1% on my face for fine lines. I have recently become aware that this can cause birth defects is this true and should I stop doing it immediately

  Answer:  it has not been studied but it is a Vitamin A derivative and Vitamin A is absorbed through the skin and excess Vitamin A can cause birth defects so I think it best to stop, just in case. JG 1.30.09

• Dear Dr. Garcia, I just had sclerotherapy on one leg. The doctor said no exercise. I then told him I was scheduled for a massage later today and he said no massage. Can you explain why? Thank you.

  Answer:  beause they want the sclerosing material that was injected into the vein to stay in place to cause it to clot and stay clotted. JG 1.29.09

• I am post C02 laser resurfacing nine months, can you tell me what products (sunscreen) you recommend for going to the beach?

  Answer:  Total Block by Fallene. JG 1.29.09

• Hi Dr, Do Vit C serums and creams actually manage to feed the skin or is it better to have direct injections of vitamins to reach the deeper layers that creams may not reach? Thanks

  Answer:  the creams work better than injections in the case of vitamins. JG 1.28.09

• In general, which is less irritative for skin and more suitable for acne prone and also senstive skin (in general), is it L-ascorbic serum 8% or Polyhidroxy Acid (PHA) cream 10%?

  Answer:  I think the L-ascorbic serum will be less iritating. JG 1.28.09

• I laughed when a co-worker asked me if applying safflower oil or emu oil to the skin could cause one to become fat...it has sparked quite a debate in the office...your knowledge in this department would be very welcome.

  Answer:  it will not. JG 1.28.09

• I have been reading thru your posts and noticed a lot about hydroquinone. Could you please let me know what it is, what are the benefit, and how to get it. I currently use retin A. I think it is the strongest (.1%).

  Answer:  it is a prescrpition skin bleaching cream used to treat and prevent brown spots. You need to get a prescription from your doctor to buy it, typically we use 4%. JG 1.27.09

• Hi, where can I get Renova from? i LIVE IN THE UK. I`m wary of ordering on line incase it`s not the real stuff. Also, would you recommend using hydrauloc acid and the peptide matrixyl 3000 on the skin?

  Answer:  it is a prescription so you need to see a doctor. As to the other products, save you money. JG 1.26.09

• Hey, for some reason (probably home glykolic peels) I´ve got darker pigmentation to the left side of my eye/cheek area. I read about your recommendations for pigmentation problems (hydroquinone combined with retin a). But then I also read on the internet when searching information that the use of hydroquinone can actually worsen the pigmentation and cause darker skin colour to certain areas!!? what do you think of that. Do you have any experience with your patients when the use of hydroquinone would have worsened darker pigmentations? And are there any other ways for example IPL, copper peptides, skin needling etc. to try to reduce pigmentation? Thanks for all your help!

  Answer:  left sided darker spots are more common due to the sunlight that hits that side of the face through car windows. I think hydroquinone can irritate the skin and if not used in conjunction with a sunblock and avoiding sun, it can temporarily cause some pigemntation to darken. IPL can help but is no better than the creams, I think copper peptides will no$t help, skin needling can likley make it worse too. JG 1.26.09

• I am 36...have brown spots showing up and some minor melasma on upper lip. What is the best regiment for treating and preventing these brown spots, other than sunscreen?

  Answer:  Retin-A 0.1% mixed with 4% hydroquinone. JG 1.25.09

• I am 36...have brown spots cropping up and a few wrinkles. I have minor melasma on my lip. Please recommend the ultimate regiment to treat AND prevent. Whether it be peels, lasers, creams, vitamins, etc...I don`t know how to sift through all the information and hype. Thanks so much. :)

  Answer:  Retin-A mixed with 4% hydroquinone twice per day and sunblock all the time, no sun exposure, if it shows no further progress, then I would go to a YAG laser treatment. JG 1.25.09

• Hello, Just wondering what your opinion on oil of olay products is? Are they effective, or would I be better off to spend a litte more on different products? Thanks!

  Answer:  I have to say that they are pretty good and also a good value. JG 1.24.09

• I asked you recently about an indented scar - it has two problems - slightly indented - that can be filled as you suggested -- what types of treatments do you recommend to rid the scar across my forehead. It is a year old.

  Answer:  it can be smoothed out by elevating it to the surface of the surrounding skin but the scar cannot be removed. JG 1.24.09

• Dr. What are your thoughts on Alpha Arbutin for pigmentation, age, liverspots etc.? Thank You so much.

  Answer:  sorry but I have no personal experience with using it on any patients. JG 1.22.09

• would using a washcloth to wipe off face/eyes in morning cause baggy eyelids?

  Answer:  no. JG 1.22.09

• what`s your thoughts on pure jojoba oil? does it help at all with skin texture, dryness?

  Answer:  good product for body skin. JG 1.22.09

• --------Hi Dr. Garcia, Can you please let me know what is the best treatment for discouloration and its prevention. it was only one spot. but now it is like spreading rapidly. many thanks,

  Answer:  if it is a dark spot I suggest Retin-A with hydroquinone and sunblock, if it is loss of pigmentation I suggest you see a dermatologist for a diagnosis and then therapy. JG 1.20.09

• Good Evening Dr. Garcia! I had an old scar (that likes to puff up from time to time) on my cheek injected with a small amount of kenalog five days ago. I noticed that the Dr. did dilute it half and half with another substance, but can`t remember the name of it (I believe it started with a B ). Anyway, I haven`t noticed any change in the scar. It hasn`t flattened any, and is actually a little puffier right now. The Dr. did mention that it will take some time for it to go down. Is this correct? When do you think I should start seeing results? Should I massage the scar, or apply any pressure to speed it along? I appreciate your time, and your kind heart. Best Wishes to you!

  Answer:  well, it is not common for it to take a number of injections to get it to flatten out, I would not expect it to be flat after this much time and as the material is still in there, it is common for it to be puffier than before for about a week or more. Will likely need a repeat injection in about 6 weeks. Best of luck. JG 1.19.09

• 1- Does Retin A worsens Melasma with some peopl? 2- What can be done to treat white heads under and around eyes? thank you so much.

  Answer:  it can at the begginig if it causes irritation and the patient is not using total sunblock. As to the white heads a dermatologist can burn them off usually. JG 1.19.09

• Is Tretonoin the same as Retin-A? I am a 44 yr old female with crows feet and serious crepiness undereyes. I am in excellent physical shape, good skin, just too much fun and sun around my eyes. Any suggestions? Had botox and Juvederm....results were not good..I think I had a reaction, looked puffy and bloated in my face for 6 months. Thanks!!

  Answer:  it is the same, might need a laser to tigthen the skin. JG 1.18.09

• What is your opinion on vitamin c injection?

  Answer:  waste of time. JG 1.18.09

• A friend of mine just found out that her morning cream and her night cream that her dermatologist just gave contains steroid in it. She has been using it constantly for 7 days & nights, but she wants to stop using it. Since she already use them in 7 days and the creams contain steroid, how is the best way to stop using those creams, just stop right away or dont stop right away?

  Answer:  that is a fairly short time so just stopping them is OK without weaning off. JG 1.18.09

• Dear Dr. Garcia, I recently had a microdermabrasion done on my face. I also had them at a different office several years ago. The current one didn`t use the crystals being sprayed on your face. It seems like a hard sponge being spread across the face. Is this new? I didn`t think it was as beneficial? Your thoughts on this machine? Is it new? Thanks.

  Answer:  if it is the wand with the diamond particles, it works quite well with less scatter of the crystals which are a nuisance. JG 1.18.09

• I have minor acne scars on my cheeks (both sides) I`ve always had nice skin until the scaring happened & I`m really nervous to try lasers, is there any creams that you find helpful to smooth out skin and keep the healing process going? Thanks so much for taking the time to answer my question, great website!

  Answer:  can try soem Retin-A and see what it does for you. All the best. JG 1.18.09

• When using Neostrata cream containing AHA at night, is it okey to use a vitamin serum 8% l ascorbic acid at morning after, or it will irritated sensitive skin in general?

  Answer:  you will have to try, it should be OK. JG 1.16.09

• which one more gentle and more suitable for sensitive skin in general, mandelic acid or polyhidroxy acid, assuming the concentration is the same?

  Answer:  no way to know becasue the polyhydroxy acid is a combination of other hydroxy acids. JG 1.16.09

• My sister using adapalane 0.1 gel for a week and now got some irritation spot, so she want to stop for a while. What she should do to make the irritation spot go away faster, is it ok if she applies a vitamin c serum in the morning to minimize the irritated spot caused by adapalane?

  Answer:  the Vitamin C might irritate her too, just use a moisturizer and let it heal on its own. JG 1.16.09

• Doctor i am the one who asked about toner containing retinoic acid and clyndamycin below. What i mean is, if i have never use retin a before and not using any retinoic cream now, is it safe to use toner containing retinoic acid and clyndamycin, start from twice a week and increase gradually to twice a day? i asked because the retinoic acid and clyndamycin is in a toner form, not cream

  Answer:  yes, that would be safe. JG 1.16.09

• What do you think of this product :active ingredient: Mandelic acid 5%, Glyceryl Laurate 2%. Other ingredients : Alcohol, Water, Glyceryl Laurate, Triethanolamine, Glycerin. It is a toner that we have to use slowly from twice a week until we can use twice a day. Claim to be noncomedogenic. Is the claim in general based on the ingredient could be true and is this gentle enough in general, for someone who never use AHA before?

  Answer:  no way to tell if you will tolerate it until you try it, although it is likely a low comedogenic product, ntohing is 100%, it is trial and error. JG 1.16.09

• What is your opinion on toner containing retinoid acid and clindamycin? the manufacturer said to slowly increase using it from twice a week until twice a day. Is it a nice idea to use this toner for someone who is about to use retinoic acid for the 1st time?

  Answer:  I typically do not use a toner on patients using Retin-A. JG 1.16.09

• Hi Dr. Garcia, are dermarollers effective? The makers of such products claim that they allow for greater penetration of skin care products. Is it dangerous for such products to penetrate your skin at this deeper level or is it beneficial and more effective as they claim?

  Answer:  no, they are not. I think getting skin products into holes in the skin can lead to infections. JG 1.16.09

• I have red spots on my cheeks I did see my doctor she prescribe some creme I have applied it to my cheeks and it started to clear and now it is starting to appear again what could it be it gets red and looks dry.

  Answer:  might be dermatitis or Rosacea, impossible to tell without seeing you in person but sounds like you need to see your dermatologist. JG 1.15.09

• Can retin A cause minor vein capillary damage on the face? If so, what can you do about it and why would anybody use it if that can happen. Broken veins in the face are about the worst thing possible in my view--worst than a wrinkle.

  Answer:  yes, it certanly can. It can be treated with IPL treatments, it does not happen to everyone, and it is more common on thinner skinned areas, it still has wrinkle reduction properties and also its original use for control of acne. JG 1.15.09

• Hello, I have been on Obagi NuDerm and my shallow acne scars appears deeper and worse looking than before. I know things are supposed to get worse before they get better but does this apply to acne scars too? I appreciate your opinion, thanks.

  Answer:  yes, it applies to that too, hang in there. JG 1.19.09

• Does the vitamin C ester serum product help stimulate collagen-- or is it just a good moisturizer that costs too much?

  Answer:  it helps stimulate collagen and also reverse some of the sun damage to the cells. JG 1.14.09

• Dr. Garcia, Do you see at any time in the foreseeable future, any advances in cosmetic surgery, that will enable people not to have to go under the scalpel, so to speak, to have tummy tucks and cosmetic breast surgery and the like? I feel that would be an awesome advancement if they could find other ways to do so, what is your opinion on this. TIA.

  Answer:  I think we are likely many years away due to technology and the testing required of all of the options that might come about or are in the development pipeline. JG 1.14.09

• To make a vitamin c serum lasts long enough and not fast to get oxidation, should we keep in it refrigerator to make it best all better at room temperature in a sidebed drawer?

  Answer:  sidebed drawer in the dark. JG 1.14.09

• Good evening Dr Garcia, I am using the full Obagi NuDerm system to fade hyperpigmentation on my face. I am considering taking a 2 week break from Obagi to accomodate some social engagements. If I do decide to take this break, will this render the Obagi less effective (for hyperpigmentation) when I resume treatment? Thanks in advance.

  Answer:  no, it will be fine and then restart, no problem, it will set you back for only a short time but it catches up. JG 1.13.09

• Hi just a clarification about my last post re: Obagi and dry wrinkles. I was talking more about my skin creasing when i sleep, then causing marks that stay. I never had these stay before Obagi. Usually they would go away in the course of the day. I have one that does not follow the pattern of my wrinkles when a frown, that remains after a month. Is this normal at all?

  Answer:  because the skin is drier, those negative effects of sleeping on the side of your face while on your pillow are more visible when on on the Retin-A products, but those negative effects are the same to all of us, just more easily seen while on the produicts. As your skin regains its normal moisture content that should get better. JG 1.13.09

• DR.Me and my sis had Botox on crows feet ,forhead and for elvate lip corner(on lower cheek)I t was so great.Skin had really visile difference for lines and wrinkles. My sis had a face paralysis about 2 weeks after the tx.Can u plz tell me that is was due to botox or any other reason??It could happen and u have seen it...She reall need botiox again but a little sacred and want to know if it was the Botox side effect...or somthing else??

  Answer:  no, in the locations you had the shot with the Botox, that is a known risk of the Botox treatment. JG 1.13.09

• You mentioned that putting Retin-A on the top lip would help the fine lines. Would Retin-A also cause the skin to thin above the lip? Would the help be just peeling exfoliation (like other peels)--or is there some other contributive function that Retin-A would play in helping the fine lines on the upper lip?

  Answer:  the only part of the skin that thins with Retin-A is the epidermis, and that is a good thing, the dermis, is thickened by Retin-A and that also is a good thing. The dermis getting thicker is really where the Retin-A effects its improvements, not in the superficial epidermis. JG 1.12.09

• does the vitamin C serums have any benefits on a more permanent basis such as collegan strengthening, etc...? Or is it just a temporary fix?

  Answer:  no permanent improvement because the aging process continues and new damage occurs. JG 1.12.09

• Hello Dr. Garcia! I have been using Obagi NuDerm for 2 months and have noticed improvements in skin tone, pores, and texture. However I am tired of being totally red and peeling all the time. Since I have noticed a lot of improvement already, the only reason I would stay on is for improvement in laxity or firmer skin. Based on your experience with NuDerm, do you think I would notice an increase in skin firmness if I stayed on for a few more months? Also, a problem I have had with NuDerm is that I get TONS of sleep creases. Have you ever noticed this with your patients? I even had one that has caused a permanent park, which really sucks. I am wondering why this would be. My guess is that the new skin is very sensitive. Is there anything to do about this situation or to prevent future sleep creases from occuring? Thanks so much for your help!

  Answer:  it will help but it will only stay that way with continued use of the product. When the skin is irritated, it is common to get some dry skin wrinkles, pretty common I am afraid, all of that gets better though after your skin gets acclimated to the irritation. JG 1.12.09

• What can you tell me about the CO2 laser treatment? I`ve been out in the sun many years and have sun damage. Will the CO2 treatment be effective for me?

  Answer:  I feel it is the gold standard for sun damage and fine lines. JG 1.12.09

• I have just ordered the eye and face creams that your office sells. Should the eye cream be used only up to the orbital bone area? Can some anti-aging eye creams make your symptoms worse if you have dry eyes? I cannot buy Restasis in Canada, what would you recommend for the treatment of dry eyes?

  Answer:  it can be used passed the orbital rim, yes. The creams should not cause any aggravation of dry eye though. For the dry eyes try using Bausch and Lomb wetting solution for hard contacts. JG 1.12.09

• These are ingredients of a soap product : Disodium Lauryl Sulfosuccinate & Sodium Coco-Sulfate & Triticum Vulgare (Wheat) Starch & Cetearyl Alcohol & Paraffin & CI7789, Talc, Heilmoor Clay, Olea Europe (Olive) Fruit Oil, Water & Glycerin. Do you think this product generally speaking is good for large pores skin (this product is marketed using Multi Level Marketing Method)

  Answer:  pretty average.JG 1.11.09

• Dr. Garcia do you know this product called Eumora facial bar? is it an okay product?

  Answer:  just OK. JG 1.11.09

• Dr. Garcia, when answering my question about moisturizer containing Petrolatum in it, you said you would avoid Petroleum in moisturizer at any cost. So is Petrolatum actually the same as Petroleum?

  Answer:  petrolatum is made from petroleum, it is an oil product. JG 1.11.09

• I have been using heavy moisturizers and face cream on my face and notice that it really fluffs up the skin and takes away the small lines and my skin stays that way all day.I also use the Vitamin C serum first.Is this fix just a temporary fix?Or does it have some lasting future value. I stay OUT of the sun and wear blocker.

  Answer:  it is just a temporary fix I am afraid, but that is not a bad thing. JG 1.9.09

• For someone who has oily skin but not very oily, large pores and very easy to develop acne, do you prefer : 1. a moisturizer in gel form (with alcohol in it), or 2. moisturizer in cream form that contains Petrolatum, without alcohol in it?

  Answer:  I would avoid the petroleum at all costs. JG 1.9.09

• Dr. Garcia, I am using the full Obagi Nuderm system (steps 1-6) for mild melasma. I am just about finished as the melasma is almost completely cleared up for now. My question is, I am out of #3clear. Can I just use #5/Blender in it`s place? Meaning, in AM vit-C serum, then blender/#5, followed by exfoderm and sunblock. In PM, apply Blender/#5, followed by blender mixed w/ tretinoin. Would this be as effective? Or should I just get another #3Clear? Thanks for your help.

  Answer:  the clear is the skin lightening agent so if you stil have some spots you need to continue it. JG 1.9.09

• Dear Doctor, if I want to use a self tanner and not have other skin products wash off immediately the color obtained with the self tanner and/or if I want it to last a bit, which products should I avoid? I guess I should not use glycolic or salicylic acid, but could I use retin-a? Or would the retin-a also take away the skin cells where the self tanner would work ? Hugs!

  Answer:  Retin-A will remove the self tanner the fastest. All the best. JG 1.9.09

• Is it possible that we can find over the counter (OTC) product for face moisturizer in a gel form, that contains no alcohol at all? Or any gel moisturizer will contain alcohol anyway since it is not a cream?

  Answer:  I am not sure, most gels do have some alcohol in them. JG 1.9.09

• Hi Dr Garcia, What do you think of a hand held device by Galvanic Spa (part of NuSkin) that claims that it delivers low galvanic currents which facilitates refreshing the skin ? There are also some claims that it stops wrinkles. Thanks.

  Answer:  save your money. JG 1.8.09

• Dr. Garcia, I asked a question about milia below. Doctor said he would use a needle. I should have asked more. What type of needle do you think it could be? It`s about 1/2 inch below my lower eye lid. Thanks

  Answer:  no special needle is needed, that only opens the top layer of skin so the oil can come out. JG 1.7.09

• My girlfriend and I had a treatment called LamProbe to remove broken blood vessels and spider veins on our faces. Both of us experienced intense pain and burning after the treatment. My girlfriend had scabs for 2 1/2 weeks on her face. What looks like 4 bright red spider veins appeared on my face in one area that was clear before. Also in other areas there is now a indent in my skin. I know the girl who did the treatment had it set on high and then turned it down a bit when I winced at the pain. Could she have burned our skin?

  Answer:  possibly, but all treatments for broken blood vessels on the face have the same risk and nothing removes them on a permanent basis I am afraid. JG 1.7.09

• Good Morning, I am so upset as I have good skin at 56 however, I saw this on-line new skin line that you fade your under eyes with alpha arbutin/lactic acid for 2 weeks prior to lighten. I then a pplied 12.5% TCA peel and kept it wet with emu oil. Now 8 weeks later my skin near my eyes are sagging and darker with black charred tissue. I have 2 strong makeup,concealer and you can see darkness and leftover burn crepey skin which I never had. Should I redo the peel or am I scarred with black crepey under eye skin? Would Renova help or Retin A in small doses at night followed by emu oil?? Help..as I hyperpigmentate and olive tone skin. I wish I did not do anything. The skin doctor 2 years ago had me on obagi and it was fine as lasers only make dark circles worse on my skin tone. Hydrquinone, after using straight...got darker. Any suggestions ..I am desperate!! Loose undereye skin, dark, crepey...hyperpigmentation.????

  Answer:  I think you should stay away from the howe treatments and see either a dermatologist or a plastic surgeon in consultation. The Renova or Retin-A might help but it sounds like what happened was a burn on the thin skin you were trying to improve so you need to be very careful with what you apply and use there. Best of luck. JG 1.7.09

• Dr Garcia, WHat would be the best treatment for milia under the eye? The doctor I saw said a needle. What does that mean? I don`t want to trade a scar for that. Please explain. Thanks much.

  Answer:  the needle is the easiest, it is where the surface of the milia is opened with a needle hole and the oil pushed out. You will likely get more in the future though. JG 1.8.09

• I have a dark spot on my upper lip (chemical burn) and am using Retin-a with hydroquinine (4%). How long is too long to use this product? Also, I only use the Retin-A at night...Can this be used during the day as well??

  Answer:  use the Retin-A twice per day if possible and the maximum fading you will get from that is usually seen in 6 months. JG 1.7.09

• Dr Garcia, I am always reading of supplements to help the skin, but the list gets exaustive (vit E, B, ALA, omegas, etc). What are the most essential vitamin supplements that will help to keep skin with minimal damage looking good?

  Answer:  Vitamins B,C,E, and the fish oils. JG 1.6.09

• I am currently using your peptide cream. I`m 53 with moderate sun damage around my mouth. Will your other AHA cream help? I find that most acid or vit c products dry out my skin and make it look worse even when I layer them with a rich moisturizer. I have the same problems with retinols. also-what do you think of the TNS recovery complex? thank you...

  Answer:  my other creams have Vitamin C or alpha lipoic acid which can irritate people with sensitive skin too I am afraid. TNS recovery is a good product, might try that. JG 1.6.09

• Hello, I recieved juvaderm injections about 4 days ago for the nasiolabel fold area and she put some of the juvaberm on each side of my mouth which left an upraised area at the corners my mouth, my question is what is the optimum time to inject the hyaluronadase? Am I seeing the end result already or should I give it a bit more time? Also when they inject the hyalurondase can they target specific spots or wil it bleed into other areas? Lastly, do you see very much migration of the juvaderm product into other areas? Thank you......

  Answer:  I would give it 7-10 days and hyaluronidase does spread a little after the injection. Juvaderm typically does not migrate much though. Best of luck. JG 1.5.09

• Dr. Garcia, What strength retin-A- do you recommend for first time users? I`m 54 and have fine lines as well as a few large brown spots. Will the retin-A even help with the brown spots? Thank you!

  Answer:  I usually start at 0.05% and then progress from there. The Retin-A will help the brown spots but do not forget the sunblock. JG 1.5.09

• Hello Doctor, can you tell me if there is another peptide cream compared to the one you sell on your web site that may be cheaper in cost. I like the one you have but can no longer aford it. Hope you can help. Thanks

  Answer:  I am sorry but none that I am aware of that have similar ingredients at that concentration, sorry. JG 1.5.09

• Good Morning - I am 53 year old Africian American women with problem skin, during my younger years I had acne, then as I got closer to my fifties my skin began to dry out and now I have a dull, ashy, gray color to my completion, which is on my face, when I put on foundation it seems to be even darker. I have tried Oil of Olay products, but it broke me out really bad in a short period of time. At the present time I am using Noxzema exfoliating cleanser and their deep cleansing cream, which is ok, but what can I use on my skin that isnot to harss to give my color some mositure back in it. Any susggestion would be helpful. Is Noxzema ok for older skin care. Thank you 12/05/09

  Answer:  Noxema is OK to use, can also try squalene oil from the health food store too. JG 1.6.09

• I`m 43 and went to the Dermatologist for the 1st time for wrinkles and acne on my chin, chest and back. She put me on retin-a micro .1% nightly and Clenia foaming wash am & pm and Duac am. When I used all together it really inflammed my skin so I stopped for 3 days and started using retin-a micro on my face only and the other 2 on chest and back. Do I really need all 3? Will I have to keep using forever? I don`t mind using the retin-a, but I`d like to stop using the other 2 when I run out (very expensive). Seems like the retin-a should take care of the problem by itself. Thank you for your help.

  Answer:  eventaully if you can tolerate all three, it will be more efective, might just need to build up to it, the Retin-A will be the most effective component though. JG 1.4.09

• Would these ingredients do anything for aging skin: Caracol Cream contains, Allantoin, Collagen, Natural Elastins, Glycolic Acid, Anti-Biotic Peptides(is there such a thing?), Vitamins (A,C and E) and also A Natural Solar Filtrate. Thank you for your time.

  Answer:  doubtful. JG 1.4.09

• Dear Dr. Garcia I am nearly 60 with few wrinkles. My complextion is pretty good but I would like to freshen up. What does your cream do exactly? If I also use retin a when would I incorporate it into my skin care routine? Thank-you.

  Answer:  my creams will reduce some sun damage and fine wrinkles in most patients and make your skin feel smoother. If you desire to use the Retin-A in addition, apply the Retin-A first, wait ten minutes, then apply my creams. All the best. JG 1.4.09

• Hello Dr. Garcia, How long does it take for juvaderm to settle in and smooth out after injection? In other words when do you see the result for what it will be?

  Answer:  usually in about 2-4 days or so. JG 1.4.09

• i am thinking to use obagi c rx system for my pigmentation problem. If my problem already gone, should i still use the night cream and the morning cream, or should i change? The reason i asked is because, you often reccomend to stop using hydroquinon when the problem is already gone, but the obagi website saying that we must using the product continously, and when we stop, our skin will be bad again. So what to do? If change after the problem gone, what should i use? why obagi web site saying that we cannot change because it interferes the healthy skin process that already we achieved?

  Answer:  I would just stop using the products with the hydroquinone in them and give your skin a break from the Retin-A for three month per year. I think their website says that so you keep buying the products. JG 1.4.09

• FOr my pigmentation problem, i`ve just got the Obagi C RX system. 1. I wonder why you only sell the Obagi Nuderm system, why is that, is the Obagi C Rx system not good? 2. Actually i have been using the cleanser (obagi C Cleansing Gel) for a while, only the cleanser. The system consist of night cream, a morning serum and morning cream. Should i add it one by one, for example night cream only, for a week, than add the other, or should i just directly use everything in the system?

  Answer:  I do not sell them becasue I feel my Vitamin C products are better. I think it is always best to add products slowly to make sure your skin can tolerate it. Best of luck. JG 1.4.09

• if someone is getting bad reaction when consuming vitamin e, d alpha tocopherol 100 mg daily(developing more acne while consuming vitamin e and have a good skin without acne when stop consuming vitamin e, ), do you think that person can still consume supplemen named Omega 3 (salmon oil, EPA 400 mg and DHA 300 mg)daily, or will it react just like the vitamin e d alpha tocopherol, make more acne to that person?

  Answer:  I think the fish oils will likely not cause the problem. JG 1.4.09

• When i read this site, i often found questions from other person mentioning anti oxidant gel. Actually what does it mean, and can you give an example of such product that can be found over the counter?

  Answer:  well, technically there is no antioxidant gel, but if there are antioxidants in it,like say Vitamin C, they refer to them as antioxidant gels. JG 1.4.09

• Is it true that sleeping with makeup on will age your skin 7 times faster? If not, what will it do? Thank you

  Answer:  no, but it will make you prone to plugged pores. JG 1.4.09

• I had fractional C02 laser treatment on my face one pass most areas.sun damage from many years ago.its only 5 days latter.still red and pealing what should i conceal with? i mean i needto leave my house.whats the besty way to look my best?and suggestions recovery expectations.

  Answer:  I think just some mineral make up is likely the best. JG 1.4.09

• I have two questions: 1. I am going to add tretinoin cream to my morning routine. I use .25 strength. If I begin the routine with the tretinoin, can I wait 15 minutes then add an anti-oxidant gel, alpha hydroxy 8% and then a moisturizer with sunscreen? 2. In the evening I currently use tretinoin followed by moisturizer. If I decide to start using hydroquinone for a period of time, can I do that in the evening in between the tretinoin and moisturizer.? Thank you!

  Answer:  Yes to question 1. Yes to question 2. JG 1.3.09

• Hello I had surgery 3yrs (2006)ago on my parotid gland which left a nasty keloid scar about 2 inches long from my ear down the side of my neck. Since then I have gone thru surgery each yr to remove the scar the first time (april 2007) we tried the kelog injections for months that worked at first but then it didnt I also tried the scar guard md on and off during the months of the first yr of the scar removal. The second year ( april 2008) I had the scar removed I went the radiation route and now its been almost a year (january 2009)and its slighty starting to form again. What should I do should I try the silicone pathes. If so which one? Should I try this kelo cote I hear about or should I use the scar guard again but this time use it everyday and 12hrs until I see results? Please help Me? Signed tired of this scar coming back......

  Answer:  I have had good succes with a combination of kenalog and 5FU injections, might want to ask your surgeon about that. All the best. JG 1.3.09

• I`ve just been put on retin-a micro .1% and I am trying to find a good day moisturizer to go with it. I tried using Neutrogena healthy defense spf 45, but it is too greasy and shiny under my makeup (bare minerals spf 15). I used to use Neutrogena visibly firm spf 20 and I loved that, but I`m afraid the spf isn`t high enough. Can you recommend a good one that won`t be too greasy or is the Visibly firm spf 20 ok?

  Answer:  I migth suggest Total Block by Fallene. JG 1.3.09

• I have had 3 Vitalize peels in the past that I have had good results with minimal down time glue like peeling. The clinic no longer does them but they said do a peel with the same results, lite minimal down time and graudually work up a higher level if I like the results and it is by Jessner. I told them I was concerened about some of the stories I hear about peels.Is this a better product with more ability to customize? Should I ask them the % and formula, what is considered mild?

  Answer:  I am sorry but there is no way to tell, all peels react differently on different people. It is a trial and error thing many times. JG 1.2.09

• Hi Dr., I have several questions, which all fall under the general category of restoring and preserving skin firmness. 1. Is Retin-A the single best product available to restore/preserve firmness. If not, then what is? 2. If it is, how often should it be applied to optimize it`s firming effects? 3. I read on your site that (jogging) can decrease firmness by tearing the skin...what exercise to you recommend to receive a good cardo/muscle workout whilst avoiding the skin tear? 4. Do you reccommend oral supplements for skincare. Or will regular daily vitamins plus a healthy diet suffice? 5. If you recommend supplements which ones and can they be taken in combo with other vitamins? 6. Most Importantly--I use Retin-A on my entire face w/ the execpetion of where my smile lines would be and on the skin b/w my smile lines and my nose because about a year ago I preformed an over-zealous at home micro-derm abrasion procedure on my smile lines and ended up rubbing my skin completely raw. To the point where it scabbed up. Totally ridiculous, I know. Anyway, it is my understanding that Retin-A thins the top layer of skin, which to me, and correct me if I`m wrong, does not seem like a good idea for the skin around my smile lines and nose due to my attempt at micro-derm last year. SO,,,,,Is there some other product that you would reccommend for that skin as oppossed to Retin-A that would have a similar firming effect but w/o further damaging/thining the skin? Or...is Retin-A okay to use in that area? I apologize for the length and detail of the questions. I really appreciate the service you provide. Thank you.

  Answer:  I think Retin-A is the gold standard against all else is measured, yes. Optimal application is at 0.1% twice per day. As to the cardio, try an elliptical machine or a stationary bike, or Gauntlet Stairs. I think omega three fish oils along with Vitamins B, C and E for the skin are good. Retin-A thins the epidermis, which is good, and thickens the dermis, which is good. Best of luck. JG 12.30.08

• For the past year and a half I have been doing what I could to recover skin health, including going through Obagi Nuderm, and following up with a regimen of beta hydroxy acid, tretinoin, DMAE, and religious use of sunblock. I wanted to see how much I could improve the skin condition in those conservative modes before I sought more out next steps for this 48 year-old pale male skin. I hoped that next step would be deep Portrait passes, but now I read that the company is out of business in the US. Do you think a technology will step in to fill the niche in the coming months or year? Thanks, Dr. Garcia.

  Answer:  I think the machine will continue to operate as there are parent companies still making the nozzles outside of the US, so either that or a very light complete surface CO2 laser might be in order. JG 12.30.08

• Dear Doc, Thank you so much fo your propmpt answer. Wishing you a Happy New Year -Adi

  Answer:  best of the season to you also. JG 12.31.08

• Dr. Garcia, Merry Christmas n Happy New Year! Thank you so much for giving us advices, you are a great doctor. If you dont mind, I would like to ask you, if someone always getting the pores look bigger in annoying way after any exfoliation (such as retin a, AHA, glycolic acid, adapalane, even wash cloth, or all scrub cream and scrub soap sold over the counter), should that person avoid exfoliation completely? Is there any way that person can clean the pores with other means, or should avoid exfoliation completely?

  Answer:  might suggest microdermabrasion or IPL treatments. Best of luck. Merry Christmas and Happy New Year. JG 12.27.08

• Would a tea made of these ingredients be good for your skin? Glycerin, honey, white tea extract, licorice root extract, burdock root, citrus rind extract, dandelion root, luo han guo extract, white tea leaf, red clover blossom, green coffee berry extract. Thank you for your time

  Answer:  not sre what if anything it would do for yoru skin, Merry Christmas and Happy New Year. JG 12.27.08

• Dr. Garcia, my sister is being recommended to use the Obagi C-Rx System. Is this Obagi C-Rx System (not the Obagi Nu Derm System) is something that one should use forever or something that one should stop use after finishing one package? Because the C-Rx System involve a night and day cream containing 4% hydroquinon. By the way, my sister dont have pigmentation problem, she just want to have glow skin, right now her skin is dull.

  Answer:  I think that is for pigment problems so I see no need to use the hydroquinone if you do not have the, the regular products will improve your skin enough in your case. Merry Christmas and Happy New Year. JG 12.27.08

• Hi Dr. Garcia, I have noticed more obvisiously these little white bumps under the skin on the inside of my eyes. They are tiny and in the area of where some people get dark circles. Is this milia? I do not have them anywhere else and wasn`t sure if that`s truly what it is. How can I get rid of this? Is there any medication that a dermatologist can prescribe to diminish these tiny bumps. I read that you can try to exfoliate the skin but I don`t want to be too rough in that thin skin area and do more damage. Thanks for your help.

  Answer:  could be milia, yes. Dermatologist can burn them off for you but they will likely come back in time, noting topical will work, sorry. Merry Christmas and Happy New Year. JG 12.27.08

• Merry Christmas Dr. Garcia!! I just got some of your peptide cream and am anxious to start using it starting tonight. My previous evening ritual was using ROC wrinkle cream followed by Kiehl`s moisturizer and then Olay regernist cream. Do I just use the peptide cream alone or do I need to use the Roc cream as well (first or last)? I am very fair, do not tan, doesn;t have a lot of wrinkles and I do not wear base make-up during the day..just lots of moisturizer. Now that I will be using your cream at bedtime, what do you suggest during the day? I am in my 50`s so your receptionist suggested the peptide cream. It wasn;t until I received it that I noticed it said at bedtime. Should I have ordered your DMAE cream for during the day? I hope you don;t mind but I am just trying to pick your brain as I wade through all of the skin creams available to find the right regimen for me? As usual, I appreciate your sharing your knowledge and opinions.

  Answer:  I would use the pepetide cream and if desired, wait ten minutes and apply the Kiehl`s, skip everything else. I actually think you can skip the moisturizer too. It can dilute the peptide cream. I would use the other products you have during the daytime and when you run out you can switch to the DMAE cream alone. Merry Christmas and Happy New Year. JG 12.27.08

• Carac cream (0.5%) made by Dermik Laboratories. I have been prescribed by my dermatologist to use this on my face for one month. It was given as an option and I am questioning whether I should use this. My previous dermatologist had retired and never had mentioned using this. I am leaning toward not applying this to my face. How important is it whether I use this or not? I have occasional freezings of small pre cancerous spots removed. I am a 64 year old male who was exposed to the sun in Florida in the 1950`s. I have dark hair and brown eyes, so am not the light, complexioned type. Thank you in advance for your help. Jim

  Answer:  it does work well for precancerous lesisons and the winter time is s good time to use it. Merry Christmas and Happy New Year. JG 12.27.08

• Hello Dr Garcia, Just want to thank you for all your help over the past year on your website. I have been using you skin care creams for 10 days and so far, am really happy with the results, particularly with the Peptide cream. Merry Christmas!

  Answer:  thank you for the kind words and follow up. I wish you the best for the Holidays. Merry Christmas and a Happy New Year too. JG 12.24.08

• Ok Doc then how long would it normally take for the halo hyperpigmentation and brown spots to fade and is halo hyperpigmentation a common side effect of Tri-Luma in African Americans? Because I am an African American and I would like to know.

  Answer:  should take about as long as for the halo to appear, so not long. JG 12.23.08

• Dear Doc. I have a complex problem. I had a hyperpigmentated brown mark on the right side of my face from a large acne cyst in late Sept of this year that eventually healed and now it has left a brown mark on my face. Another doctor prescribed Tri-Luma which I used for a few weeks on it until it left a halo hypopigmention surrounding the mark. I need to know can this be treated and healed permanently and what do I do in this situation? I can send you pics to get a better idea. Please help.

  Answer:  well, any change in pigmentation like you describe is temporary, I normally suggest, when we use creams such as that, to apply it to the entire face and not just the spot. I would either leave it alone and let the pigment return, it will, or you can apply the TriLuma over the entire face and it should balance out. Later just slowly taper off of it. JG 12.23.08

• Hi Doctor, I have been successfully using 10% benzoyl peroxide cream along with salicylic acid pads to help keep deep painful zits on my nose at bay. I recently unnecessarily added a 10% BP wash in the morning to my regimen, and I can vaguely see light jagged edges where it stripped away a layer of skin on my nose. It doesn`t hurt, but I can notice it when I look closely. I stopped using the wash but continue my 10%BP cream and Salicylic acid regimen. After 2 weeks, I haven`t noticed any new skin blending in the jagged edges. Do you suggest I do anything or will it take care of itself in time, even if I continue my regimen SA and BP? Thanks.

  Answer:  it wil take time but with the salicyclic acid it might take longer, might want to just use the cleanser for now until all settles down. JG 12.23.08

• Dear Dr. Garcia, I went to a very good and well respected ENT physician yesterday for a medical condition. He had info around the waiting room about Botox, Juvederm and Restelayne. Is there a way to find out, without asking him,if he is doing fillers after a weekend crash course? Should I skip him and only go to a PS? Is it really buyer beware out there? It sdeems that the FDA and govt has their nose in every drug but once approved they don`t care how it is dispensed??!!I am confused and wary. By the way, thanks for all of your help answering many questions this year. In the spirit of the true meaning of Christmas and this giving season, I would like to make a donation in your honor to Dr. Magee`s Operation Smile or The Smile Train. Do you have an affiliation with either or a preference? I can make a smaller one to each or to any charity that you prefer. Bless you and Merry Christmas. Christine

  Answer:  I think just asking him a simple question like how long he has been doing it will give you the answer you want. The materials have been out for years so if he has only been doing it a couple of years, then it is likey it was an afterthought. You can also ask to speak to some of his patients too. I appreciate your kindness as to the donation, it is very thoughtful and I am sure there will be children helped by it, no matter which one. My usual one is Smille Train. May the Christmas spirit fill your home this year with cheer and happiness and I wish you the best for the coming New Year. JG 12.23.08

• Hello: what is your opinion on refirme skin tightening technology and/or the accent alma system. Happy Holidays Paula

  Answer:  Sorry to say I am not a fan or believer in either. Happy Holidays to you too. JG 12.22.08

• is generally speaking a vitamin c based product (such as face cleanser containing vitamin c / l-ascorbic acid) can stimulate more acne for acne prone skin?

  Answer:  it should have little negative effect on acne. JG 12.22.08

• I have been interested in getting rid of the saggy upper arms and seen a product called HTY Gold. Would this work on my arms or is it a waste of money, it is quite expensive. Also interested in Tummy Tuck, what is the down time for this procedure and estimated cost. Thank you for your time and help.

  Answer:  I personally do not think it will help. The tummy tuck downtime is one month before full actiivity and the fees are comensurate with time so I would need to see you in person to determine what is needed. JG 12.22.08

• Dr. Garcia, i have 2 questions : 1. if i want to use obagi C Cleansing Gel Cleanser, do you think i should go to dermatologist or i can buy it directly at obagi store near home? 2. Do you think this cleanser is suitable for someone who has sensitive acne prone skin but dont have active acne?

  Answer:  well, to be honest I never heard that there were Obagi stores, it is supposed to be sold only in doctor`s offices unless they have come out with a weaker version, but when it comes to facial cleanser, there is nothing in it strong enough that would make it needed to be sold at a doctor`s office.So as long as it is the real thing, buy it where it is cheapest. I do think it is OK for sensitie skin though. JG 12.21.08

• Dr. Garcia, i really like to have an anti aging topical for night routine for my face. Unfortunately retinoids such as retin a and adapalane make my pores bigger. So now i am considering another option. These are the option : 1. Gel that contains AHA 10% and hydroquinon 2%, or 2. Vitamin C cream. Which one you suggest or maybe you have other opinion?

  Answer:  if you do not need discoloration treatment I suggest the Vitamin C. Best of luck. JG 12.21.08

• Ijust read a post below about the diolite laser treatment for milia. Is there another name for this laser How does it work on the milia? Thanks

  Answer:  usually I just hyfercate them, it is an electrical machine, no need for a laser, if I laser them I use a CO2 laser. JG 12.21.08

• What products should black man/women use on their skin. My husband is getting bumps on his face now that are bothering him (vainity, the bumps don`t actually hurt or anything) and so many products that or commercialized aren`t for ethnic skin. What would you recommend or what should we look for in the products?

  Answer:  The bumps on his face are likely ingrown hairs, I suggest trying a product called TendSkin for that.It is sold online. JG 12.21.08

• I am a bi-racial woman and I am trying to find out the best way to lighten skin. Not just spot treatment, all over is what I am searching for. I have seen pills and products, but at heft sums. My complexion is medium, about the same color as Halle Berry or a tad lighter, not much. Happy Holidays and thank you for answering questions so close to the holiday!

  Answer:  I am sorry but there is nothing safe for that. JG 12.21.08

• Dr. Garcia, if my pores are big after using retin a (my sister told me that my pores are big but clean), and also every time i have scrub cream on my face, it will be cleaner but the pore looks bigger. So in this case, do you think a scar gel / topical will help, what is your suggestion in minimizing these pores, since i dont think i want to give up retin a cause i still want the anti wrinkle effect..,

  Answer:  I would rather suggest some light chemicla peels, IPL laser or micordermabrasions for the pores, topical scar gels will do nothing for them. JG 12.20.08

• Hello Dr Garcia. I tried posting a question a few days ago but it disappeared so let me try again ;). I am 26, good skin but a bit of red hyperpigmentation issues, a couple fine wrinkles, and pore issues. I am on a moderate program. Obagi tells patients to use between a half gram-one gram of Retin A which is a huge amount. Do you recommend this amount? I got irriration on my cheek, resulting in a red patch that is still red a week later. I made an appointment with my derm but its not for over a week. Do you think it could be permanent redness? What should I do in the meantime? It is not raw or tender, just slightly more red that surrounding skin. Now I wish I had not used the 0.1 retin A since I think it is too harsh for me. My own guess is that my skin got too thin, and the adding of the exfoderm AHAs, and reapplication of more Retin A, caused the red hyperpigmentation patch. Please let me know what you think I should do. On the plus side, my pores are smaller, and wrinkles reduced.

  Answer:  do not think it will cause anything permanent and I know Obagi is aggressive with his Retin-A, yes. You might want to try some squalene oil from the health food store, should help to settle it down faster. JG 12.19.08

• hi, Dr. Garcia , what exactly is acne surgery ? does this involve extraction of pus from an acne lesion ?

  Answer:  it is when they cut the depressed scar out and close it, it cannot be done while there is pus in the cyst. JG 12.19.08

• Dr. Garcia, i used to use a sunblock gel from my derm without knowing what the ingredients, but it feels good on my skin. Now i really aware of the importance of using sunblock, but i cannot tolerate any sunblock cream or lotion, feels very sticky. Unfortunately its been a really long time so my derm already passed away and the office is closed. Do you have any recommendation what brand of sunblock that is in a gel form, not cream, not lotion? thanks in advance

  Answer:  What issues you have had are more dependent on your skin than on the brand, I personally do not use any gel sunblocks but I am sure some exist, you will need to look and then it will be trial and error, sorry. JG 12.19.08

• Dr. Garcia, would you explain a bit, why a topical that is intended for scar, cannot work to minimize the appearance of pores at our skin?

  Answer:  a pore is visible because it is plugged with oil or dirt deep down inside and that prevents it from closing. The scar creams do nothing to help extract that plug so they are therefore useless for that. JG 12.19.08

• hi , Dr. Garcia .. when injecting steroid into an acne lesion that is pus - filled .. is it really necessary to sort of do acne surgery first -- ( meaning draining a little of the pus and extracting ) before injecting the steroid into the acne lesion ?..

  Answer:  steroids slow the healing of infections so should never be injected into an active infection. JG 12.19.08

• Dr. Garcia, do you think i can apply topical scar gel (its called activa condolisa scar gel) to try to minimize my large pores at cheek area? my sister has it so i dont have to buy it if i want to try it on. What do you think?

  Answer:  do not think it will help, sorry. JG 12.18.08

• Can I apply your peptide cream over Skinceuticals C&E Ferulic and hydrating B-5 gel? Thanks for your time.

  Answer:  better mine underneath. JG 12.18.08

• I want to star using retin a for skin around eye for its anti wrinkle effect. Do you think i should start with 0.01 (the weakest) in gel form, or 0.025 in a cream form? and why you choose what you choose?

  Answer:  I suggest the cream at 0.025% and start every other night only at the begiing and increase as tolerated. JG 12.18.08

• Will I derive the same benefits from Obagi (albeit slower) if I do the Obagi just at night? Meaning, #3 clear followed by tretinoin mixed w/ #5 blender? Thanks for your advice.

  Answer:  yes, slower and less dramatic. JG 12.18.08

• Dr Garcia, I have been using Obagi, it seems to be making more pores larger/more visible. Does this make any sence at all?

  Answer:  no, might want to decrease it and see if it is due to too much oil production from too aggressive of an application in terms of irritating the skin though. JG 12.17.08

• In order to prevent wrinkle and have anti wrinkle effect on skin around the eyes, i am thinking to use retin a daily on eye areas only (the rest of my face currently i am using differin, but i dont put differin around my eyes). What do you think? Will skin around my eyes peel if i do this?

  Answer:  the skin wil peel but it will help with the slowing down of the progression of the wrinkles. JG 12.17.08

• sorry, i should have clarified - my concerns for the tca peel are in terms of discoloration due to my darker skin tone. thanks for the quick reply!!! i can`t get over how awesome this site is!

  Answer:  yes, the Levulan is riskier. JG 12.16.08

• hi dr. garcia, thanks for the reply about my jessner`s peel (and my peeling). today looks much better and i`m optimistic about the results (for acne, dark marks from old spots and uneven skin tone - in combination with blu lite/levulan, 2 treatments so far). my derm says i can do another one in 2 months. what is the optimum length of time in between jessner`s peels? due to my olive skin tone i am hesitant to do a tca peel. would you say these therapies is good course of action for clearing the skin? i am 27. i am trying to clear my skin in time for my tropical honeymoon in june. what would you recommend for clearing up back acne most effectively? i`m already on BCPs and don`t want to do oral antibiotics or accutane. i know obagi works (at least temporarily) but it`s too pricey to treat my body. benzoyl peroxide washes don`t do much and i don`t want to use a BP cream and bleach everything. thanks for your time, this site and your knowledge is amazing.

  Answer:  Jessner`s peels cna be done every 3-4 weeks. I am a little confused about your concern about the TCA peel though as the Levulan with Blu lite is much harsher on your skin than any TCA peel would be. I think beta hydroxy acid peels for the back might help too. Best of luck and thanks for visiting and the kind words. JG 12.16.08

• Hi Dr Garcia, I am just about to start using your products for the first time ... eye booster, DMAE, and Neuropeptide. I have used Retin A for over a year. Do I need to stop the Retin A or can I add this to your products... I prefer to use it in the evenings but was not sure if its ok to mix with the Neuropeptide? I am 40 with fair, slightly sun damaged skin. Thanks

  Answer:  you can use my products over the Retin-A if you wish. Keep me posted on your experience. JG 12.16.08

• A friend of mine has been using retin a for 6 months, she only use it twice per week at weakest concentration (0.01) because if she use it more than twice a week, she cannot tolerate it. In the morning she always avoid sun and using sunblock. Can she still get the antiwrinkle effect of retin a if she only use it twice per week, and never get peeling from it? Is she better switch to vitamin c serum or stick with retin a though cannot increase the frequency of using retin a?

  Answer:  I think the effects will be mild if anything at all, likely not worth it for wrinkle reduction. I think the Vitamin C will help but not as dramtically as Retin-A would if used daily. JG 12.16.08

• What would you recommend for skin lightening? Something that is for all over lightening, not just spot treatment. I am searching and searching for something that isn`t prescription at this time. Thank you in advance for any assistance!

  Answer:  I am sorry but I do not recommend anything for that, if it did work, it would be uneven and probably would return with time anyway. JG 12.16.08

• What about lemon juice, I read in threads that it can lighten red acne marks/scars, also potatoes? any home remedies you can suggest?

  Answer:  it is an acid, it will not help the red. I reiterate my suggestions, LEAVE IT ALONE. JG 12.16.08

• Dr. Garcia, easier said than done obviously, would a 1064 yag laser do the trick in fading this spot/removing the redness? and I also read a thread on Finacea gel (15% alezaic acid) I know im being a pain, but im desperate.....

  Answer:  the Finacea gel will make it worse and the 1064 laser might help, but can make it worse in the short term, and will take a series of treatments, one month apart. Don`t think you have enough time to have it work. Looks like make up is the safest option. JG 12.15.08

• Dr. Garcia, The reason why I am so worried about this red post acne mark is that im getting married in february and I have this bad feeling that it wont clear up by then, what about laser, what kind of laser options will offer a quick fix and clear up the redness? also is it ok that I am applying bacatracin antibiotic ointment on the spot all day every day?

  Answer:  I think you should let it fade and heal on its own, if you keep irritating it, it will take longer. JG 12.15.08

• Dr. Garcia, I`m the guy with the red acne mark, so I applied the aloe vera gel last night and no change, ever since I applied the neutrogena saliciyc acid and glycolic acid rapid clear gel, that spot has turned from very light pink to very bright red. It is now more noticible than it ever was. I put some antibiotic ointment on now and I don`t know what else to do, is there anything else can do to decrease the redness so it fades back to being pink atleast how it was? I made an appointment with my dermatologist for tomorrow but I don`t see what he will be able to do for me, aything please I heard some people talking about tretinoin? or vitamin E,tree tea oil please HELP

  Answer:  it will take weeks to get better, Aloe nor any other topical product never will help that fast. No Retin-A either , it will make it more red. JG 12.15.08

• This is ingredient of a vitamin c serum product : active ingredient : 8% L ascorbic acid and ginkgo biloba. Full ingredients : Aqua, Propylen Glycol, Ginkgo Biloba Extract, Ascorbic Acid, Octoxynol-11 (and) Polysorbate 20, Imidazolidinyl Urea. What do you think of it, is it generally an okey vitamin c serum product or not?

  Answer:  sounds pretty standard. JG 12.15.08

• What is your opinion about sunblock in a pill form? Should we take it and combine with using sunblock on our face to get best sun protection?

  Answer:  will not work. JG 12.15.08

• Do you know the product called Heliocare FLuid Gel spf 50, what do you think of it?

  Answer:  no personal experience with it, sorry. JG 12.15.08

• Do you know this product called flavo c? what do you think of it?

  Answer:  I would never trust a product that does not state their active ingredients. JG 12.15.08

• Dr. Garcia, I bought 99% aloe vera gel, should I rub it in or just put some on a fingertip and put it on top of the post acne mark? or both

  Answer:  just on the acne spot. JG 12.14.08

• Hello again, What do you recommend for crows` feet? Botox? What about the DMAE cream that you sell? Is it specifically for the eye areas? What strength Retin-A do you suggest? The Renova that I currently use is only .02% strength. I am 57 and very healthy but am seeing the results of too much time in the sun when I was younger. (The swelling of my submental lymph node is subsiding...very strange occurrence.)Thank you for your replies. You are obviously providing a great service for us.

  Answer:  I use Botox to help with crows feet yes. As to the eye cream we sell, the peptide cream is the strongest, and I do think Retin-A helps too. I usually let he patient increase the strength of the Retin-A to the maximm tolerated. Glad the lymph node is getting better, best to you for the season. JG 12.14.08

• Dr, Garcia, should I buy squalene oil or squalane oil, and how should i use it on the post acne mark, andh ow often, and can i use it at the same time as the aloe vera gel

  Answer:  they are the same and it can be applied 2-4 times per day, cannot use it with the Aloe, one or the other. JG 12.14.08

• Hello Doctor, Is Pycnogenol good for the skin and should it be applied topically or taken orally? Thank you for your time

  Answer:  no definite evidence of its effects on skin, a good antioxidant in general when taken orally though. JG 12.14.08

• Dr, hope you dont mind but to the poster who asked about aloe vera gel, the purest, she should look up Key West Aloe. It is a factory in Key west that has the best aloe products around and they have a 99% pure aloe vera gel that is fabulous! you can order off there website.

  Answer:  thanks for the info.JG 12.14.08

• what kind of aloe vera gel should I go out nd buy, they only realy sell the kind with other ingredients that you use after a sunburn. will that be ok to use on post acne marks to help it heal or should I be looking to buy a 100% aloe vera gel somewhere?

  Answer:  that is OK to use. I do not think you need 100% gel. JG 12.14.08

• I tried that neutrogena rapid clear and fade gel (salicyc acide and glycoic acid) that is supposed to fade post acne red marks. I started it on friday and now the spot is much redder like you said it would be, if I stop this right now will the redness subside and return to the color is was (pink)?

  Answer:  well, it might help control the acne and it might fade the brown spots from acne but it will never help the red ones. I would stop it and let them fade on their own in time. They will go back to the way they were. JG 12.14.08

• Is your DMAE & Vit. C cream specifically for the eye area? Thank you!

  Answer:  it can be used on the face too if desired. JG 12.14.08

• dr garcia, what works best on new scars.. vitamin E gel or mederma?

  Answer:  Mederma or ScarGuard. JG 12.13.08

• Dear Dr. Garcia, I am anxious to get your neuropeptide cream next week. I am sure I will love it! I do need to ask if you are plannig on offering an exfoliator for the face or any masks in the future or do you feel the market is saturated already and what is out there is okay. If you are not offering any and you like some on the market can you advise me? I have been blessed with good skin and am in my 50`s. I have very pale skin that does not tan whatsoever. Thanks as always for your insight.

  Answer:  well, the market is saturated, yes, but I am in discussions with a company that I might do some more new prodcuts with soon. I think the Oil of Olay Regenerist line for OTC is quite good though. All the best.JG 12.13.08

• Hi Dr,, What do u think of Priori products? I bought the eye serum and it contains LCA complex & MFAS along with hexapeptide (all means nothing to me). It was $65.00, so not sure if I was ripped off or not....??? Thank you!

  Answer:  I have had no personal experience with those products, sorry. JG 12.13.08

• also, is it better to apply aloe gel or bio oil.. or should i just conitnue applying vitamin e to prevent scarring and stuff.

  Answer:  any of them would be fine. JG 12.12.08

• hey dr garcia, im the one who had ripped the skin off my upper lip while waxing... its been 2 days now and i keep it moisturized alll the time with vitamin E oil. however whever its dry its like tight and the skin is a little shriveled.. is that part of the heeling process and is it normal?

  Answer:  all normal, and yes, part of the healing process, like a bad sunburned area feeling tight. JG 12.12.08

• Dear Doc. I have tiny red pimples showing up ALL over. Is there a body wash you can recommend for body acne? Thank you

  Answer:  look for any with alpha hydroxy or beta hydroxy acids in it. JG 12.12.08

• can bepanthen cream(bayer)be used inside mouth of babies? and if not why?

  Answer:  I am not aware of it being tested for safety in children. JG 12.11.08

• Dr Garcia, what, in your opinion, is the most effective chemical peel for fine lines, mild sun damage, and to just general brighten the skin? How do you feel about Jessner and how many sessions are required for ultimate results? I have had MLP and PFL, both by Sciton MLP was ok, only done at 6 microns,decent results, face clearer, and Profractional, around the mouth, the tech did it for free. she said that the actual holes were indeed laser, but that area still looks basically the same. I have a lower face lift coming up and want to keep up with my skin care but would like to go the chemical rupte instead of laser. I am having Co2 around my mouth durnig surgery. Would like your thoughts on good chemical peels(not Phenol, tho) Thanks! I am fair-medium complected

  Answer:  The only chemical peel that will treat spots and fine lines is a phenol peel, all other peels will help the spots but not the lines, and remember, all the improvements on the spots is temporary, no matter which peel is used. I think what you desire is not acheivable with a chemical peel. JG 12.11.08

• Hi, I am currently pregnant so no longer able to use retin-a which was keeping my skin clear. Instead I have prescriptions for clindamycin antibiotic gel and finacea (azelaic acid). I also would like to use a bha and moisturiser. What routine should I follow for applying these products? Can any of them be layered? Thanks so much Dr, and have a great Christmas and New Year!

  Answer:  BHA first, then the antibiotic, then the moisturizer, waiting a few minutes between each application. JG 12.10.08

• Is it better to use a lower strength (0.025%) every night or should I switch to 0.05% and use it 2-3 times per week? I am 45 yrs old with very dry skin and use professional products and sunscreen on my face every day. I`d like to reduce the fine lines on my forehead. I`ve read the lower stength of renova isn`t as effective at minmizing wrinkles. Would you recommend a strength higher than 0.05% for someone my age to prevent future wrinkles?

  Answer:  I think daily use is better than intermittent use. JG 12.10.08

• hey dr garcia i was waxing my upperlip and it peeled the superficial top layer off skin last night and its red and burns. i immediately applied vitamin E gel from the capsules as well as neosporin. I continually apply that even till now. how long will it take for the skin to come back and look normal again?

  Answer:  depends on how deep the skin removal was, might be as long as a week in some cases, stay out of the sun too. JG 12.10.08

• Hi Dr Garcia, Would Retin A be helpful in thickening the skin which has been thinned by steroid injections? Thank you

  Answer:  likely not to any appreciable visible extent I am afraid. JG 12.10.08

• Regarding the Pearl Laser, what effect would it have long term in either thining or thickening the skin...another way to ask it would be, does it age your skin in the long run? thank you

  Answer:  the only thickening wil be in the docotr`s wallet, save your money. JG 12.10.08

• Dear Dr. Garcia - Is Velashape heat your skin when you undergo the treatment. How hot it is because I`m under Accutane. Thanks much !

  Answer:  it does generate a minimum amount of heat, nothing that should affect the skin in terms of Accutane. JG 12.9.08

• Hi Dr Garcia, Have you heard of Inedeen capsules-purporting that they help reduce wrinkles? Any truth to that? Thank you

  Answer:  save your money. JG 12.9.08

• Hello Dr. Garcia. I am using Retin-A cream 0.1 % nightly. I love the results, but my skin does not glow as much as it did when I used a 10% glycolic acid cream nightly. Is there any way to incorporate AHAs into my regime while using Tretinoin nightly, without causing irritation? Some of the options I was considering are: Glycolic acid wash or toners, or Salycilic acid wash or toners. I heard that Salycilic acid is an anti-inflammatory related to Asprin, so do you think it would be less irritating than glycolic acid? Thanks

  Answer:  I think the salicylic acid is pretty similar to the glycolic in general, might want to try it but might not do much, the Retin-A might be just drying your skin out and removing the glow you are looking for, might want to back of a bit. JG 12.9.08

• Dr. Garcia, I went to the drugstore looking for squaline oil but they didnt have it. and they only had aloe vera gel for after sunburn, is that ok to use for fading a red/pink mark from acne. I also bought a neutrogena salicic acid 2%spot gel and it says that it treats acne and fades post acne marks with (it also has a glycolic acid ingrediant) do you think this is ok to use on the post acne spot and will it help fade it?

  Answer:  the squalene is sold at health food stores, I think the Aloe will help some but likely not as much as the squalene. I think the Neutrogena product you have will make the red worse, it is for brown spots, not red. JG 12.9.08

• Dr. Garcia - What is the difference between an endermology machine cellulite treatment and a Velashape? If you have a choice between these two treatments, which one would you choose and why? Can this be efficient having them both one after the other? Thanks much!

  Answer:  there are very close but the VelasShape has a light source that attempts to increase blood flow, it appears that the VelaShape works more effectivley than the regular endermologie though. I see no need to use them both. Neither has long lasting effects though. JG 12.8.08

• Hello Dr. Garcia....do copper peptides creams and dmae creams offer different benefits? should they be both be used or one or the other? thanks much!

  Answer:  I only use the copper peptide creams after a laser or a peel of some sort, otherwise the DMAE cream. My peptide cream is not a copper peptide though, it is a proprietary mixture of five peptide but no copper. JG 12.8.08

• Dr. Garcia, Do you think if I apply aloe vera gel or antibiotic ointment to the pinkish mark left after acne it will help it fade the redness? and where can I bu squalene oil, do they sell it at drugstores? and is it natural? Thank you

  Answer:  squalene is sold at health food stores and the aloe might help some but the antibiotic will not help the pinkness. Squalene is totally natural, yes. JG 12.8.08

• Currently I use the following products on my face daily: a vit A,C & E cream, B5 gel, moisturizer, emu oil and sunscreen on my face. I use renova once or twice a week at night. I also apply a night cream. During the day, would I be better off using a C & E serum with the B5 gel and a combination moisturizer/sunscreen if I wanted to streamline what I apply to my face? I appreciate your recommendation. FC

  Answer:  I agree with the plan. JG 12.8.08

• Dear Dr. Garcia I am the lady who asked you about using copper peptide creams with your neuropeptide cream after seeing my friends great skin. You said you would have to know the brand name of the copper peptide crea,. I found out it is Jan Marini Age Intervention Peptide extreme. What do you recommend? I am 59 and have good skin. I don;t mind using products that are somewhat expensive as long as they work, there is nothing less expemsive that is equal (yeah generics) and I am not wasting my money on products I don;t need. If you think I only need one do you think I should buy your DMAE or N-peptide? If both products are equal and you don;t feel that I need both(yours and Marini), I would rather buy yours. The least I can do after all of the questions you have answered for me. Now, abputh that book you are writing.........Christine

  Answer:  I am sorry, although some people are fans of Jan Marini, I am not, I find her behavior on previous issues circumspect and I do not endorse her products. I do not mean to sound self-promoting but I think you will get much more from my pepetide cream. I think my peptide cream is stronger in its effects than my DMAE cream. If you want a single one, use thev peptide cream. As to the book, a work in progress I guess. JG 12.7.08

• Dr. garcia, Can you recommend any topical treatment over the counter to speed up the healing process of a reddish/pinkish mark left after a healed acne?

  Answer:  squalene oil and sunblock is about all, could also try Mederma or ScarGuard. JG 12.7.08

• hey dr garcia! is it possible that hydroquinone 4% could cause herpes? i have been using hydroquinone for 3 days now.. without diluting it with lotion... and i developed a smalll rough spot on the top sife of my nose. could it caused by hydroquinone? also can it cause the skin to initially darken a little and be rough a little at first? and if so, how long will it take to start seeing results?

  Answer:  it cannot cause herpes, but it can irritate the skin and if the skin loses its superficial covering it can become vulnerable to the herpes virus if it comes in contact with your skin. The exfoliation caused by the hydroquinone can cause some temporary skin darkening, yes, but it gets better with continued use. Usually the fading takes 4-8 weeks and continues after that. JG 12.7.08

• Dr. Garcia, If I have a freckle on my cheek lasered with the q switched ruby laser, what happens to the skin surrounding the freckle? Could it lighten too, or change pigment? Thanks

  Answer:  it might lighten to a small amount but not as much as the freckle and it should regain its color in time too. JG 12.7.08

• My skinceuticals vit C serum has become orange. Can I still use it or is it time to replace? It has been opened about 5 months or so. Thanks for your help!!

  Answer:  it might have lost some of its effectiveness as it is at least partially oxidized. JG 12.7.08

• Hi Dr. Garcia, i just wanted to tell you that I am light skinned

  Answer:  still the same. JG 12.7.08

• Hi Dr. Garcia, I used a topical corticosteroid lotion on a small spot on my forehead for a slight patch of redness, i developed a mild acne pimple in that spot and i squeezed it, picked at it. It has been 3 weeks, the pimple has healed but it left a pinkish mark/sometimes the mark looks darker red. and when I feel it, it seems like the spot where the pimplee was is still a little raised. what can I do in this sitation? should I apply a small amount of the corticosteroid again to see if it can clear up color difference or what else can i do?

  Answer:  I think just leave it alone and let it heal, do not irriate it any it will get better. JG 12.7.08

• I have a small white scar on my left cheek, I was wondering whether the plasm skin regeneration or psr 3 level would be able to stimulate the collagen in the scar area enough to repigment it

  Answer:  afraid not. JG 12.7.08

• Hello Dr. Garcia. There are a lot of skin products on the market which contain questionable ingredients at high prices. I found a good moisturizer that works well for me, but unfortunately it contains Alcohol denat among the first 4 ingredients! Is it harmful to apply Alcohol to the face in your opinion? Does it matter if it is of plant origin ? If it will cause my skin damage in the long run I will avoid it! I am 26 and I want to treat my skin well. I use Retin A cream nightly, and antioxidants and suncreen daily. Thank you.

  Answer:  I think low dose will not hurt and if it is helping I would continue to use it. I think the term plan origin is alot of hype. Best of luck. JG 12.7.08

• Dr Garcia, I am using Obagi Clear (product #3)morning and night. Can I use it up to the day of my IPL treatment? Can I continue use of it that same night? Thanks for your help. Greatly appreciated!

  Answer:  yes, OK right up to it, I might wait until the next day to restart though, just in case the skin is too irritated. Best of luck. JG 12.5.08

• Since one of the main problems of older skin is thinning-- do you think that Retin A (which thins the outer layer of skin but supposedly eventually thickens in lower layer) should be avoided. 50+ skin does not need any thinning in my view and could trigger more fine line wrinkles while waiting for a thicker under layer. Wrinkles then have to be lasered or burned off with acid or pulled and cut off. What do you think?

  Answer:  I think since Retin-A thickens the dermis it is good to use, what it thins is the epidermis, which is also good. Once the wrinkles are established I agree the lasers are a better choice. JG 12.5.08

• Does using a topical face cream that contains some estrogen pose any type of health risk regarding breast or uterine cancers? Or any type of risk?

  Answer:  it would be a very low risk if any. JG 12.5.08

• I have tried the bare minerals powder type make up & it always looked dry on my 50+ skin. Should older ladies use a liquid make up with some moisterizers in it? Make up gets in the fine lines and pore & makes us look older. Is there an answer? Should I try the bare minerals again? Help.

  Answer:  there is no 100% answer, everyone`s skin is different. JG 12.5.08

• Dr Garcia: Last week, I consulted a treatment center for my abdomen skin. I had liposuction 2 years ago and for the moment I`m under 5mg accutane. I need something that will make my skin looks even. They told me to wait 6 months before going under Thermage procedure. I wondered which treatment I can have when I`m taking accutane. I need to tighten up my skin. Also I want to know what is the difference between Thermage, VelaShape, Accent. Which kind of treatment would you suggest that doesn`t heat the skin? Thanks

  Answer:  I think the Accutane will not affect the Thermage treatment but I think the Thermage will likely disappoint you. I think the differences between the machines you mention is small, I find them all ineffective for the most part. There is not a reliable, reproducable external treatment for skin tightening. JG 12.4.08

• another ques.. what exactly is benoquin? does that really whiten the skin?

  Answer:  it is a medication used to fade sun spots, will likely not make your skin tone lighter if you are speaking about genetics. JG 12.4.08

• hey dr garcia! I have uneven skin tone and want to lighten and brighten my skin over... mostly lighten.. I have some prescribed 4% hydroquinone cream. can I mix that with my moisturizer and apply a thin coat all over my face and neck before going to bed? will that help even my skin tone and lighten the shade somewhat?

  Answer:  yes, you cna do it that way and once tolerating it then use the hydroquinone on its own. It will lighten any sun spots but not your genetic skin tone. JG 12.4.08

• Dr. Garcia, do your creams on your shopping cart act as a moisturizer or underneath moisturizser creams? I am running our of my Kiehl`s moisturizer with sunscreen and wanted to try your creams. Just wanted to know before I buy more Kiehl`s and your creams as well. Thanks for your help.

  Answer:  yes, no need for a moisturizer on top of my creams. All the best. JG 12.4.08

• I was wondering if you can either set my mind at ease or reccommend or suggest...... I tried prevage MD a couple of days ago by my upper cheeks well I had a reaction to it> have been red and area is very sensitive to touch> IS this normal or bad reaction? Its still quite red dont know what to do? Most likely will it jus dissipate orrr....... I am no longer goin to be using that product. Thank you for any suggestions.

  Answer:  it is a bad reaction, not normal. It will likely go away on its own in time though. JG 12.3.08

• Hello. I`ve alway had clear skin but when i went off the pill 12 months ago - i broke out a lot - nothing big and cystic although there were a few tiny ones of those but mostly whiteheads and those small raised red ones that don`t really develop. My skin is finally almost clear but there`s still a lot of little red marks which have been left behind and seem to be lingering for months. They are not indented or raised - just small red discolorations so i don`t know if they are scars. Will they fade in time? I have always taken good care of my skin and continue to get microdermabrasion and ipl but i`m starting to wonder if they will go away. In the past if i got the occasional pimple it would heal and the mark would go away really quickly - these ones i have now have faded a little over time but are still there months later - what`s the difference?

  Answer:  time should heal it but some IPL treatments will speed it up. JG 12.3.08

• Are cysts inject with a steriod that is diluted likely to make an indent afterwards? Thank you

  Answer:  it is not uncommon for a dent to occur afterwards, correct. JG 12.2.08

• Dr. Garcia, Thanks for your replies to my questions on cellulite and h.g.h. With the h.g.h., i thought that as we age 50`s,60`s and beyond, that our bodies would be depleted of this, thought this was just a fact, as everything else seems to diminish or change at that time of life. So how would you know if you needed to be supplemented with it or not,and from everything i have read about h.g.h., it certainly does seem to increase vitality. Or do you think i have read a lot of misinformation about it? Thanks.

  Answer:  you need to get blood tests to check you levels and see if you qualify to receive it. I think it is a wonderful thing but I think the claims are also over-inflated, it is not the silver bullet that will stop your aging. JG 12.2.08

• dear Dr. Garcia I just saw a friend of mine who I hadn`t seen in 6 months and her skin looked wonderful.She is in her late 50`s and she said she has been using copper peptide cream. What is the difference between that and your neuropeptide cream if any? She got hers from a plastic surgeon`s office but I forgot the brand name. I(f there is a difference can you use both for better results? Hope you had a wonderful Thanksgiving.

  Answer:  had a great Thanksgiving,thank you, without knowing what the copper peptide brand is I cannot comment much but my peptide cream does not have any copper in it, I only use copper peptides right after a resurfacing procedure. JG 12.2.08

• Are chemical peels good for those vertical lines under the eyes? I`ve read that botox has moderate results. What do you recommend?

  Answer:  I am afraid chemical peels only help for as long as there is swelling and I would never use Botox for lines of the lower lids JG 12.1.08

• Dr. Garcia, Could you please tell me what actually causes cellulite and why men don`t seem to get it, only us poor women unfortunately! Does it have anything to do with how the body stores or deposits fat? Also what do you think of H.G.H.,in delaying the aging process, and is there any OTC products that really work as opposed to the expensive injections? Thanks.

  Answer:  cellulite is an abnormal amount of connections between the skin and the underlying tissues that causes a cushion like effect. It has nothing to do with fat storage though. As to HGH delaying the aging process, sorry, there is no evidence that it deos so. There are no OTC products that can come close to the effects of injectable HGH. HGH should only be used in deficient individuals, and only to replace their levels to normal, not as an anti-aging drug. JG 12.1.08

• Do you accept Mastercard in your online store? It just said PayPal

  Answer:  sorry, just Pay Pal, or you can call the office and give the Mastercard info to the ladies and they will process it that way. JG 12.1.08

• Hello Dr. Garcia! I used your neuropeptide cream the other night and i forgot to put back the lid, it was left open for about 6 to 7 hrs. I`m just wondering if it`s still ok to use and will it have an effect on its effectivity? Thanksyou very much..

  Answer:  just stir it up with a Q-tip, should be OK but try not to do it again. JG 12.1.08

• I just bought some cream for under my eyes - it has alpha lipoic acid , vitamin C and DMAE. Is this a good choice?

  Answer:  well, I cannot say as without knowing the concentration it might be too strong or too weak. JG 11.26.08

• Docter G, How can I tell if I have hormonal acne or allergies or ACNE ROSECIA? When I hit 30 last year my chin and neck OONLY started to breakout...it flares up. My derm put me on NICOMIDE and it helped but when i go off it it flares up! Iam now on OBAJI for acne...its sooo dring to my skin now everything itches! My PS office wants to do a peel...am i going in the right direction..or is this Roecia or maybe something else? How can i care for my skin to make it better?

  Answer:  well, allergies typically do not affect the skin unless it is a contact dermatitis, it is very difficult to distinguish rosacea from acne but rosacea is typically on the nose and the central cheeks only where normal acne is all over, including the jawlines. I think part of what controls it is the drying effect of the medication and wil likey be needed for it to control it, the peels are liek turbo-charged creams and will help for a short period of time but will not eliminate the need for the creams after a few weeks. If it is rosacea, IPL treatemns will help to a great degree or VBeam laser. Best of luck. JG 11.26.08

• Dear Dr. Garcia, I posted a question the other day about DMAE cream and DMAE vitamins, but it is not to be found, so I thought I`d repost. As mentioned, I read a book by Dr. Perricone who highly recommended DMAE cream (and the vitamin). My ps hinted that Perricone was not to be believed. I also read in Dr. Oz`s most recent book to stay away from DMAE (ie., cell damage, etc - which I noted another person posted) What are your thoughts? Thank you.

  Answer:  I think Periccone overhypes things, including himself. I do not think oral DMAE does much but I have used topical DMAE for a long time and seen no negative effects, I do think the negative reports in the media about DMAE for the skin are not really applicable to human skin though, they were done in rats that have propensity to have skin problems. JG 11.25.08

• HELP!! Iam 31...And my face is an oily thing. I have major breakout only on my jawline and chin. My plastic surgeon/spa have me on OBAJI CLENZIDERM MD for acne. Tho i dont have acne just breakouts....ive been on it for two weeks and it has kept my oil at bay and breakouts calm down tho i have redmarks. Well at the ps/spa office they want me to do a PEEL!!!! iam VERY FAIR SKIN like SWEEDISH RED HEAD and VERY sensitive....are peels safe or will they ruin my skin and if not which do u suggest...im afraid

  Answer:  they are safe, might also want to use a little low dose Retin-A. Best of luck. JG 11.25.08

• I use .5 skin ceutical retinol. I think I`m ready to try the 1%. What is the difference between retinol and dr. prescribed retin-a? I tried retin-a and it was too tough for my skin.

  Answer:  what you are using is much weaker than a prescription Retin-A. If that is all you can tolerate, then that is what you need to use, and maybe move up as tolerated. JG 11.25.08

• Hi Dr. Garcia, Can a healthy diet with minimal salt help reduce dark circles? Also, is there any cosmetic/surgical solution for dark circles that is worthwhile? I believe my dark circles are the result of blood vessels as opposed to lack of sleep or hereditary. They were fine a year or so ago, but have become very very dark in this short time.

  Answer:  I cannot say that salt reduction will make a big difference, I think the new cream I had made and that we sell in our office does help in most patients, but it is not on the shopping cart yet, so you need to call the office to order it. JG 12.1.08

• Hi Dr Garcia, Last question for the day, probably for the week too. Which filler would you recommend for an indented scar? It was from a biopsy, on my mid cheek. I know technique is important, but which filler do you think is best? Thanks again.

  Answer:  I would try Radiesse in that area for that purpose, best of luck. JG 11.22.08

• dear doctor, which is stronger? your DMAE Eye Booster Cream with DMAE and Vitamin C or your DMAE Facial Rejuvenation Cream with Alpha Lipoic Acid, DMAE and Vitamin E? thank you for your time.

  Answer:  well the Face cream is stronger because the eye booster has Vitamin C instead of the lipoic acid as the amount of lipoic acid we put in the face cream is too strong for the thin eyelid skin. Best of luck. JG 11.22.08

• Dr G: I used Nutrogena Anti-Wrinkle Intensive eye cream (for deep wrinkles)under my eyes before I went to bed on night - the next morning - the skin under my eyes were so wrinkled and baggy - I almost could not go to work - I had to cake on tons of foundation to try to soften it - the skin under my eyes eventually went back to normal within a couple of days - what happened? I am 47 years old.

  Answer:  most likley it irritated your skin and dried them out, maybe too strong for your eyelid skin. JG 11.22.08

• Dr G; What is your best otc under eyer craeam to tightern and firm?

  Answer:  I feel our eye booster cream on our shopping cart is the best. JG 11.22.08

• I forgot to ask, a derm recommended silicone for indented scars. Said its not approved for this, but results are very good. I know nothing about this, please help. Thanks again.

  Answer:  I would not inject silicone for any purpose. JG 11.22.08

• I just reread my question to you, about sebaceous hyperplasia and freckles. That was a 1064 for freckles. Is that a yag laser? And of course, safety? Thank you.

  Answer:  1064 is better, does work well for the brown, the 532 is better for the red ans should be on the laser if it is a Q-switched laser, it is quite safe too. JG 11.22.08

• What are your thoughts about using the erbium laser to remove sebaceous hyperplasia? Chance of scarring? Also, have you heard of a 1094 laser for removal of freckles/brown spots? Does it work and is it safe? Happy Thanksgiving. I do give thanks for all the help you have give me over time. It has been very much appreciated.

  Answer:  well, it will work, but like all other methods, is is temporary. I think chances of scarring are all related to depth though. I think the other laser will help with the brown spots, not too sure about the red ones. Thank you for the encouraging words and Happy Thanksgiving to you also. JG 11.22.08

• Hello Dr. Garcia, Have you heard of TCA Cross and if so, what are you opinions on it?

  Answer:  yes I have and I feel it is a big waste of time. JG 11.22.08

• Hi Dr. Garcia stopped using retin-a on the advice of my dermatologist since my skin was very red, particularly in my tear troughs. It has been 12 days now and my skin is still red, is it abnormal to still be red after this amount of time or does it usually take weeks for it to subside? Thank you

  Answer:  normal yes, might suggest some copper peptide cream or at least some squalene oil for it. It will get better in a few weeks. JG 11.22.08

• DOCTOR PIERCE, PLEASE TELL ME THE DIFFERENCE BETWEEN RETIN A AND TAZOREC CREAM. I AM NOW USING THE TAZOREC WITH NO OBVIOUS SIDE AFFECTS. I AM WONDERING WHY THIS MEDICATION INSTEAD OF RETIN A. THANK YOU.

  Answer:  essentially the same, but Retin-A is cheaper and there are more studies showing the Retin-A works for wrinkles. Doctors are using it more as it is newer and the drug rep has pushed it over the older Retin-A. JG 11.22.08

• Dr. Garcia, I got a prescription for Accutane in a different country. I know it is a powerful drug and I got it in Mexico because my dermatologist here in the United State did not want to prescribe it to me since I only have moderate acne and I don`t have any insurance. I will only take it in very low dosages, do you think I should risk it and take it. I am tired of battling acne for the past seven years. It isn`t severe acne but I am tired of dealing with this persistant acne. Are there serious side effects when taking Accutane? Will low dosages work for moderate acne? By the way I had laser acne treatments that haven`t been successful because my acne keeps comming back.

  Answer:  There is a reason yoru dermatologist would not give it to you an I think you should heed his advice. Low doses may and may not work and it should only be used for severe cystic acne. There are a number of serious side efects that you can read about on the Accutane website. Some are terrifying. No treatment, even laser, is not meant to be permanent, it is just a temporary control mechanism. JG 11.20.08

• Dr.Garcia- I am a woman in my mid-sixties and have been using various anti-aging creams for the purpose of tightening and firming loose skin under my chin and neck. I`ve also used the LED hand held tool. All these products have not really helped much, and I notice that they all produce irritation, burning, and a feeling of tightness, pressure and a general uncomfortable feeling under the chin and neck. Is there a better method or product that will be effective in tightening these areas without the irritation and discomfort- it`s getting really frustrating and costly! Please let me know what you would suggest. Thanks. Linda

  Answer:  I am afraid there are no creams that will acheive what you desire, I think surgery is the only legitimate option, sorry. JG 11.20.08

• Dr. Garcia, I ordered a cream called KaraKol Kream for my skin. I have acne prone skin and the cream supposibly works wonders on your skin. Have you ever heard of it? It`s been two years in the market. Should I trust it and use it on my skin. What do you think?

  Answer:  I do not think it is any better than the creams you can buy at any store. JG 11.20.08

• Hi there Dr.......I have rosacia on my nose....sometimes it flares up with pustules and sometimes with scale. My nose turns red with the cold or drinking alcohol to which I now try to stay away from. One skin professional told me that I have AK`s. What would you suggest to do for the scaling and redness.

  Answer:  might suggest a series of IPL treatments and topical Clindamycin. Best of luck. JG 11.20.08

• Dr. Garcia, I would like to ask what would be a good overall moisturiser for the body to keep skin supple and moisturised? We concentrate a lot on the facial area yet the skin is a very large area that covers our entire body, and as we age that also shows in areas other than the face/neck area. Also can Portrait be used in other areas of the body other than the face?, for deep wrinkles, and is it expensive? Do you think Portrait is a good treatment? Thanks for your opinion.

  Answer:  I think for the body things like Lubriderm are good, I personally do not use the Portrait except face and neck. All the best. JG 11.20.08

• I would like to know if you have ever heard about the KaraKol Kream. I ordered it from a spanish TV commercial. It is suppose to help your skin stop from having acne breakouts. Do you think I should trust them and order it for my skin?

  Answer:  save your money. JG 11.20.08

• Dr. Garcia i am very sorry.., i am the one who asked about the best vitamin c OTC product, i live in Singapore so the cost to ship your cream to my country will be very expensive for me.., hope you have other suggestion, other international product perhaps? thanking you in advance,

  Answer:  SkinCeuticals is good too. JG 11.19.08

• What is the best OTC products if we want to look for vitamin c cream / lotion to be put topically to our skin that suits sensitive skin (generally speaking)and in general can be used in combination with tretinoin?

  Answer:  well, at the risk of sounding self serving, I think ours on our shopping cart is the best. It can be used with tretinoin, yes, the tretinoin first. JG 11.19.08

• Hello Dr. Garcia. I`m planning on taking with me to another country the neuropeptide that I bought from you. Just want to ask if the luggage storage in the plane is not hot enough for the cream to weaken its mixture? The travel time is 9 hours. Thanks.

  Answer:  the luggage compartments should be OK for the cream, best of luck in your travels. JG 11.18.08

• Hi Dr.Garcia, my face is very dry an peeling at the moment, can you tell me what to use for that.thank alot an have a great day..

  Answer:  try some squalene oil frm the health food store, best of luck. JG 11.18.08

• What kind of skin lightener would you suggest for me? I have cystic acne and have been going to the dermatologist for about 2 years now, since it started, and have acne scars from the ones that have gone away. I started on birth control, which has helped some. The dermatologist gave me a 9% benzoyl peroxide face wash, which I use every morning only along with 20% Azelex cream, again only used in the mornings (followed by moisturizer). At night I use Philosophy Purity face wash and their On a Clear Day H202 cream. I have been on Differin and it hasn`t helped much, so I stopped using it after the tube ran out. I know I can`t use hydroquinones or retinol with the benzoyl peroxide, so I`m confused what to use for my hyperpigmented scars/uneven skin.

  Answer:  I think a different face wash and the Retin-A and hydroquinone might help. The Retin-A and not retinol should also help control the acne. JG 11.17.08

• Hi Dr Garcia, What do you think of Eucerin lotion for the body? It feels nice and absorbant when I use it on my body. Do you think it will have any effect on improving aging skin? Is it possible that any lotion will actually provide improvement? thank you.

  Answer:  it is a good moisturizer, not sure how much reversal or prevention it will do, but not using it will likely allow your skin to be dry and age faster, so it is worthwhile. Skin lotions for the body yield very little in reversal, as the price for it to be effective would be huge. JG 11.17.08

• hey dr garcia! i have2 questions for you.. i have been reading that L-Glutothione supplements have a side effect of skin lightening.. is that true? and secondly what can be done to make a nose tip less bulbous? my doctor suggested injecting some corticosteroids in the tip and he did that like couple of days ago. how long do i have to wait to see results? and how effective are those injections?

  Answer:  well, I take glutathione for other reasons and my skin has not gotten lighter over the past 5 years I have been taking it. As to steroid injections into the tip of a nose after surgery, the improvements if any will take 4-6 weeks, and it does not work for all patients. Best of luck. JG 11.17.08

• Hi Dr.Garcia, my domestic worker has a small child who burned his face with boiling porridge. He is African American and now has a flat pink scar on his brown complexion. I know nothing will remove a scar. Is there any topical i could use to help him fade (darken) the scar so it is less noticeable ? Thanks for your help.

  Answer:  might suggest Mederma or ScarGuard, both OTC, best of luck. JG 11.15.08

• Hello Dr. Garcia. I have red pigmentation in my tear trough area -- very noticeable and difficult to conceal with makeup. I`m not sure of the cause (seemed to get worse after lower bleph 2 yrs ago) but wondering if you thought your new cream could help with this. If not, any other thoughts? Thanks!

  Answer:  not sure any cream would help but if it is red I might suggest a VBeam laser or a YAG laser to fade the redness. JG 11.15.08

• When using differin gel, is it okey to apply moisturizer such as squalane oil (99% squalene), or should use oil free moisturizer? Will squalane oil made from 99% squalene prevent irritation from differin or will it worsen it?

  Answer:  squalene is OK to use, it is an oil but is very similar to the natural oils in your skin. It should help the dryness but not the irritation, that is required I am afraid. JG 11.14.08

• Dr. Garica, I know Accutane is a drug with potentially severe side effects. My question is, does it work for sebaceous hyperplasia? I know they will come back afterwards, but will it clear them up? If so, would RetinA prevent them from coming back after going off the Accutane? Thank you.

  Answer:  I would not use it for sebaceous hyperplasia, nor do I think a dermatologist would prescribe it for you for that problem. Retin-A might slow them down but not very effectively. JG 11.14.08

• Dr. Garcia, it seems you prefer sunblock with spf minimum 50 in general. Why is it, is higher spf mean higher protection? I read articles that says higher spf doesnt mean higher protection, maybe you could explain a bit why you prefer higher spf sunblock such as 50 more than sunblock with spf 30,

  Answer:  yes, a higher number means stronger protection, correct. The SPF 50 if applied every two hours will protect the skin about 60% more than the SPF 30 applied every two hours. JG 11.14.08

• wow ok i found a 4% kojic acid cream on the youngagain site. are you sure its a safe product and not just a duplicate item or a scam? Just want to make sure before I purchase it. Can you also get just the kojic acid from the pharmacy where u soak sum in a cotton ball and apply it evenly all over the face before going to bed or something?

  Answer:  I do not believe it is a scam, no. I am not sure a pharmacy would make it for you without a prescription and then it would have to be a compounding pharamcy, not a regular one. JG 11.13.08

• hi dr garcia! u recommended some kojic acid to reduce the hyperpigmentation. where can i get some?

  Answer:  EVitaminStore or youngagain on the web sells it. JG 11.13.08

• Hi Dr, I just read an article about long term usage of botox can lead to muscle atrophy. I have never heard of this before and have never been warned by any doctors in the 8 years I have been having botox. What are your views on this doctor? Thanks

  Answer:  it can, but if you are using it for frown lines, then it is a good thing, you will need less Botox over time. If you stop using the Botox, the muscles build back up, it is not a permanent, thing, it is like all muslces, if you do not use them you lose them.JG 11.13.08

• Hello Dr. Garcia. If your neuropeptide cream is stored in a hot place for a long period of time, will it lose its effectiveness? thank you..

  Answer:  in direct sunlight or in a hot place it might, yes. JG 11.13.08

• I use sunblock for my body when i`m driving my car to work. But what i dont understand is, when i put sunblock constantly every day for 2 weeks, then i get discoloration on my arms and hands, the part that covered with bangles or watch is white, and the rest is tan. But on lazy days for about 2 weeks later i dont put sunblock on my arms and hands, and the colour of my arms and hands become even again, they all same colour that we cannot distinguished which part we put the watch / bangles on because the color of the skin become even, no part that is more white and also no part that is more tan. What is your opinion on this and should i stop using sunblock on my arms and hands?

  Answer:  not sure why that is happening, but the amount of sun you get through the car window is not large and it`s effects would not be seen the same day. I would still use the sunblock. JG 11.13.08

• I have acne prone yet dehidrated skin, my activities is usually indoor activities. For daily basis i use sunblock. For daily basis, which do you prefer to put on after sunblock, regular loose powder or mineral foundation in a loose powder form?

  Answer:  probably the loose powder if it will do the job. JG 11.12.08

• dr garcia, do computer or laptop rays tan skin?? i also heard fluroscent light tan skin too.. is that true?? there are so many sunblock creams available on the market, which do you recommend to PREVENT tanning in the sun and not ONLY prevention of harmful rays. I dont want my skin darkening at all in the sun.. lemme know thanks!

  Answer:  no, the screesn used on compuers do not do that. Flourscent lights can after extended time damage the skin but not tan it, but not computer screens. We use Total Block by Fallene, but any sublock with SPF 50 or higher is fine. JG 11.12.08

• hey dr garcia im an asian (indian) female with light olive skin tone. I have been using sally hansen`s facial hair bleach cream to lighten my facial hair. I use it about once every two weeks and have been using it for about 6 months. However, I am noticing that my skin has darkened overall. I know its the cream for a fact because I do not expose in the sun at all neither do i use any other products. will this fade away as I stop using it? is there anything else you can recommend.. as far as lasers, natural remedy, or cream (besides obagi and hydroquinone)? thank you!

  Answer:  it migth fade but I cannot say 100%, you might try getting some Kojic acid if you want to avoid the hydroquinone, or try some beta hydroxy acid peels is about all I can suggest. JG 11.12.08

• What do you think about growth epidermal serums? I have been using this product for about a year. Do you really think it can contribute to collagen reproduction?

  Answer:  the only ones I have seen work are pretty expensive ones, not in most OTC products. JG 11.11.08

• Lately I have been reading that primers applied before foundation are a benefit, because they reduce the look of fine lines and pores. Do you sell any product of this nature that would be oil free? I break out very easily. If not, could you recommend one? I have read that smashbox photo finish foundation primer dermaxyl complex it great, but I called sephora and it is not oil free :o(

  Answer:  I we do not sell any products such as those, sorry. I am afraid with things like that, it is a matter if trial and error as all people respond differently. JG 11.11.08

• Which squalene oil for skin stinging because of retin A? Shark liver oil or Olive oil? I would thing the shark liver oil would smell fishy!

  Answer:  I prefer the Shark and it will not smell fishy, not to worry. JG 11.11.08

• I am sensitive to Vitamin `C` and I have T-Zone Combination skin and 47 years young; what can I use on my skin to make it look younger and keep it healthy...

  Answer:  try DMAE creanm, should not irritate you, or OTC Kinerase. JG 11.11.08

• I am a 43 year old female. So far, so good facially - no wrinkles to speak of. My only problem - and I`ve had it since I was in my 20s unfortunately - are puffy/baggy eyes. I have a holiday party of December 11th. I would like to look my best. Is there any facial procedure (not surgery but more dermatological) that you would recommend for both tightening the facial skin *and* the eye area? Thank you.

  Answer:  all I can suggest for the short term time you have is Restylane to hide the puffiness, best of luck. JG 11.10.08

• my face has been stinging lately due to recent Retin A use. What moisturizer can i use that wont sting, besides greasy Aquaphor? I need SOMETHING due to the peelies.

  Answer:  Copper peptide cream or squalene oil from healthfood store. JG 11.10.08

• Dr. Garcia, for removing make up throughly nowadays the cosmetic industry has 2 method, cleansing milk or cleansing oil. After that followed by foaming cleanser. For sensitive acne prone skin, in general which do you prefer to remove make up before facial wash, it is cleansing milk or is it cleansing oil?

  Answer:  I like the oil. JG 11.10.08

• Hi, Dr.Garcia. Some people believe that copper peptides are helpful with skin remodeling, and I believe that I have seen that you have said that it helps with wound healing. Would it make sense, give an extra kick to my skin care regimen, to apply a copper peptide half an hour or so after retin-a? Thanks!

  Answer:  if you are using an exfolaint like Retin-A it might help yes. JG 11.9.08

• Right now my skin loves this baby diaper cream produced by Bayer called Bepanthen (dexpanthenol 5%), so i use this cream every night on irritation spots on my face (my face can easily irritated by alcohol, acne medication, etc). Is it safe to constantly put this medication on face?

  Answer:  should be fine to use as long as you can tolerate it. JG 11.9.08

• Can Hydroquinone 4% be purchased with a prescription without Retinol in it? Thanks

  Answer:  yes, it can. JG 11.9.08

• Dr. Garcia, i know that you are not a fan of milk bath. But if one wishes to do it by put 2 litres fresh nonfat milk into the bathtub, what is the frequency doing it that you suggest that will not harm the skin, (every day, or every other day, or twice a week, or once a week, which you prefer),

  Answer:  I guess if you are intent on doing it I suggest doing it as soon as your skin returns to the previous feel. JG 11.9.08

• Hi Dr again, I am 6 1/2 months pregnant and have noticed that i have dark blotchy skin on my nose and cheeks forming. is it safe to use Cosmedix Lighning serum on the blotches, or is there something else i should get that is safe for pregnant women? Thanks so much

  Answer:  I would use the sunblock only or now, none of the fading creams have not been tested on pregnant females. JG 11.9.08

• Dr. Pierce, I am a 52 year old Black female with dark circles around my eyes, I have tried everything to lighten or remove them and nothing helps. I am afraid of a skin peel because I was told that black skin doesn`t heal properly with this technique. Could you please tell me what I can do to remove or at least lighten around my eye area. I am told that I have beautiful skin but I just hate the dark circles around my eyes. Thank you, Lynn 11/08/2008

  Answer:  very difficult problem I am afraid, I have a cream for sale that helps about 60% of patients, it is not on the lvcosmeticsurgery.com website shopping cart yet but you can call the office and they can help you. JG 11.8.08

• Hi Dr, With regard to Retin A, I am currently using 0.05 strength but it does not seem to be doing much after 6 months usage.... what strength would you suggest I change to? Thanks

  Answer:  increase it to 0.1% twice per day and use sunblock too. JG 11.8.08

• Hello Dr. Garcia.I have cherry angiomas on my tummy. I went to a dermatologist and she hyfercated them off. She turned up the machine for the larger ones. What is the correct voltage to use for these and how dangerous is the hyfercater? Also can the hyfercater remove brown moles? Freckles? Thank you in advance.

  Answer:  there is no correct energy setting for a hyfercator as it varies from patient to patient and also varies due to size of lesion being hyfercated. The energy is not dangerous unless it causes a burn, that is rare. It really cannot help with the brown spots reliably though. JG 11.9.08

• Hello Dr. Garcia..If the mixture of your peptide cream separated bec. it was put in the fridge, how do I turn it back to its original form? Thanks.

  Answer:  use a q-tip ad mix it up is all. It will not harm the product in terms of effectiveness. JG 11.7.08

• Dr. Garcia, I am writing to let you know that i started using your face and eye creams, and after a couple of days of applying them have already an improvement. Maybe my imagination, but i don`t think so. There is just one question i have concerning the Facial Rejuvenation cream, and that is, could it be dispensed in a different type of container, maybe a jar, because i have had a problem with the container in transit, and want to avoid this from re occuring. Thankyou, and Thanks for such a great website.

  Answer:  we are in the process of doing that very thing, if there is a problem just let us know and we will replace it for you. Thanks for the follow up too. JG 11.7.08

• About DMAE creams--I just read this report. What do you think about it> It is the second report negative on DMAE that I have read--plus after a year of using DMAE, my skin looked almost dead --very sallow & colorless. Since I`ve stopped using it, I look more normal after a year. Here is the article: DMAE: This so-called instant facelift ingredient in wrinkle creams works by damaging cells, which causes slight swelling. Yes, the swelling smoothes out wrinkles temporarily, but that doesn’t mean it’s good for your skin.

  Answer:  I am sure there are people that have negative reactions to just about anything, I have not seen that in my patients, but if you are concerned, then I suggest you use something else. I think anecdotal reports do not mean the product is the cause, unless the entire medical history is examined. I think calling DMAE an instant facelift is also wrong and misleading. JG 11.7.08

• Hello Dr. Garcia..My sister brought your neuropeptide cream. Shes putting it in the fridge. Is it just ok or she needs to remove it? Will it deteriorate the quality of the cream? Thanks.

  Answer:  just keep at room temp is better, we ship it on ice as we do not want it to get too hot. It might seperate if too cold. JG 11.7.08

• Dr. Pierce does Retin A more for acne or wrinkles? Everything I read about Retin A, it states that is used for acne.

  Answer:  it does work very well for wrinkles, and acne both. JG 11.7.08

• Dr. Pierce does vitamin c serum help diminish lines and wrinkles? What vitamin c do you recommend?

  Answer:  yes, it does, I suggest the eye booster cream at the lvcosmeticsurgery.com shopping cart. JG 11.7.08

• What do you think is the very safest thing to use for freckles on the face? Won`t bleaching creams lighten the area around the freckles also? Thank you

  Answer:  a Q-switched YAG laser, but if you go in the sun they will come back in time. JG 11.6.08

• Hi, this is the first time posting a question... I love your site, very informative... I`m 47 with pretty good skin but recently heard about Hydrolift. How does it work and would you recommend it? Thank you Dani

  Answer:  save your money, stay out of the sun, use a facial cleanser, sunblock and a good moiturizer is all. JG 11.6.08

• What would be the most effective DMAE cream OTC, as there are a few to choose from? Thanks.

  Answer:  respectfully,mine, sold on our shopping cart. JG 11.6.08

• Dr. Garcia, What do you know about the AlexTriVantage by Candela for freckles? Would it be safer than a Q switched laser? Thanks.

  Answer:  I personally do not think it is as safe as the Nd:YAG. JG 11.6.08

• Tell me what you know of the hydraFacial is it effective at reducing wrinkles & skin discoloration on Asians?

  Answer:  I have never has any patients use it so I cannot say, sorry. JG 11.6.08

• Dr. Garcia, Could you please advise on what kind of dermal filler is best for giving plumpness to the cheeks,facial areas and that is long lasting? Do you think Sculptra or Artefill maybe? Also what do you think of Aquamid? A couple of doctors i have asked say they won`t use it because it is a permanent filler, and as one goes on in the aging process, it may give an unsatisfactory appearance.

  Answer:  I would use Sculptra for that, I think Artefill would be too expensive and I would not suggest Aquamid at all for anything. JG 11.5.08

• You said postmenapausal was the 2nd reason for hair loss. What hormone needs to be replaced to address that, low estrogen or low testosterone. What should the ratio be. thanks

  Answer:  progesterone helps compete against the small amount of testosterone your body is making that is getting turned into DHT, that affects the hair loss. So you likely need progesterone, not the others. JG 11.4.08

• I recently had an accident which left me with a large scrape on the side of my face, i have been applying neosporin on it. How else can i make sure it heals with minimal scarring? thanks alot Doc!

  Answer:  once the surface is better can use Mederma or Scarguard too, along with sunblock. JG 11.4.08

• Is there much success with infra red home devices for skin tightening, i have seen a few products on the market that claim to help with this issue, and i know for a fact that infra red is a very good way to heal certain problems. I get very bad sciatica and use a hand held infra red massager on the area, and this does give good relief. They also used infra red years ago in hospitals to heal sutured areas with good success.

  Answer:  I have never seen any tightening except your jeans fitting looser as your wallet is thinner. Save your money. JG 11.4.08

• What would you say on the success rate of endermologie please?

  Answer:  yes, but only as long as you continue the treatments, once you stop it all comes back. JG 11.4.08

• Dear Dr. Garcia, I have just ordered your skincare products, and do you think in conjunction with these i would be able to use a retinol cream? What do you think about the topical applications of a skin product that has Matrixyl 3000, Agirilene, Hyaluronic Acid and fresh Collagen in it? I did use one that contained the first three products i mentioned, but not any collagen. I was told that the topical application of collagen does not get into the deeper dermal layers, so hence it does not do what it claims to do. I found the cream that i said i used with the other products was not making any marked difference to my skin, apart from the fact it felt nice when applied, yet they say you need a cream that contains all these three ingredients to do anything at all to help with wrinkles and collagen production. The overview on skincare products also mentioned that DMAE was not any good in these products?

  Answer:  I think using retinol before my creams is OK, just wait about ten minutes inbetween, I think the other cream is not needed though. Topical collagen does not get into any layer of the skin. DMAE is a good product and we ave had very good success with it. Best of luck. JG 11.4.08

• I am wondering what skincare products you can recommend for topical application to firm and tighten skin and reduce deeper wrinkles? I am tired of wasting money on products that don`t do what they claim to do. Thanks for any advice on this.

  Answer:  I suggest as OTC DMAE crema, Vitamin C cream or serum, or Kinerase, otherwise Retin-A is a good one as far as prescriptions go. JG 11.4.08

• Do we need sunblock while we sitting and working in front of computer?

  Answer:  if you are under fluorescent lights, yes. JG 11.4.08

• Dr. Garcia, years ago my derm told me that make up such as foundation tends to be pore clogging, so she suggested i use loose powder for daily activities instead of foundation. Well nowadays there are many brands that have mineral foundation with SPF, and the form is in powder form, not liquid. So in general, is this mineral foundation classify as a foundation or can be classified as loose powder since it is actually in loose powder form?

  Answer:  yes, it can. JG 11.4.08

• Dr. Garcia, what about taking a bath in a bath tub filled with water (full) and 2 liters of nonfat fresh milk? This thing usually is done at spa near my house. Any precaution in doing that, and what benefit can be expected, in general it is a common practice at spa,

  Answer:  any benefit will be from the protein on the skin giving it a very temporary smooth feeling that will not last more than 24 hours. Just because it is common does not mean it does anything. JG 11.4.08

• I have dark circles around my eyes. Would thermage help? I can only do any procedure that does not necessitate the need of surgery. In short a lunch time procedure is all that I could be capable to attend to as I would have to do this without anyone`s knowledge. I just did full lipo for my abdomen and hips 3 weeks back and looking great now. It was also a lunch time affair. I wish to do the same for my eyes. I have real dark circles around my eyes. Please advice.

  Answer:  I do not think Thermage would help dark circls or much else. I think there is nothing reliable within that time constraint that will get you to where you want to go, sorry. JG 11.3.08

• Sorry, Dr. Garcia forgot one question. Would you say the QLag Laser or the Perfecta would be safer for brown spots? I appreciate you alot.

  Answer:  I feel the Q switched YAG is safer. JG 11.3.08

• Concerning the vbeam laser, have you heard that the newer model, the Perfecta is more likely to leave an indent, whether it is done for redness or brown spots? Thanks

  Answer:  I have not heard that, no. JG 11.3.08

• Is fulguration or desiccation setting usually used with hyfrecator for sebaceous hyperplasia? Any chance of an indent? Thank you

  Answer:  little chance if indentation in experienced hands and you should leave the setting to the person doing it. JG 11.2.08

• Hi Dr. Garcia, If hyfercator done correctly for sebaceous hyperplasia, how should the treated area look immediately after, and say a week later? What setting is used and does it scab over? Thanks much

  Answer:  a small scab right after and a small red spot a week later. The setting varies from patient to patient, the lowest possible setting is used. JG 11.2.08

• Dear Dr. Garcia, have you know anything about Kelo- Cote? I have an keloid on my arm and has acouple time of kenacort injection and it really stink, my scar after breast implants is very dark and in 5 days I`m going t have my redo, that is mean new scar again. My question is will Kelo Cote help reduce the scar? Seem they only sale in in Canada, UK and USA. If not do you know any cream that can help me? if do please let me know where can I buy in USA as I live in Australia. Thank you Dr..

  Answer:  I have had pateints use it, I saw no better response than just massaging with regular moisturizer creams to be honest. We use ScarGuard and Mederma and that help fade the redness after surgery. JG 11.2.08

• Hi, Dr. Garcia. I recently browsed a website that had the following posted regarding DMAE. I would like to know if you agree. Thanks! Our DMAE topical contains DMAE in its AMINE form. This is the ONLY form of DMAE that is absorbed by the skin. If you are using DMAE bitartrate or are making your own DMAE solution, you are not using the right DMAE product.

  Answer:  DMAE Bitartrate is an active ingredient that promotes firm skin, fullness of the lips, and has age management properties. DMAE bitartrate is neutralized with tartaric acid to make it suitable for skin care. `Pure` DMAE (amine) is extremely alkaline and not suitable for skin application.  Even if you have the anime form, it will still need to be neutralized to make it suitable for use on the skin.  DMAE bitartrate, is already neutralized with tartaric acid. Sounds like they are making a claim to make it sound like their product is superior. JG 11.1.08

• A strange remedy was suggested to me by a family doctorwho also does some dermatology work. Put a dab of olive oil on a sebaceous hyperplasia at night. Scrap off in am. Do for four nights. He said for some people this will peel off the part of the sh that is on top of the skin. What do you think? Is it folk medicine? Thanks, thought I would run it by you.

  Answer:  waste of time in my opinion, could make it worse by plugging the pore even more. JG 10.31.08

• hi dr.garcia, what is pitted scar?do u get pitted scar fr black head? what the best treatment for pitted scar, an is it permanent treatment for it.thank alot

  Answer:  a pitted scar is a scar that is depressed due to scar tissue deep in the skin pulling the surface down, it is most commonly from an acne inflammatory reaction that causes scarring deeper in the skin. It is permanent unless treated with subcision and or a filler. JG 10.30.08

• Does Renova come in .1%? Also, how do you feel about buying Retin A onliine without a prescription? i just ordered some. They have you answer a bunch of medical questions. I paid 190$. I hv heard of 12$ thru MexMeds? Opinion? How do you know you are getting the real deal? I only ordered it online because i dont have time to go to appt that derm wanted before prescribing it again.

  Answer:  not it does not come in 0.1%, I feel strongly that a prescription should be used. Deals are fine but all of the things that could happen with Retin-A need to be discussed with you prior to using the cream, and if you do not have a prescriptiuon you have no one to turn to in case of a problem, not taking the time has its risks and buying a prescription medicine wihtout an in-person physician evaluation is illegal, but that does not stop it from happening for profit. JG 10.30.08

• Is Renova still made? I really liked it but was told by my Derm a few years ago they quit making it. Is it back? Does it come in .1%?

  Answer:  still being made and sold. JG 10.29.08

• Dear Doc. In your opinion what is the BEST Retinol cream out on the market? Thank you for your time.

  Answer:  not much difference, just need to compare the concentrations, if the company will tell you, but retinol is retinol, it might vary due to the other products they put into it though. JG 10.29.08

• Can I use Benzoyl Peroxide 5% together with Differin in the evening ?

  Answer:  yes, you can. JG 10.30.08

• Have u ever heard of a peel called SkinCoulture USA? It`s a homecare product that is FDA approved, supposed to be good for helping w/acne scarring? thanks

  Answer:  I cannot endorse and I find their website full over over-inflated claims and misinformation. JG 10.29.08

• Dr. Garcia, why is it that some Retin-A users peel while others do not. I peel. Is is because I have more sun damage? I am just curious about the physiological basis for the different reactions. Thanks :)

  Answer:  thicker oily skin will not peel, also, some people have alot more damage and it takes longer for the wax to come off to see the irritated skin. It also depend son what strrength is used, if it is too weak, there is no peeling, or if moisturizers are used the peeling is not a visible. JG 10.28.08

• hello, my skin never peels like everybody else complains about when i use retin-a my skin only goes a bit red and flushed. if im not peeling does that mean its not working?

  Answer:  not everybody needs to peel to get the benefit, it is still working. JG 10.28.08

• Hi Dr. Thanks for your quick response regarding the plugged oil glands. If i use retin-a after how long should i see changes? is it a slow process or will it act quickly? and what exactly would be the mechanism that it would be enacting to help my skin? and lastly would an exfoliating facial scrub help at all? thanks once again!

  Answer:  whatever you will get from it will be seen in 6-8 weeks and then slowly continue for about one year, at that point, that will be the maximum improvement. The Retin-A helps by removing the top layer plugging the pore, by exfoliating, so other exfoliants will assist it. JG 10.28.08

• Hi Dr.garcia, do you have any idea what these white bumps are under my eyes? and is there anything i can do to get rid of them? They appeared suddenly a couple of months ago and i have no idea what caused them. http://i259.photobucket.com/albums/hh302/nocode1985/eye/DSC09845.jpg http://i259.photobucket.com/albums/hh302/nocode1985/eye/DSC09838.jpg thanks for your time

  Answer:  plugged oil glands, can try Retin-A or very light ablative laser like a light Rhytec, bu they will likely come back in time, your skin is prone to them and there is no permmanent solution, sorry. JG 10.28.08

• I ordered your peptide cream recently. I was suprised at the type of container it was in. Is it OK for it to be exposed to the air like that? Can I also layer it with another moisturizer after about 20 min.? thank you.

  Answer:  OK for it to be like that, will not affect the cream,as to mixing it with a moisturisr, one can put the moisturizer on top after 10 minutes but you likely will not need to use it. JG 10.27.08

• I had a portrait plasma treatment on the 15th of this month. My skin peeled and all seemed well as of the 22nd. Then I stopped using aquaphor and switched to cetaphil on Dr`s advice. As of this weekend, I have developed a red rash with raised lumps like red pimples all over my face. What do you think is wrong? Thanks for your advice. t

  Answer:  the Cetaphil is just too irritating, stop it, use just plain water and return to a moisturizer or Aquaphor for a few more days. Should be better and able to tolerate the Cetaphil in a bit. Not an unsual thing. JG 10.26.08

• What are your suggested treatments for sebaceous hyperplasia? Is there anything to prevent more of these appearing on my face and what have you found most successful in removing them? No dermatologists in my area where I live are very encouraging about any treatment for this. I am willing to travel to other areas of my state if there are some effective treatments available there - I just need to know what to look/ask for. Thanks for any advice you can provide.

  Answer:  can try Retin-A to try to prevent them, but not very effective. As to treatments we usually hyfercate them. All treatments are fairly temporary. JG 10.25.08

• Hi Dr. Garcia do copper peptides thicken skin? is there any need to use them if already using retin-a to try and thicken skin? and do they require a prescription?

  Answer:  by helping the normal repair process in your skin as it repairs on a daily basis the damage that occurs. I think applying it on top of the Retin-A might help, there are no studies done to show that benefit though. JG 10.23.08

• I have my doubts that dermarollers create a visible amount of collagen, but they seem like a very good idea to use for deeper penetration of topical products like Retin-A as they create tiny holes in the skin for deeper product penetration. Thoughts?

  Answer:  might also cause a previuosly unrecognized problem due to the non-certified application depth, along with the possibility of causing pimples where the carier base is inserted too deeply. JG 10.22.08

• Hello Dr. Garcia, What can be done for the dynamic wrinkles below the crows feet... (ie. they are sort of at a 45` angle coming down from my eyes toward the bottom of my earlobe) & they are there only when I`m smiling... I think they are too far down for botox to work there without making my smile funny... Help!

  Answer:  lasers to thicken and tighten the skin so it does not fold as easily is about all. JG 10.22.08

• why do they say not to use filler if u have svereve allergies or are allergic to microoganisims gram posotive bactera? what does that men? Is filler bacteria? is that y i feel sick? also how do i know if im sensitive to the gram posotive and if i should continue using filler? please help...confused

  Answer:  it is a precaution is all. Once agioan, I think you might certainly feel sick but it is not due to the fillers. I stongly advise you NEVER use fillers again due to your concern. JG 10.22.08

• I was just told that the VBeam laser and the pulse dye laser are different. Is that true, and if so, how? Thanks alot.

  Answer:  they are different but are used for similar things, not much difference clinically. JG 10.22.08

• hey dr garcia! I have an olive skintone. I have been using tretenoin 0.025% for about a week now (every nite) with no sun exposure what so ever.. however my skin has darkened overall evenly.. does tretnoin activate melanin in your skin?? what should I do? will this go away? please let me know! thanks

  Answer:  it is attemping to remove the top layers of the skin and is begining to exfoliate the skin in order to make it better, not unusual. It gets better and fades with time. JG 10.21.08

• Hi Dr. Garcia! Is your eye cream for dark circles available for sale now? What is it called? Also, you mentioned that not all patients will benefit. What type of dark circles will benefit/not benefit from this cream? Thanks!

  Answer:  yes, but not on the website yet, can call the office and they will help you out, it is effective for dark circles that are bluish in color and the three pigements that stain the skin, effective in about 60-70% of patients. JG 10.21.08

• I used to do retin A .05% then graduated to some smaples of .1%, to see what a difference. I just started back on it, in anticipation of a lasering(at PS request), but Dermatologist gave me script for ,05%. Granted, its been awhile since have used it, all summer, basically. The .05% isnt doing much. Should i have gotten the .1% for better/faster results?

  Answer:  if it is just prep for the Laser that should be good enough. JG 10.21.08

• approx what is the down time for co2 laser, one faily deep pass for moderate wrinkles and sundamage? Down time for Rhytec? same? 1 pass? also, what is the best after laser treatment to make results last i.e. Retin A, (what percent) or other facial treatments/topicals?

  Answer:  2-3 weeks before makeup on the CO2 and 2 weeks for the Rhytec but the pinkness on the Rhytec will be gone in 4-6 weeks while the CO2 might take 2-3 months. Once healed sunblock and Retin-A help maintain it all. JG 10.21.08

• Was is your opinion on the Obagi C skin care products???

  Answer:  good stuff. JG 10.21.08

• Hello Dr. Garcia, There is so much hype out there about anti-aging products etc - it is confusing. Before wasting money, I would like to know, bottom, line, which ingredients are truly effective? I am in my early thirties and my skin looks pretty good - just want to start early!! Any advice would be appreciated. Thanks

  Answer:  retinols, DMAE and Vitmain C. JG 10.21.08

• I was prescribed use retina. I used to use it before, years back and i was like WOW! i had the most beautiful skin! and later as i continued it, it made my skin peel or worsen. So i stopped using it. My skin started to break down so my doc prescribed it to me again. why do you think it doesnt give a good result anymore? AND... when i went to the chemist instead of giving me retina they gave me ReTrieve Cream (stretinoin 0.05%) They said its same as Retina.. is this right? coz its only been aweek im using it now...

  Answer:  the material they gave you is essentially the same and as to why it does not work as well over time is because your body`s ability to react and form new collagen decreases with time. JG 10.21.08

• Hi there, certainly appreciate your advice. What is your best recommendation for dark under eye circles? Thanks a lot.

  Answer:  we have a new cream in the office but there is nothing great, even my cream will not help all people. JG 10.20.08

• I have sebaceous prminence on my penis. Basically I want to know if they can be rid of. I have looked up on the subject. Some people claim that they can be cut out. This seems like it would work but I would never do this myself. As mush as I want the aliment gone theres no way I am doing a home scalpel remity. Any how I would love some info. If it is considerd cosmetic surgery I would pay. I will also travel to see any specialest. Thank you doctor hope to here back soon

  Answer:  I think you should see a urologist for an evaluation and treamtent recommendations. JG 10.20.08

• Thank you in advance. 43 Years old white female observing strict sun precautions for the past 10 years (alas too late!) with UVA/UVB, retin-a, hats, obagi, peels etc. For several years I`ve considered a phenol peel for skin rejuvenation, pigmentation, fine lines and elasticity but didn`t want the anesthesia/downtime. Within the next year I am having bunion surgery with its attendant 6-12 weeks enforced downtime. Do you have any suggestions? Different procedure? Other things to consider? What to ask my PS? EJM

  Answer:  I think an abaltive answer will be safer with less risk than a Phenol peel, preferably a CO2 laser if you want significant improvement. JG 10.19.08

• Hi Dr. Garcia, What is your opinion of the Clairsonic skin system? Also, do you think Yag lasers will tighten the jowl line? Thank you so much for your time.

  Answer:  not a believer in the Clairsonic skin system and do not think YAG lasers are strong enough to tighten the jowls. JG 10.19.08

• Hi Dr., I have been using TriLuma for 6 weeks, is this better than Retin A. What the is difference between the two?

  Answer:  it has a topical steroid along with a bleaching cream, so if you are trying to treat brown spots it might work better. JG 10.18.08

• Is it true that overhead office lighting will age you just like the sun does? Do I need sunscreen in my office building. Thank you for all of your answers and advise.

  Answer:  flourescent lights due have aging effects of about 1% strength of the sun. So if under flourescent lights, use sunblock inside too. JG 10.17.08

• Dear Dr. Garcia, About 2 weeks ago I came down with shingles. I immedediately got on Valtrex - which I finished after 7 days; steroids, which I`ll be done with in 2 days, and pain medication. The rash is definitely improving but it`s still there, and am taking 600 mg of neurontin at night plus OTC pain killers during the day. My question is this: since I will probably be off from work next week too, I`d like to take advantage of the time I`ll have and get some restylane or juvederm, and also get a light (25%) glycolic peel. My shingles are on my torso by the way. Do you think it`s safe to have these things done now? I don`t want to take any chances of spreading shingles to my face, though, or my body reacting badly to the restylane due to the illness or the medication. Thanks much for your thoughts!

  Answer:  I would suggest you do none of that while having the active virus only partially controlled, too risky. JG 10.17.08

• I have read on your website that Efudex is used as a topical cream to treat pre-cancerous lesions & AKs. Does Efudex leave a scar or white mark after the lesion heals? If Efudex does leave a scar or white mark discoloration of skin, what would your recommend instead?Thanks for you caring about all our questions.

  Answer:  if the lesion was deeper and it is adequately treated with the Efudex, it can leave a paler patch of skin. As to any other option, I am afraid there is nothing else, lasers can leave a scar, surgery will leave a scar and liquid nitrogen can also leave a scar I am afraid. JG 10.16.08

• Dr. Garcia, i am the one who asked you about trying to eliminate the red marks from acne, which actually can be gone but in very long time. You said to speed up the process topically, i should use squalane oil. I just looked at my kitchen and i have extra virgin olive oil, can it worked? also what do you think if i use Apolar Cream containing desonide 0.5 mg?

  Answer:  I would prefer the Squalane to avoid any potential contamination. I do not think the cream you mention would help it, sorry. JG 10.16.08

• Dr. Garcia, every time i heal from acne and recover, the red marks will stay for a long time. It will go away but the time needed is too long. What can i do to speed up the fading of the red marks, what topical should i use on that spot?

  Answer:  can try squalene oil topically and YAG lasers also to help fade the redness. JG 10.16.08

• DR GARCIA, CAN YOU SUGGEST ME OF A GOOD CREAM FOR MY FACE?I WANT TO FIRM AND SMOOTH MY FACE WITHOUT ANY TYPE OF SURGERY. I AM IN MY LATE FORTIES. ANY HELP WILL BE MUCH APPRECIATED. THANK YOU MARIE 10-16-08

  Answer:  Retin-A. JG 10.16.08

• Dear Dr. Garcia, Do home facial ultrasound machines really work to tone skin and help reduce wrinkles? I ordered one to try and help reduce the hematoma I developed after my Quicklift surgery 4 weeks ago. They advertise that they will on line but I could not help but notice in reading through your archives that you say ultrasounds will not help scars, so I was wondering how they could reduce wrinkles?

  Answer:  no, they do not, even the strong ones in therapy offices do that. They do help with swelling though. JG 10.15.08

• Dr Garcia saw someone asking about hair removal. in the mostache area waxing can cause wrinkles over time creams can burn and tweezing can damage skin not everyone can afford laser why cant women just shave that area?

  Answer:  tweezing will daamge the skin the least but waxing can pull skin off and cause scarring if the skin is too sensitive. JG 10.15.08

• can using retin a eveynight cause and kind of vitamin a toxcicity?

  Answer:  I have never heard of that happening. JG 10.15.08

• OK, no mixing of the retionoid and the vitamin c. Which one should go on first? Should I wait a few minutes before putting on the seconde? Be well, and thanks.

  Answer:  Vitamin C ten to fifteen minutes after the Retin-A if you are dead set on using them both. JG 10.13.08

• That you for answering my questions...Have you ever prescribed CARAC and what your opinion on CARAC, do you think it is more effective than Efudex? Thanks for your time...you`re the Best!

  Answer:  I never have becasue I find Efudex to be as effecive and cheaper. Best of luck! JG 10.13.08

• I have pre-cancerous lesions and AK from my head to my toes. I was a sun worshipper starting at age 12 until my 40`s. Now I am 58 & paying the price for all my sun damaged skin.I have too many AK lesions to freeze off so I have been treated with Aldara & efudex=5%. Both having terrible side effects. Have you heard of a new product called :Carac and is only .5% by DERMIK, Aventis)It too is a fluorouracil cream like Efudex but the side effects are not as bad as Efudex & I have read that CARAC is more effective than Efudex. What is your opinion. Have you any experience with prescribing Carac? Thanks

  Answer:  you will essentially react the same way, that is how it is going to have to be, sorry. JG 10.13.08

• Dr Garcia you have very nice skin. What treatments or procedures do you use on yourself if any?

  Answer:  I use a facial cleannse with glcolic acid, shave daily with a regular razor, use sunblock during daytime and use my DMAE cream twice daily, and thank you. JG 10.12.08

• Dr. Garcia, my skin care person recommended I use my 10% obagi C under my .025 retionoid. I like to mix them together because it makes the retionoid spread better. Is there any value in this? Is there any reason I shouldn`t? I use the retionoid every third night or so. Thanks a lot!

  Answer:  well, it will make the retinoid less strong, it is better to put them on sequentially. JG 10.12.08

• I mentioned previously that I am on .1% Retin A. I previously used a lower % and am just starting to use the higher %, after not using it al all for the summer. I have definitely noticed that my skin is more sensitive. I get a burning sensation when I use my moisturizer and eye cream. Do you think that I am damaging my skin and should I use creams that do not irritate it, or is the irritation good? The irritation does not feel so bad that I need to discontinue it, if it is doing my skin good. I guess what I am asking is am I doing too much? Do you have the new eye cream available? The one for dark circles. I have been patiently waiting. Thanks

  Answer:  that is a normal repsonse to the stronger one, might want to use the ligther one and then advance once your skin gets more tolerant, but it does get better in time even if you continue, there is no damage per se, that is part of the exfoliation that is occuring and desired. The dark circle eye cream is for sale at last, I still do not have it on our shopping cart but you can call the office and they will help you out. All the best. JG 10.11.08

• I`ve had a scar on the cheek which was stitched more than two years ago. The scar is still somewhat red even though its been two years. The redness seems to get more prevalent at times due to random factors like when I just wake up in the morning, when I am running, etc. The doctors say it is due to the dilation of blood vessels. I have had at least six vbeam treatments and the problem still persists. One doctor said IPL might be a better option. Do you have any recommendations?

  Answer:  I think IPL, VBeam and YAG lasers are all options but no way to tell if you will respond, it does not work for all patients I am afraid. JG 10.11.08

• HI, I have a customer using lactic 5 % +hydroquinon 2%, her skin is asian brown. She used it almost one month all over the face. now her face suffers white spot, uneven, just like a people having ptyriasis rubra or tine versicolor. her white spot is plenty. I`m only have chemical peeling and microdermabasion on my clinic. What can I do for making her face become even and clear out all of the white spot. please help me, I`m so confuse. Do I have to peel her? by Glycolic acid or tca? thank you doctor

  Answer:  she needs to see a doctor to make sure she does not have a fungal infection on her face, what you have been doing should not casue that type of color loss. JG 10.11.08

• Just found you last nite..been reading for hours & my head is spinning...OK, I`m 46, ok skin texture but 3 areas of concern are making me look soooootired: want to eliminate fine eye lines,a dime size brown/tan spots on each cheek, nasty under eye circles. Laser?IPL?Chemical peels?Bleaching?Retinols? I need minimal down time because both my kids are autistic & I can`t mess with alot of aftercare(& yes $ is always an issue). THX! D ps. have any idea you how many people you`ve comforted, given peace of mind to, & helped save tons of $$$..?!?

  Answer:  start with retinols and bleaching creams first ansd see what happens, then progress to lasers, the dark circles are hard to improve, might not be able to be improved, might benefit from fillers on the rim at times. All the best and prayers for your children. JG 10.11.08

• dr. garcia, could you please tell me if electric current- administered, for example, in a health spa to facial area cause loss of color or pigment in lip area? i`m pretty sure wand was placed on edge of lip and resulted in a loss of color on one side of bottem lip, i noticed this right away afterward the treatment but is not part of any warning. can`t believe this happened...i know thinning lips are part of aging but i think this was definitely due to treatment, since the color and line of my bottem lip is irregular now.

  Answer:  it could do that if the electricity burnt your skin. JG 10.11.08

• Thank you Dr garcia for answering my question about plasma laser, you said cream with Colloidal Oatmeal is only tempory in softening the skin , what do you think would be best for Seborrheic Dermatitis my normal doctor told me use any cream and not found anything that really works. The aveeno feels better but would like something that really helps. Thanks again .

  Answer:  I think seeing a dermatologist is best, might want to try some Cetaphil cleanser and squalene oil for the moisturizer. JG 10.10.08

• Forgot to ask you about a recent suggestion a derm made to be about sebaceous hyperplasia. He memtioned injecting a small amount of some type of steriod, can think if it was Kenalog or something different. What are your thoughts on that ? Thanks

  Answer:  won`t work and can cause new and different problems. JG 10.9.08

• Dear Doctor, I have been trying to find a good lipstick with UV protection, but those I found were not too good in terms of UVA protection (not broad-spectrum). I was thinking of using a sunscreen lotion with mexoryl, avobenzone or a mix of those and other ingredients over my lips, to let it dry and then apply lipstick on top of that. I have pale lips and can`t go without lipstick. I do not have lipsticks with UV protection... would that system (using sunscreen over the lips and UNDER the lipstick) provide some protection? (assuming I am going to use a cream or lotion of SPF30+)

  Answer:  I think your plan is a good one. JG 10.9.08

• hi dr.Pierce. I have one customersuing lactic 5%+ hydroquinon 2%, her color skin is asian brown. She used it for almost 1 month. and now she suffered hypopigmentation spot (white spot), while the other skin still brown. what can I do for making her skin become an even skin tone? should I peel the skin? I`m only have chemical peeling and microdermabasion in my clinic, I don`t have a laser or IPL. thank you

  Answer:  I suggest stopping the cream and asking her to throw out all of her other creams and purchase new ones, it sounds more like a superficial fungal infection causing the pigment loss rather than the creams, as the creams would not make it go away in one spot and not over the other areas. As to the other issues, you need to ask your supervising physician, it would be inappropriate for me to answer those questions for you as you either should have someone supervising you or should be acquainted with the issues already. JG 10.9.08

• Me again. I use Retin A .1%. What is the differnce between Renova and the Retin A? I also have a product by the Vital Therapy line. It is a Vitamin A with EGF. Should or can I use it with the Retin A?

  Answer:  some people have an easier time using the Renova due to less irritation, they are pretty close in effectiveness. Retin-A is a strong Vitamin A derivative so I see no need to add the other product as the Retin-A is stronger. JG 10.8.08

• We have just had new flourescent lights put in at work the long tubes quite bright. How much sunblock should I use while working under them? Also you read so much can mineral powder over sunblock cause the sunblock not to work? So sorry one last question mine says to use on clean face first then moisturiser does it really matter? Thanks so much for all these answers. Oh and can having a skin peel help the appearance of moles or just freckles and skin damage like that thanks

  Answer:  I think sunblock of SPF 50 or more. I am not sure why the mineral make people are making that claim, I know of no interaction that would cause that to happen. I think it is always best to apply all creams on your face after cleasing, yes. JG 10.8.08

• Dear Doctor, I received aretefill injections for a depressed area (scar) in the skin on Friday. The area that was injected remained quite red/bruised until today (Wednesday) however I was outside in some hot weather and was sweating a bit and I noticed when I looked in the mirror that the entire area that was injected became extremely red and looked quite awful. Do you know if this is normal or will go away in time? If not, is there anything I can do to prevent this from happening again. Thanks

  Answer:  all normal and is temporary, apply a little ice and it will get better over the next few days. Sunblock will help some, along with a baby aspirin 1 hour before going outside in the sun. JG 10.8.08

• Dr Garcia, How soon after an IPL treatment can I resume the use of retin-a?

  Answer:  2-3 days. JG 10.7.08

• Forgot to ask if Levulan and activation by Blue Light or VBeam is effective for sebaceous hyperplasia? Risk of scarring? Thanks

  Answer:  I do not think it is any better than hyfercation and can be more risky. JG 10.7.08

• what is the recovery time on a medium TCA peel?

  Answer:  6-10 days. JG 10.7.08

• will a medium strength TCA peel help with fine line wrinkles over the mouth--or crepy skin on the cheeks?

  Answer:  no strength TCA will help with wrinkles after the swelling goes down. JG 10.7.08

• Dr Garcia, You are such a kind and patient man. You spend so much time answering questions. You are certainly appreciated. My question. If you had to choose between CO2, Erbium lasers, or herfercater for sebaceous hyperplasia, which would you choose? Which one is likely to leave a scar, especially if done lightly? I know they do come back. Thanks you.

  Answer:  I would choose the hyfercator, quick, cheap, and as effective as the others. Healing time depends on how deep you go, that being the same, they all heal at the same rate. The risk of scar is due to the depth of the injury so they can all leave a scar if you go deep enough. JG 10.7.08

• Hi Doctor, On the subject of Botox, I spoke with my PA about the single use per patient and she told me that she never double dips the syringe and therefore can`t spread any diseases. If that is the case, can the bottle then be used for more than one patient? My fear would be that what if she had a bad day and didn`t realize she put the syringe in twice and then went onto the next patient. I guess if I ask for a new bottle and she said no, I would just go else where. Better to be safe than sorry.

  Answer:  I know that is what the doctor says but she is absolutely incorrect, if that were the case then the cases of hepatitis in Las Vegas and the cases of hepatitis in New York would have never occurred, nice try but false. Always better safe than sorry, there is no cure for hepatitis. JG 10.6.08

• Hey Doc, What`s the update with the undereye dark circle cream? I am waiting patiently!!!! Thank You

  Answer:  we are bottling it as we speak, will be up for sale by calling the office later this week and then will get my webmaster to put it on the shopping cart after that. JG 10.6.08

• Thank you for the reminder that Botox is for single use only by same patient, not to be shared. I remember 10 years ago when i first started getting it, the dermatologist off ice would start calling regular users because they always needed 3 people. Why would that have been? And are spas more likeyly to break this rule than a PS office? or a PS themselves? I will definately ask to see the box and how do you know that if you just see the bottle, it is unopened, without asking? Or do you? Also, is it the norm to have it be more expensive to have any injectables done by an actual PS, rather than an anestician? Considerbly more? Is it worth it, in your opinion, to pay more to have a doctor do it,( i am talking botox, in particular, for myself in this instance, i have never had any problem with anyone, and i have had dermatologist, PS, NP, and just spa chicks inject it. BUT, if i am doing a brand new area, like i mentioned upper lip and mouth corners, i am only having a PS nurse do it, should i be worried? she said botox combined with lip border filler of some sort, helps the vertical lines, but i m waiting for my face lift for the surgeion to do fillers so i will just be getting botox. should i skip the upper lip botox and wait for the surgeion to laser it, as planned, during surgery? I certainly dont want to drool!

  Answer:  well the reason they did that way back then was because the people training newer physicians in Botox were instructing us to do it that way, the maker of Botox knew that but did nothing about telling people that what they were being taught was wrong. Spas are much more likely to do it than doctor`s office because they set lower price points. I would ask to see the bottle and ask them to destroy the remainder in front of you before you leave. Have them reconstitute your bottle in front of you always. The bottle should be in a sealed box that they should open in front of you. I think in general it is more expensive to have it done by a physician, yes. I think for many areas it is similar in technique and safe for both nurses and doctors, but I will also say that, although there are aestheticians out there injecting Botox, in most states that is illegal, only nurses, doctors and in some states medical assistants can administer any medication through an injection. As to upper lips and DAO, I would only have a docotr inject it, especially because they are off-label sites and you need to be informed that it is a non-approved site they are using it on, it is also illegal to advertise off-label sites of injection like the ones you are having done. I would skip the vertical line Botox injections. All the best. JG 10.6.08

• Hello Dr. Garcia. Regarding the question below- I mean is it just okay to use facial wash w/ exfoliating effect or it will be harsher on the skin if I have to follow it up w/ your neuropeptide cream? Thanks.

  Answer:  the neuropeptide can be used after, no problems with harshness there. JG 10.6.08

• Hello Dr. Garcia. Is it okay to use johnson`s gentle exfoliating facial wash followed by your neuropeptide cream or it`s better to use a more gentle facial wash w/out exfoliating effect if I`m using your peptide cream? Thanks.

  Answer:  creams always go on last, the cleanser is used first. JG 10.6.08

• How does Botox work to lift the corners of mouth slightly and does it also help soften vertical above the lip lines? if so, where r these injections placed? I go for some botox Wednesday and these 2 places were suggested to me. I usually just get the forehead and crows feet.

  Answer:  as to the corner of the mouth it helps by weakening the muscle that pulls the corner down, as to the vertical lines of the upper lip I find it either does not work well or too well and then you drool. One more thing about Botox. It has come out that the education that injectors were given since the beginning of Botox release was incorrect. The bottle is to be used for a single patient. That means that a bottle should not be shared between multiple patients. The company that makes Botox has known about this but has never issued an alert to doctors or patients. The risk is that of the bottle becoming contaminated and passing a communicable disease like HIV or hepatitis from one patient to another. There are no known reports of disease transmission in the use of Botox, but it has not been looked at yet in order to determine that issue. For that reason I strongly urge you to demand that a new bottle be used when you are treated and then observe the injector destroy the remainder of the bottle. If that is not done I urge you to contact the local board of health for the violation. Ask to look at the box it comes in and you will see the single patient, single use wording. JG 10.6.08

• Hello, I have several questions that I have been wondering about. 1). I have a dark bluish area under my left eye only. Is there anything that will help this - it is almost impossible to cover it with make-up. I have read about a cream called Hylexin - is this really effective?; 2) I have a scar on the side of my nose it is raised slightly and the perimeter is pale with a slightly darker area in the middle. Would IPL be effective in treating this area? If not, can you recommend something?; 3) Is there a treatment (other than birth control pills) for hormonal acne? My face only breaks out during the week before my period. Any suggestions would be appreciated. Thank you.

  Answer:  not sure Hylexin would work, it great depends on what is causing the bluish color. As to the nose, the IPL would help the darker spot and mabe flatten the scar if it is red but that is about all. As to the hormonal acne, you could ask your dermatologist to evaluate you for Accutane. Best of luck. JG 10.5.8

• Just over three years ago, someone cut the skin above my lip. This scabbed over but left a red broken capillary and over time a pale mark appeared. I have had this treated with one Nlite and around three IPL sessions. This has helped the mark improve. However a red mark still shows in certain circumstances, for example when I am hot and there is still a pale mark. I find this very bothersome. Please can you advise me of a treatment that can help this further? If I have any more IPL or Nlite treatments I am worried that these may cause pigmentation problems. I have read about MCA dry needling but again I am worried about pigmentation problems. I have also heard of a treatment called Lamprobe, but do not know a lot about this treatment. Please can you advise me of what is the best way forward. Your advise is very much appreciated.

  Answer:  I am sorry but I do not have anything reliable and predictable that would help. JG 10.5.8

• Hi there, I`m 23 and Irish with fair-ish skin. I came off Yasmin a few months ago as I developed what I think is melasama near both my eyes. I have had it for almost a year at this stage. I am very careful in the sun and wear factor 50 and sunglasses at all times. I have been using a variety of inexpensive creams that claim to fade melasma but I have not seen any results. Are there any procedures that actually work or I am destined to have this forever? Also how safe is hyrdoquinone, if that is your recommendation?

  Answer:  I suggest prescription Retin-A and Hydroquinone, and if that does not help move to a Q-switched Nd:YAG laser, best of lcuk. JG 10.5.8

• Hi Dr. I have recently started using Retin-A on my face and I have been told I cannot wax the area. If I decide to stop using the Retin-A, how long should I wait before getting waxed?

  Answer:  you should stop it a 3 days before and not start for a 3 days after is all. JG 10.5.8

• Hi, I received a Kenalog injection for a tiny zit on the skin between my lip and chin (on the right side). It`s been 6 weeks and i know I was injected way too much because there is a dent there the size of a pencil eraser, but not quite as deep. How long do you think this will last? If permanent, do you recommend a filler like Restalyne? Will a fill help it fill in on its own? Any help is greatly appreciated! Thanks.

  Answer:  in most cases it comes back on its own, whatever is going to come back will do so in the 6 month time frame. If it really bothers you a shorter term filler like Restylane could be injected but if the tissue continues to atrophy do not blame it on the Restylane, might be best to wait until it is stable and then treat it if needed. Best of luck. JG 10.3.08

• I used IS clinical`s Super Serum advance and Pro Heal serum advance and after a few uses, there`s a lot of raw like dryness especially in areas already `under attack` like blemishes, my hairy chin that i`m always plucking, etc. what could`ve caused this?

  Answer:  some of the exfoliating ingredients likely irritated it, I would stop it all and let it heal. JG 10.3.08

• I have just read a lot of bad things about the effect of Thermage treatments from women who leave messages. What is your opinion of it.

  Answer:  I would not recommend it. JG 10.2.08

• I have just read a lot of bad things about the effect of Thermage treatments from women who leave messages. What is your opinion of it.

  Answer:  I would not recommend it. JG 10.2.08

• Thanks for your answer from Yesterday. I am so sorry that I have more, but I’m kind of desperate to get this whole skincare deal worked out because it’s extremely impt to me & I feel like I’m spinning my wheels w/ all the products on the market and all the issues that need to be addressed w/ regard to skincare i.e. wrinkles, elasticity, collagen breakdown, free-radicals, ect. It’s difficult to determine what works for what skin issue and what products don’t work. Okay that said, As I stated before I am 27, fair skin,( ex-smoker, smoked for about ten years) and until a few years ago would tan outside a few times a year. Despite all of this abuse my skin looks pretty good. I would like to correct the existing damage, which include extremely small smile lines, which are not visible until I’m literally on top of the mirror. And s more visible smile lines around my eyes. I would also like to take measures to increase collagen and whatever else is impt. to correct the existing damage. I am also wanting to est. a preventative skincare regimen that provides protection against free radicals. I mentioned yesterday that I was using Skinceuticals CE Ferulic to additional prevention against free-radicals, but it seemed to be increasing the wrinkles around my eyes. Is that possible?? Could you please give me a detailed list of what the best products are for restorative measures? And Also what the best products are for preventative measures. And what skin issues will be addressed through the use of those products. I’m willing to do/purchase whatever you recommend.(Already ordered your DMAE cream—per yesterday’s answer)(I also have an unfilled script for Rentin-A 0.5%) Dr.Garcia, I am so sorry for this lengthy email and the detailed answer it may require but I’m literally going broke trying to find the right products and est. the correct regimen, for both prevention and restoration. Thank you in advance.

  Answer:  if the Skinceuticals product irritated your skin I think it can temporarilly increase the wrinkles. As to what I would suggest, I think a glycolic acid facial wash, either Retin-A or DMAE cream twice per day,or could alternate the Retin-A at night and DMAE during the day, total sunblock, minimal sun exposure and reduce smoke exposure, that is all I would do. Most of what is on the market will not get you what these few will do and there is only so much your skin can absorb anyway, save your money. JG 10.2.08

• Hi Dr Garcia, I was reading some of the other questions posted and came across one which concerned me. Someone on the board said that using Skinceauticals caused them more wrinkles and lines. Can this product actually do that? Also, I am 22 yrs old and would like to prevent aging and correct any prior sundamage. I have been using Estee Lauder Advanced Night Repair as well as the Estee Lauder ANR Concentrate version. My skin has been doing well with that, but I wanted to amp up the amount of protection and restoration to my skin. So, I was bought the skinceauticals CE Feurlic serum. Is this the best way to go? I was also considering Revale Night Cream since it has coffeeberry in it. Could I use the Revale with the Skinceauticals serum? Lastly, are photofacials or lasergenesis detrimental if you already have good sking for the most part? I heard that they can stimulate collagen. If starting these procedures early, at 23, can you postpone aging and make your skin look even better, or will it harm your skin and will you suffer from unnecessary side effects?

  Answer:  any product that exfoliates can in the short term cause dehydration and irritation of the skin that can make wrinkles look worse. I think everyone responds differntly so a short trial period is what I would suggest. None of the companies have tried to test for compatability, so you will need to do the trial of the combiantion on your own. I think the light treatments do help, but nothing visibly at this point in your age demographic. The most important things, more than what you are doing, is no smoking and absolutely no sun, always use sunblock. Best of luck. JG 10.2.08

• will a TCA peel do any skin tightening?

  Answer:  I do not believe it will after having done them for 22 years. JG 10.1.08

• Hi Dr. Garcia--I`m 27 w/ fair skin. I have some restorative skin products but I`m looking for suggestions on good preventative skincare products. I used to use Skinceuticals C E Ferulic, but I think that actually contributed to more lines. So, I`m looking for a new product w/ the same preventative benefits CE Ferulic claims to provide, but would work for me. If you cant think of any single product, can you provide a morning skincare regimen for me to follow that would provide the preventative benefits I`m looking for. I already use sunscreen daily, SPF 55. Also, is it okay to use restorative products w/ preventative products at my age? e.g. are there products that may benefit more mature skin but actually harm younger skin? Could you please try to address each of my questions sequentially so I have a clear understanding? I thank you & so does my pocket-book. Molly

  Answer:  I suggest our DMAE cream on our shopping cart. I think preventative and restorative can be used together, but at different times of the day, restorative at night is better. JG 10.1.08

• Could you please tell me can botox be used for bags underneath the eyes. Know it can be for wrinkles around. Also I had a mole thing was raised slightly brown form my cheek two years ago it is raised again isnt`t couloured. Do you think it is worth getting done again? Forgot to say the first time I had to get it done twice as didn`t really work. Or do you think it will just keep growing back and getting worse. Can live with it how it is but don``t wont it to get darker or bigger? Thanks once again.

  Answer:  no, it cannot be used for the bags and actually can make them worse and cannot be used for the wrinkles on the lower eyes as it will weaken the muscles of the lower eyes. If the mole bothers you then it is likely worth having it treated again. If you do not want it to grow back it needs to be cut out but then it leaves a scar. JG 9.30.08

• What do you think of OTC product (moisturiser) containing alcohol as list no 3 in their ingredients? Usually listed no 1 is water, no 2 is glycerin or cyclopentasiloxane, then no.3 is alcohol. Is alcohol ok if listed as no 3 in the ingredients lists, is it good or bad for skin?

  Answer:  it is not a good moisturizing ingredient. JG 9.30.08

• Dr. Garcia, this is the way my skin reacted after any exfoliation (whether its just with wash cloth, with scrub, or with retin a or BHA), it always react the same, making my skin more oily, and the pores cleaner but more visible. I read everywhere that exfoliation is a must. What do you think i should do with my case? Should i avoid any exfoliation at all but my pores look dirty, or should i perform exfoliation in different way perhaps you can suggest anything?

  Answer:  well, there is nothing you can do except stop it, there is no 100% thing and in your case you cannot do it as you cannot tolerate it. Will need t try other things like IPL or microlaser peels to take the top layer of skin off intermittently. JG 9.30.08

• Doctor, I have noticed that retin-a comes in my country in various concentrations: 0.025, 0.050 and 0.1%. What I wonder is... if a person uses consistently the product and does not experience negative side effects from any of those concentrations (I have used all of those rx at some point), is using daily a 0.1% better than using a 0.05% one? Or, say, using a 0.05% concentration of retin-a works just as well if used daily, while the 0.1% every two nights? Is it the concentration or rather the consistency and frequency of retin-a use what makes it work? I am asking this because I have noticed that the formula for 0.1% does not cause me any trouble, but the cream in the 0.05% concentration (different brands, both good laboratories here) has a better consistency, easier to apply to the skin, not too thick nor thin, etc. Should I go for what feels best for the skin and use it more often? or still go for the stronger one but not as nice as a cream? Would I slow or reach way less benefits from the reti-a by using the 0.05% daily rather than the 0.1% dose? Thanks again for everything!

  Answer:  the stronger is better if tolerated. Consistency is also important, but if you can be consistent with the stongest, that is the most effective. All the best. JG 9.29.08

• Dear Doctor, funny but I was going to ask something somehow related to the question made by someone else below. Doctor, does the ingredient that creates the fake tan in sunless tanners for the face work if the person uses at night retin-a? I assume the glycolic acid fades the fake tan as it gets rid of the skins that are tainted by the DHA ingredient, right? But does the same happen with retinoids? If one wants to have a tan develop, does one have to stop using either acid, or one of them? Or is it a matter of just not applying one right after the other, in whatever order? How would you suggest someone to get a fake tan while still using retinoids or BHA or AHAs? Hugs!

  Answer:  yes, the Retin-A or the glycolic acid will really lessen the time the fake tan stays on. The Retin-A is stronger so it will affect it more. JG 9.29.08

• Dr. Garcia, I use Tretinoin Cream,.025% every night. I use an antioxidant concentrate every morning but would like to also use the antioxidant at night. Would this routine work OK: 1. Cleanse 2. RetinA 3. Wait 10 minutes, then apply Anti-oxidant 4. Moisturizer. Thanks as always for your response.

  Answer:  yes, that would be OK to do. JG 9.29.08

• I notice that most older men have very taunt cheeks--not wrinkled and sagging like many women of the same age. Is this development due to the exfoliation of men shaving every day? If so, should every woman start exfoliating EVERY DAY? Is it ever too late to start exfoliating? What do you think is the most gentle method?

  Answer:  partially, but it is also due to the fact they have thicker skin with more collagen and better blood supply. I think exfoliation is fine, but not too much. Retin-A or hydroxy acids are all that is needed, maybe occasional mmicrodermabrasions. JG 9.29.08

• what is the highest potency of vitamin C Ester serum available on the market?

  Answer:  I believe there is some out there for 20%, most common is 10%. JG 9.29.08

• i have juvederm now which I think i had a bad reaction to. Didnt feel weel after for a while. It is starting to diminish, can I add restylne for me refill instead of juv even though its still there? Also how long after a refill can you go on a plane, and will a plane affect impants?

  Answer:  well Restylane and Juvederm can be used together, I am not sure what is going on with the reaction. Airplane travel will not affect it and the repeat injection can be done at any time you wish. JG 9.27.08

• Dr. Garcia, i am the one who gets visible pores after using retin a. You said to stop using it. What do you suggest i should use? I want the benefits of retin a minus the visible pores it caused me

  Answer:  well I will be hoenst, if you have that type of reaction to an exfoliator, about all you can use are things like DMAE creams, but they do not exfolaite, although they do help build collagen and temporize the damage from the sun. JG 9.27.08

• whats all the hype about idebenone, and where do you get it. also im 27 I usr oly regen serum during day and retin a micro at night. with benezecline alternating days. I s this the best for me right now at this age to help w plumpness. collgen, acne. Any other suggestions, i would appreciate. I also use fillers...

  Answer:  that is exactly all it is, hype, there is almost no medical literature to back up the claims, they are riding the coattails of CoQ 10 and idebenoen comes from CoQ 10, so that being the case, use the CoQ 10. I think what you are doing is fine and also avoid all sun exposure and smoking too. JG 9.27.08

• Hi Dr. Regarding skin atrophy due to the use of topical corticosteroids on the face, why do some doctors say this is reversible over a long period of time (a year or more) whereas other say it is irreversible. Why the inconsistency and what is the truth? Thank you

  Answer:  the older you are the more irreversible it is, the stronger the steroid, the less reversible it is, there is no black and white on this one. JG 9.27.08

• In my case, why is retin a make my pores bigger? I do it exactly right, put just a little bit at night, and use moisturizer in the morning. Everything is great except my pores become so visible and wont go back to its size even when i tried to resume / stop retin a,

  Answer:  yes, stop it. JG 9.27.08

• Dr. Garcia, in my case, retin a is doing good for my skin except its making my pores become visible all over my face. Its like making the texture all over my face so obvious. I tried everything, from increasing retin a until reducing retin a, but the pores wont come to its normal size. So do you think maybe i should stop retin a completely? what is your suggestion?

  Answer:  I think you should stop, yes. JG 9.27.08

• This is just a curiosity question. You recommend that Retin-A users take a 3-month break from the product each year. Why is that? And won`t I have to get my skin used to the Retin-A when I start back up after 3 months? I have been using 0.1% three nights per week for over a year now so my break is overdue. Thanks!

  Answer:  yes, your skin will need to readapt and the reason is that it is never a good idea to cause constant irritation to the skin as it will have negative side effects. JG 9.27.08

• doctor to continue my question below about retin a is great for my skin except make my pores visible, i cannot afford IPL or microdermabrasion or such things, so i am looking for topical solution (cream or gel) if you have any suggestion?

  Answer:  nothing topical, sorry. JG 9.28.08

• Using retin a is really good for my skin, except it make my pores become visible. I tried both gel or cream version, the results of both are great except both also make my pores so visible. What can you suggest?

  Answer:  could try some dermabrasions or IPL to shrink the pores. JG 9.28.08

• I have been using efudex for 2 weeks now for skin cancer and am experiencing quite a bit of puffiness under the eye, Is this something to be concerned about or is it normal with the treatment.

  Answer:  no,part of the normal swelling response from the treatment. JG 9.28.08

• Hi Dr Garcia, I have just placed an order on your site for your eye booster cream, DMAE and Peptide cream. I am 40, fair skinned with mild sundamage. Would Vitc C with DMAE in the mornings and Retin A and Peptide cream in the evening be a good regime. If I want to introduce Copper Peptides at some stage, where would this fit into the daily skin care and would it be necessary at all since I do not have major skin damage. Thank you

  Answer:  I think that woudl be fine, I think the copper peptides, unless there has been a recent microdermabrasion, peel or sun tan would not be needed at this point. All the best. JG 9.26.08

• Dr. Garcia, some people use different method in applying face creams. One method is make a dot to every area at face then spread it to the face. Other method is put the cream on hand 1st then rub to bring to skin temperature than pat on the hand at face. My questions : 1. What is the difference in result between those two methods? 2. Which one you prefer, number one or number two

  Answer:  well, applying it in your hand does warm it but some will be absorbed into your hand and will not get to your face. JG 9.25.08

• DEAR DR GARCIA I SAW A DERMATOLOGIST RECENTLY WHO HAS TOLD ME MY ROSACEA HAS BURNT OUT, MUST ADMIT DONT GET FLUSHING LIKE i USED TO AND NEVER HAD ANY SPOTS WITH IT, I HAVE THE BROKEN BLOOD VESSELS ON MY FACE THOUGH. I DIDNT THINK ROSACEA EVER WENT , DOES THIS MEAN i CAN HAVE LASER TREATMENT NOW FOR FINE LINES THE DERMATOLOGIST SAID IT WOULD BE OK TO GO AHEAD,THANK YOU

  Answer:  well I think it is OK, but there is no guarantee the Rosacea will not come back at some time in the future, best of luck. JG 9.25.08

• I have read about the dmae. Is it a cream? Where do I purchase it?

  Answer:  it is a cream sold on this website`s shopping cart. JG 9.24.08

• Thank you for your advice about sunblock. I had a look in the chemists here and everything just says sunscreen? Useless new zealand so I ended up getting Daylong Suncreen with lipsome technology say it last 8 hours and did have a good report on T.V programme here have you heard of it? Says to put it on before your moisturiser does it really matter?. Also did notice that my makeup didn`t go on as easy. Do you know if marykay sunscreen or neutrogen the new ones with the heppilox complex are any good. Or where would I get a sunblock as like I said everything here says sunscreen Please Help Have good skin but want to keep it that way.

  Answer:  if all they have is suncreen, look for the largest number 50 or higher then. I always think sunblock should go on last bur if you are wearing makeup, then apply the make up last. The Neutrogena product is good. JG 9.23.08

• hi Dr. I went to the dermatologist thinking i had lots of milia all over my orbital rims and expecting them to be removed but the doctor informed me that they were not in fact milia, they were my sebaceous glands showing through the skin, since it is very thin. so they essentially look like clusters of tiny dots spread all over that area of my skin. He suggested that he could cauterise the area but was slightly hesitant since he said it could cause redness. so we did a small test patch and so far so good. i just want to know what your opinion is on cauterising the sebaceuous glands under the eyes. do you think it is effective? thank you!

  Answer:  it is the best option but in time they will come back I am afraid. JG 9.23.08

• Thanks for answering my question, but what I was asking is your opinion as to which of these is the best moisturizer: 1) Olay OR 2) Skin Biology`s Day Cover (with titanium dioxide, SRCPs, antioxidants, allantoin, and lipids) If Olay, which version is best? Thanks

  Answer:  I am sorry but there is no best one of them, the differences are almost imperceptible. JG 9.23.08

• Hi Dr. Garcia Do you know anything about dermaquest products. I was wondering if you think their peptide serum is worth the price. It sounds impressive and my skin reacts better to serums than creams. Thank so much

  Answer:  sorry, I do not have any patients that have used that brand. JG 9.22.08

• could you please recommend a sunblock that is not too expensive that is good. I was reading that a good one should have zinc oxide and titanium dixxoide in it. The one I am using is a meleluca sunshade spf 30 but it doesn`t say those ingredients just Octyl Methoxycinnamate methylbenzylidene Camphor Butyl Methoxydibenzoylmethane and a couple of other things. I want something the kids and I can use everyday on our face etcc Thanks

  Answer:  I think Coppertone or Fallene Total Block are good sunblocks, you need a sunblock, and what you are using is a sunscreen only and not as strong. JG 9.22.08

• Hello Dr. Garcia, just a ff-up question regarding your neuropeptide cream, how many times do you apply it in a day.. Can I use it only once a day (every evening)bec. my skin is oily in the mornings or do I need to apply it twice a day to obtain maximum results? Thanks.

  Answer:  usually at night but it can be applied twice daily in people with severe damage. JG 9.22.08

• Dear Dr. Garcia, I just wanted to ask about your neuropeptide cream, can it address these issues around my eyes? ---improve the look of sagging skin above and below the eyes and diminish the appearance of crow’s feet, fine lines and wrinkles around the eyes---Thank you very much. God Bless..

  Answer:  no cream helps sagging skin, they will help with fine lines only, and our peptde cream does that. As to the crow`s feet, to some extent yes, but usually crows feet are due to dynamic issues of the muscles and are much deeper than fine lines from sun damage so the degree of improvement is less dramatic. All the best. JG 9.22.08

• I am taking 100mg of CoQ-10. Is it better to find a face cream with this as the primary ingredient, or is taking it internaly better? Thank you

  Answer:  if you want it for skin then it is best to apply it topically. JG 9.21.08

• I have been using retin-a for 1.5 years and have noticed small squiggly red veins (maybe broken caps) on upper cheeks. Im only 20 and have been using retin-a micro .04% and retin-a .1% alternating. Should i stop using it. I dont wanna get anymore.. is this causing them? Thank you

  Answer:  you seem pretty young to be using Retin-A unless it is for acne, decreasing the strength of the Retin-A will slow the formation of new broken blood vessels but they also form from sun exposure and age. I would loook for something less irritatiing for your skin, like a DMAE cream. JG 9.20.08

• I have been using SKINMEDICA TNS Recovery Complex and Neocutis Bio-restorative Skin Cream on each side of my face. After 6 wks the SKINMEDICA side seems better, but is it too early to know? Please tell me if a version of Olay or Skin Biology`s Day Cover (with titanium dioxide, SRCPs, antioxidants, allantoin, and lipids) is the best daytime moisturizer. Or do you suggest another? If Olay, which version is best? Thanks

  Answer:  I think that moisturizer will do fine. JG 9.20.08

• Hi Doctor, regarding my 13 yr old son that the derm suggested accutane. turn out he has tried retin a already, .025%. his face is still pretty bad, really has not improved much at all. should i do the accutane? thank you.

  Answer:  I would increase it to 0.1% before using the Accutane, and Accutane is only for very severe cystic acne, might want to see a different dermatologist, can also use some beta hydroxy acid peels. JG 9.21.08

• What is the best eye cream for dark circles and puffiness?

  Answer:  nothing on the market yet that will reliably work on most people. JG 9.20.08

• For correcting facial wrinkles, some deeper than fine , which product or products would be most helpful: ROC Retinol Correxion Moisturizer, StriVection SD Cream, or Tretinoin Emollient Cream 0.05% (Renova)? Or is there another product that has proven to be more effective? With so many products on the market and the difficulty in finding genuine evaluations of them, I really appreciate your answers. Thank you!

  Answer:  Renova will be the msot effective for the fine lines and likely none will help the ones past fine in depth. Sorry. 9.20.08

• Hello Dr. Will rogaine for woman is to avoid hair loss or just to grow hair? if I start using it for hair loss, what happens after I stop it? will I lose more hair? thank you

  Answer:  it should do both. If you stop using it whatever you regained will fall out. It will not cause any new hair to fall out if you stop though. JG 9.19.08

• Hi Dr.Garcia, To compare among Accutane, Retin-A, and Differin, which one is the best to use for acne scars ? Thank you.

  Answer:  I feel Retin-A is and Accutane controls acne but does nothing for the scars. JG 9.19.08

• dr garcia, IPL guy follwed by some textural damage. I am applying jojoba oil and emu oil for the last 4 months since my last IPL. The area still looks crocidile dry, does not hold moisture and is different pigment colour i guess than my normal rosacea skin. What should i do.Thanks

  Answer:  I am afraid all else that would be used for skin like that would flare up and potetnially worsen your Rosace. JG 9.19.08

• dr garcia, after undergoing many IPLS for my redness, flushing and blushing, I am fnally done. My flushing is in control, but looks like I have some textural damage due to some agressive Txs. My skin near my sideburns and below my eyes are dry, creaky and does not hold moisture. What should I do. Should i apply some cream or undergo some lasser again. I am olive skin. Thanks

  Answer:  try some squalene oil or emu oil for it and see. JG 9.18.08

• This is being touted as a hydrator for eyes: Ceramides (and) Cholesterol, Herbal Extract, Water, Glycerin, Silicone, Propylene Glycol, Diazolidinyl Urea (and) Methylparaben (and) Propylparaben, Triethanolamine.Just what are ceramides and will this improve the skin around my eyes? Thank you for your time.

  Answer:  ceramides are a category of proteins and there are some that help the skin, but not all. No way to tell if it will help without them telling you what they have in there. JG 9.18.08

• Oh im sorry dr, the skin minor skin concerns would be light brown spots no wrinkles. i dont like microdermabrasions because i have gone to 3 different places to get micros and it ends up leaving scratch marks on my skin that take a long time to heal.

  Answer:  then I would say IPL Fotofacials. JG 9.18.08

• Hi Dr. Garcia, I wanted to know if there was a light to medium peel of any type that you would recommend just for very very minor skin concerns, maybe something i can do once a month or so.

  Answer:  not knowing what the minor skin concerns are, whether brown, red spots or wrinkles, I suggest micordermabrasions. JG 9.18.08

• is there like an aha product to use at home thats safe, thats not a peel?

  Answer:  cleansers and topical creams, but I do not suggest home peels. JG 9.18.08

• they keep saying use aha peels at home. what do they mean, what is it, and is it safe. and where do you get that? i have 15% glycolic elite pads i use, is that similar?

  Answer:  I would not suggest you do them at home, the pads are not a peel and are OK to use though. JG 9.18.08

• they keep saying use aha peels at home. what do they mean, what is it, and is it safe. and where do you get that? i have 15% glycolic elite pads i use, is that similar?

  Answer:  I would not suggest it as you can burn yourself, the pads are only for wiping and are not a true peel. JG 9.18.08

• Hi Doc.....my dermatologist is recommending my 13 yr old son goes on accutane for his acne. We`ve already done antibiotics and prescription topicals (not retin a though) and laser treatments. He is 5`11 and 135. First of all would you put your son on accutane, if it were you and what dose do you recommend? thank you

  Answer:  try the Retin-A first, no doubt. JG 9.18.08

• I forgot to ask you if you recommend your peptide cream for treating the appearance of fine lines.How long before you may see a difference?

  Answer:  yes, I do and most people see diferences in 3-8 weeks, the older you are the longer it takes to see. JG 9.18.08

• Hi Dr Garcia. THANk you for the answer regarding the botox paralyzing the forehead, yes I know this is what it intends to do, the problem is that I`ve seen other people with botox whose face don`t look weird(like mine does) when they laugh...so I wonder what is wrong? thank you

  Answer:  they might have stronger muscles that were not totally paralyzed or maybe you got a larger dose of the Botox. JG 9.18.08

• hi dr pierce i m thinking of getting cortisone injection to flatten a raised scar. not a keliod.. what are the side effects from this..will it be bruised.. and does it work. i m also looking for a lightening cream to lighten a dark scar on my leg. will triluma work for this? what do u suggest. thanks

  Answer:  it might brusie, it might cause a depression under the area, it can cause some dilated blood vessles ands at times color loss of the skin. I think the TriLuma is worth a try on the legs. JG 9.16.08

• Hi Dr. Garcia, what do you think of the green peel? are there different levels of the peel you can do and do the normal side affects of other peels apply to the green peel as well?

  Answer:  I think it is a waste of time and a lot of unsubstantiated hype. JG 9.17.08

• Hi Dr Garcia. I had botox once and I noticed that when I laugh my forehead wouldn`t move along with my mouth, eyes, etc and my face would look weird...family members noticed this too? can you tell me why this happened? thanks so much

  Answer:  well, what happened is what is supposed to happen, the muscles of the forehead were either weakend or paralyzed so they could not move, that is what Botox is intended to do, If you were not told that, it was poor education on the injector`s part. JG 9.17.08

• dr garcia, you Procyte and neutrogena copper peptides for some textural and irregular skin after my IPL sessions for rosacea. WHich Procyte product are you referring too. Can you please name it.Is it safe for rosace skin type.Thanks

  Answer:  Complex Cu3. As to being safe, it likely is but everyone responds differently. JG 9.15.08

• putting filler in cheeks couldnt cause a neurological problem, could it. and theres noway a lot of juv would cause dryness of sinusus or dyhydration?

  Answer:  never heard of that, must be something else. JG 9.15.08

• At night I alterate using a retinol product and a vitamin c product from Skinceuticals. Is it ok to introduce during the day a copper peptide product? It seems I remember reading that vitamin c and copper peptides counteract each other. Should I avoid the copper when using vitamin c or am I just plain wrong?

  Answer:  OK to use them on the same day but not at the same time. JG 9.15.08

• I`ve been using Retin-A for about a year now for acne and sun damage from working outside while using tetracycline. I am getting really discouraged. The results seem pretty good but now i am hearing that Retin-a causes broken capillaries and problems. I`m 21 and i was wondering if you could give me some advise on what to do. Should i keep using it? What percentage? Also i`ve noticed under my eye there is two small blue veins perpendicular to my eye. Are these broken capillaries. Thanks in advance sorry for the long ?

  Answer:  the Retin-A should not cause blue blood vessels to develop, especially in this amount of time. I think topcial antibiotics and oral antibiotics along with occasional beta hydroxy acid peels might help control your acne and allow your Retin-A to take a break. Broken capillaries on the face would be red. Best of luck. JG 9.14.08

• dr garcia, i have a olive skin type suffering from roscea, have gone numerous IPL, some mild some very agressive. My blushing and flushing is nearly eliminated but there seems to be some textural problems, especially below my eyelids and in front of my sideburns where the skin is thin, unalble to retain any mositutize and in general very different, no matter how much i moisturize. Can i try some of the copper peptides, or similar creams with retinal aldehyde to see whether the textural problem improves. What do you recommend in my rosacea skin type. Any specific brand for sensitive skin. Thanks.You do an awesome job.

  Answer:  I do not think the retinal aldehydes will help the moisture but the copper peptides are worth a try. We use Procyte but Neutragena is good too, just not as strong. Best of luck. JG 9.13.08

• dr garcia, after going through numerous IPL for rosacea, my skin is less red but creepy dry and looks as if it has lost its lustre. What should i do Dr?Thanks.

  Answer:  need to moisturize, try squalene or emu oil. JG 9.13.08

• what is a good 30 sunblock that doesn`t clog your pores?

  Answer:  I am afraid it is a matter of trial and error, no way to predict. JG 9.13.08

• dr garcia, my derm prescribed me desonide for my rosacea for my beard junction saying it might be dermatitis. Wont it make my rosacea bad. He told me to apply it once for a month. I am confused. The skin is not red, and not itchy and turning more darker, purplish...what does it sound to you. Is the Tx right? Thanks.

  Answer:  well it can but it is to be used only for a short period of time so it is OK to proceed. JG 9.12.08

• Dr Garcia, I hear that by doing liposuction the skin gets stimulated and gets tight, so now I am confuse...does this means that liposuction promotes skin tightening while losing weight by just dieting doesn`t? for skin tightening I am better off with lipo than just losing weight the normal way? thanks

  Answer:  that is what some people claim, but it is not true, in the vast majority of the patients it has no specific skin tightening effect over what was there to begin with. Your skin will shrink better if you lose weight on your own. JG 9.12.08

• Dr. Garcia, while losing weight by just dieting; 30 lbs or more, will using a support or comprension garments will help the skin to be in better shape and more tight? or will this won`t make a difference in the skin? thank you for your advice

  Answer:  I am afriad not, the damage to the skin was done during the stretching phase, not the shrinking phase. JG 9.12.08

• dr garcia, i have rosacea and very sensitive skin. I applied a shampoo on my beard for dermatitis, and my skin became red. It has been two days since it is red. I am applying calendula gel over it. Is this a reaction. How long before it goes away. Can i shave or not. Thanks

  Answer:  might take a week in some cases, I would say you can shave but be careful. JG 9.12.08

• One more question: I`ve been using the RetinA .025 for about a week -- the first night I felt peeling when I applied moisturizer on my face. Since then, I haven`t experienced any noticable peeling. Does the product work if it doesn`t produce any noticable peeling? Thank you for your time - you are a nice man.

  Answer:  yes, it can still be working. JG 9.10.08

• Hi Dr. Garcia, I just started using RetinA .025 and am wondering if it`s OK to use it on my neck. Would it do any good? Also, would it have any adverse effect on the thyroid? (I have hypothyroidism.) Thanks, as always.

  Answer:  yes OK to use an should help some, it will not affect your thyroid. JG 9.10.08

• Hi Dr. Garcia, I am male who has some small red spots( macules) on my face from recent bout of Folliculitis.What would you recommend to fade these spots? I have a fair complextion. Thanks.

  Answer:  IPL treatment every 3-4 weeks or so. Could do a YAG laser too, more effective but possibly more downtime where the IPL will not have any downtime. JG 9.10.08

• to the firmness question you mean the retin a micro, right? If not what retin a? They dont make the high strenght no more. Also what doe th genesis do and do you need lotion over that?

  Answer:  yes, the Micro is fine to use. If you are using the Retin-A Micro you likely do not need the genesis, just use a cheaper moisturizer ten minutes after the Retin-A. JG 9.10.08

• what do you think of loreal skin genesis?

  Answer:  fairly good product, reasonably priced for an OTC. JG 9.10.08

• honest opinion. I f i were to come 2 u for firmer skin with a cream out of three which would you pick tazorac cream 0.1, tazorac gel 0.1, or retin a micro 0.1?

  Answer:  Retin-A. JG 9.10.08

• About a year ago, I had a non cancerous, small growth removed on my face via cryosurgery. Once the scab formed, and fell off, I was left with a depressed, white area on my skin, which is very noticable, even with makeup. Is there any procedure which will restore color to the area,as well as raise the depression? Thank you so much for your help.

  Answer:  the most relaible way is to cut it out and stitch it together to bring the deeper and the superficial tissues together so there is no depression. JG 9.9.08

• dr garcia, I have vascular rosacea and recently I have increased sensitivity, itching on my beard and eyebrows areas. My Derm said that my redness might be due to sebborhic dermatitis and gave me desonide cream to apply followed by a moisturizer for a month. Is it Ok to use desonide cream for a month in my condition. Wont it make my rosacea worse. thanks

  Answer:  it might not be Rosacea, it might be the dermatitis and it will get better with that cream, a short period of time will not make the Rosacea worse so it is worth a try. JG 9.9.08

• dr garcia, does emu oil or any oil as a mositurizer, is bad for sebborheic dermatitis. Thanks.

  Answer:  different people react differently, there is no 100% guarantee, sorry. JG 9.8.08

• dr garcia, i have red cheeks of rosacea and sebborheic dermatitis of the eyebrows and sideburns and forhead which is scaly and itches. The redness of my cheeks is just scaly not itchy. So is it because of rosacea or can it be sebborheic dermatitis of the cheeks also.Thanks

  Answer:  could be seborrheic dermatitis of both. JG 9.8.08

• I`ve noticed some small white spots in my skin in my arms and legs...Is this vitiligo? and once a person gets these spots it is more likely to get more or that these ones become larger? thank y0u

  Answer:  could be, it can also be some small areas of a topical fungal infection that can be treated and then the pigmtent returns with sun exposure. You need to see a dermatologist. JG 9.8.08

• Hello Dr, what is the best cream in the market for stretch marks and also to prevent new ones while losing weight? I`ve heard that revitol...any advice is much appreciated. Thank you so much!

  Answer:  sorry, there is no such thing as a good cream for stretch marks to go away. JG 9.09.08

• What is the best treatment for pre-cancerous lesions (AK). my body is sun damaged from head to toe...I am a former sun worshiper! I am always treating these lesions. There are too many to cut off/freeze so I have been using a topical treatment called Aldara but the side effects are terrible. I would prefer to be treated with light or laser or something that would take care of lesion, as well as, improving my skin.. What do you recommend. If possible, I would prefer to treat all my skin so that I could perhaps stop more pre-cancerous lesion from coming out. Thanks so much for your help!

  Answer:  lasers cannot be used for the body, just the face, Aldara or Efudex are the ways to treat it I am afraid. JG 9.8.08

• sorry me again meant to say would you have to do IPL on your whole face or can you just do parts?

  Answer:  usually the whole face. JG 9.8.08

• Hey just wondering if you can help. Just notice out of the blue this morning a large outline of pigmentation of my forhead just between my eyes. It isn`t dark inside just around the edges. Help its just popped up would it be hormonal? Or would you recommend IPL. Also can that be done just in a certain area or do you have to do your own face. Also I am 34 but have bags under my eyes creeping in wrinkles o.k but more bags think its from my day does botox work for that? would that help. Have always used a good eye cream which helps but still there no matter how much sleep I get. Thanks heaps

  Answer:  I am sorry but I am not sure what is happening and without seeing you in person it would be hard to determine what is causing it and without knowing that, I cannot venture a guess as to what can help. sorry. I will say that I seriously doubt that it is something hormonal though. JG 9.8.08

• dr garcia, i have rosacea redness and very sensitive skin. I am tired of trial and error, and was wondering if its fine to just cleanse once a day with luke warm water. I use emu oil/as my moisturizer for my rosacea which is thick but is the only one i can tolerate. Thanks

  Answer:  sounds like a good plan. JG 9.7.08

• Is lactic acid considered a humectant moisturizer? i`ve googled about this and some statements indicated that this is true, so i wonder is this would be a great moisturizer to combine with retin a,

  Answer:  no, it is not a moisturizer of any kind, it actually is the opposite, it is an exfoliant. JG 9.7.08

• In general, which you reccomend for a very sensitive skin with big pore problems who get very easy irritated (almost by all OTC anti aging creams), which will be more gentle, retin a 0.01 (the weakest)in a gel (not cream) or retin a 0.025 (stronger than 0.01) in a cream (not gel)? i got only those two available in my country so i have to choose only amongst those 2,

  Answer:  I suggest the 0.025% cream. JG 9.7.08

• Do you think Obagi system is effective in improving skin texture, spots, etc? Would one see a plastic surgeon or dermatologist to get prescription? Thank you!

  Answer:  only if it is used with the bleaching cream and Retin-A, not on its own. You would need a prescription for those things, yes. JG 9.7.08

• Hi Doctor, under my right eye there is a uneven texture, the skin is just not as smooth under this eye as my left eye. Is there something you would recomend for this to even it out. I use retin A and have been for years. I just turned 44 and don`t really have wrinkles maybe some lines, but that texture bothers me. Can you help? Thanks

  Answer:  hard to say whtout seeing you, might benefit form a laser or a resurfacing procedures of some kind. JG 9.06.08

• dr garcia, i have rosacea and sensitive skin. By afternoon, my skin on my cheeks become tight and flaky. Is it because it needs moisture. Currently I use squalene oil or emu oil as my moisturizer. If you think dryness is the cause can I apply a liberal amount 2 times a day to get rid of the tight and dry feeling.Or is it because of something else. Thanks for yr advice.

  Answer:  yes, just need to moisturize more often I am afraid. JG 9.06.08

• dr garcia, I am olive skin guy with rosacea redness. I had nearly 30 IPLs performed over the last 2-3 years. I am tired, and right now just applying moisturizer and doxyxyxline. How long should I wait to give my face to settle down. Its been 3 months since my last IPL. I still have a lot of redness to tackle? Thanks

  Answer:  I think you can restart now. JG 9.6.08

• dr garcia, i have rosacea redness and dry skin.I cant use any moisturizer. I tried squalene oil but broke out. I am trying emu oil. When I use it on my dry face its greasy and my face becomes slightly red but next day it absorbs well and feels moisturized. Is this normal. Can I expect reuction in redness once my skin is moisturized.Thanks

  Answer:  yes, it is normal, the oil will help moisturize your skin but I cannot say whether the redness will be alleviated by the oil if it is due to the Rosacea, if it is due to it being due to dryness, it might help that. JG 9.6.08

• Hi DR Garcia. I am losing weight and notice my neck skin less tight too, will using the obagi system for the neck, decollate or something like that, help for my neck look tighter? thanks

  Answer:  topical creams will not tighten losse skin I am afraid. JG 9.6.08

• dr garcia, i have a type 3b- 4 skin type with vascular rosacea. I had numerous IPL (around 25) with around 50% reduction of redness. I am frustrated now, what else can i do to control the redness. Will low dose V-Beam and Yag help.Please advice.

  Answer:  might be worth the try, I sugegst trying the YAG first as it is less intense and less risky. JG 9.5.08

• Dr Garcia, what do u think of the new filler Evolence? Im not sure if im spelling that right but it said to be clinically proven to last through 6 months

  Answer:  that is the msot it will last, likely closer to 3 months for most people. JG 9.5.08

• Hi Dr. Garcia, I have been doing laser hair removal for some fine facial hair for a really really long time now. I do not expect it to permanently go away, I am doing it for more of a maintance around once every month and a half. Although a lot of the areas on my face have completely stopped coming back ( i kno this because i took a break from laser for a few months and it was just little patches of hair here n there coming back. So my question is, is it bad to have had so much laser on my face for such a long time? (over 4 years) i believe they use the candela laser. i take good care of it applying sunblock and staying out of the sun. and ive never had any complications from it as far as hyperpigmentation. is it okay if i continue going?

  Answer:  the lasers that are used for that are relatively safe compared to other lasers as they are color dependent so I would not worry about prolonged intermittent treatment and possible long term effects. JG 9.5.08

• Sorry just to add question below, when i scratch my skin (accidentally) with my nail, there is little blood coming, then it stops, then it feel stinging,

  Answer:  use Neosporin until it heals. JG 9.5.08

• Dr. Garcia, right now i have some red spots on my face (very little spots, about 5 spots) because i scratched them with my nail, while the skin is in peeling process (currently using a cream containing glycolic acid, which i stop now). In order to make the spots heal, i applied a soothing moisturizer (brand RoC, the name is Calmance)at those spots. But it stings when i apply the moisturizer. Does it mean i better not to treat those spots with that moisturizer, or is it actually a healing process? Should i continue that soothing moisturizer or it will make things worse?

  Answer:  I would keep the moisturizer out of the scratches until they heal a bit more. JG 9.5.08

• There are people that i know that mix differin with Estee Lauder Advanced Night Repair serum. They claim they get benefit from retinoids and also from antioxidant. Is it ok to do so, mix them both? Any precaution,

  Answer:  I am curious to know how they know it is a benefit from the antioxidant ingredients and not just the Differin and the moisturizer component of the cream, there is no way for them to tell that. Neither company has tested the product compatability so there is no way to 100% know, but you can certainly try it. JG 9.4.08

• Some friends say that their skin looks nice while using differin, but when take a break for about 2 weeks (after using every night for a year), the skin immediately broke out. So what to do then, since we need to take a break for certain time before get back to differin? What can be done so the skin is not immediately breaking out, since they already cleanse the skin properly,

  Answer:  can try some oral or topical antibiotics. JG 9.4.08

• Some friends say that their skin looks nice while using differin, but when take a break for about 2 weeks (after using every night for a year), the skin immediately broke out. So what to do then, since we need to take a break for certain time before get back to differin? What can be done so the skin is not immediately breaking out, since they already cleanse the skin properly,

  Answer:  can try some topical antibiotics or orals ones. JG 9.4.08

• any point of using neutrogena anti wrinkle night cream intebsives with retinol sa if u use tazorac?

  Answer:  no, I see no need to use them besides the moisturizing effect that can be gotten for a lot less money. JG 9.4.08

• If using corticosteroid topical mix with differin or retin a to minimize irritation, for how long at maximum the corticosteroid should be used? Cause i heard long time corticosteroid is actually bad for skin, (is this true?)

  Answer:  ideally for as short of a time as needed , until the skin can tolerate the Retin-A without irritation, but in sensitive skin that might not happen. Strong steroids on a long term basis are not good, one needs to take as low of a dose as needed and take breaks once in a while. JG 9.4.08

• dr garcia, i have rosacea redness with very sensitive dry skin. After much trial and error, I finally found emu oil whih does not make me red.I use 2-3 drops when my face is wet. It is oily first but when it dries my skin is still flaky. Does that mean that i need more moisturization?. If so should I apply when my skin is dry or flakiness is something else.Thanks.

  Answer:  try applying it on dry skin and you will likely need it a number of times per day. JG 9.3.08

• DR. Garcia, YOU ARE PRICELESS! Keep up that sense of humor for us. One question, I have stopped using Retin-a ,05% and Obagi blender for a brown spot several months ago. My skin feels crusty and scaling in that one small spot. What should I do as exfoliating it hasn`t helped so far. it doesn;t look bad it just feels bad.

  Answer:  try some squalene oil to regain its moisture content. And thank you for the kind words. JG 9.3.08

• Hello Dr. Garcia: I had an acne flareup and one particular spot is taking a while to heal. It looks inflammed around the edges but dips down in the center a bit. Any reason that the edges flare up like this? Just due to the way the tissues are healing maybe? I don`t recall having this type of dip in the center with other acne spots. Thank you!

  Answer:  just the degree of inflammation is what is the cause, the dip is from more robust inflammation at the edges and some atrophy in the center part. JG 9.2.08

• In you opinion, what is the most effective way to get rid of a wart? Any recommendation for a topical treatment? Thanks

  Answer:  having a dermatologist freeze it with liquid nitrogen is the best. OTC things work only so-so. JG 9.2.08

• Still about glycolic acid cream. Can we apply it to skin near eye area? Thanks so much for your advise doc

  Answer:  yes, OK to use there. JG 9.2.08

• Dr. Garcia, thank you so much for your answer regarding glycolic acid cream. Once it is tolerated, should we add retinoids as well? if using retinoid after our skin is getting use to glycolic acid, should we use the glycolic cream alternating with retin a / differin or should we use the glycolic cream in the morning after apply retinoids at night before, which one you think will minimize the irritation,

  Answer:  if you can tolerate them, yes, there wll be significantly more improvement with retinoids. I would use the Retin-A or Differin at night to reduce possibility of sun sensitivity. Once tolerated those can be used twice daily if desired, again with sunblock over them in the morninings. I think once you are using the retinoids you can likely skip the glycolic as it wil not be needed as the retinoids are stronger. JG 9.2.08

• hello dr garcia i have noticed indentations on both my thighs, like someone tied a tight rope. any ideas thank you taylor

  Answer:  could be loose skin from aging, could be from prolonged pressure from something resting against the area for long periods of time, could also be an area of localized celllite too. JG 9.2.08

• When do you feel will be the best time to apply glycolic acid cream, is it at night (as night cream) or is it in the morning before sunblock? Perhaps you could explain a bit,

  Answer:  it can be done twice per day if desired, they are not that strong, and if applied in the morning then wait at least ten minutes before applying the sunscreen on top. If you are concerned about irritation, then start at night and progress from there. JG 9.2.08

• Is it OK to apply Retin A Micro Gel directly under the eye area? Also, what product would you recommend for a morning routine of either a scrub or type of glycolic acid? Many thanks for this great website and to you.

  Answer:  just be careful not to get it into the eye itself is all. I think scubs or glycolic acids are OK in the morning as long as you stay away from the eyelid skin. Thanks for visting. JG 9.1.08

• Hi I think that I have a keloid or wart on my hand? How can I tell what it is... It looks like a small raised bump on my hand? How can you tell the difference? What do you recommend that I could do to treat the bump myself before I go to the Doctor. Thanks : - )

  Answer:  well, if you soak your hand in warm water for 10-15 minutes, if it is a wart, the surface will open up and you will see like tiny little seeds, the keloid will remain smooth. If it is a wart you can try the OTC wart removers, not much you can do for the keloid though. JG 9.1.08

• Hi Doc. I have seen question on your website that make reference to 5FU topically. What is 5FU topically and what is it used for??? I have a few actinic keratosis..can you recommend a topical treatment?

  Answer:  it is also called Efudex and it is used to treat skin cancers and pre-cancerous skin spots.If they are pre-cancerous it should work, otherwise they can be hyfercated off. JG 9.1.08

• dr garcia, i have had nearly 30 IPLs over 2-3 years. My skin has become less sensitive and I am finally using a moisturizer for my dry skin after 2 years. How long should I wait till i start my next series?. Should I go for IPL or Laser genesis since I am olive skin. Thanks.

  Answer:  3-6 months if you can hold off. I would stay with the IPL. JG 9.1.08

• Dr. Garcia, is it considered okey if a dermatologist prescribe a corticosteroid topical to be mix with retin a during 1st month of use (ratio corticosteroid tpical : retin a is 2:1 on 1st week, then change to 1:1 on 2nd, and 1:2 by 3rd week, decreasing slowly the cosrticosteroid topical). Just to get your opinion, is this okay, actually under what circumstances usually a derm prescribe something like this, what is the goal and is it more safe to do that or no need? Appreciate your thoughts, thanks in advance doc.

  Answer:  yes, that is OK to decrease the irritation some. JG 9.1.08

• dr garcia, after undergoing 20 IPL for my moderate rosacea, i am planning to be agressive especially to reduce my redness down. Since I am olive skin (type 3b or 4) should I go for a v-beam or ND-Yag or genesis. Also should I wait for 6 months since I had the 20 IPL non-stop for 2 years.Please help me with your expertise.Thanks

  Answer:  I would wait at least 3 months and start with the YAG as it is less risky. JG 8.31.08

• Dr. Garcia, i am trying to minimize my visible pores at cheek, and my derm told me that i should start regimen consisting glycolic acid cream and retin a. Since my skin is super sensitive, i want to start one thing 1st then move to the other. Considering my skin is sensitive, which do you think i should start first, a. glycolic acid cream then adding retin a after 3 weeks, or b. retin a then adding glycolic acid cream after 3 weeks,

  Answer:  glycolic acid first, good luck. JG 8.31.08

• How does one order your eye booster cream if one is not a patient of yours?

  Answer:  it can be ordered from the shopping cart on this website. JG 8.31.08

• I hear you are developing a cream for dark under eye discoloration. Does it really work? How can we order?

  Answer:  should have it in stock in a few weeks, I feel it does work by removing some of the iron stains. I will post it on the website when available. JG 8.31.08

• Dear Dr. Garcia. Have you heard of Johnsons gentle exfoliationg facial wash? Is it a good facial wash? Thanks. Have a nice day.

  Answer:  sorry but have not had anybody I know use it. JG 8.31.08

• Hi Dr. Garcia, have you heard about this new topical treatment for rosecea that will combat flushing and redness? It is called Sanrosa or Col/118. Here is a link of related press releases and articles. It is said to give instant gratification of facial redness, erythmia and flushing without the potential of rebound. I would be curious to hear your opnion...thanks! http://rosacea-support.org/articles/sansrosa

  Answer:  in general, anything that promises instant gratification is likely not truthful. JG 8.30.08

• Dear Dr Garcia, I am a Dutch woman and i saw your site. Ik think you give very good advice to people. I am thinking of a c02 laserresurfing. I have not wrinkles Is that the good word for it? i mean lines in the face. i want a more fresh face and pores are a little great in Dutch porien)When I take a co2 laserresurfing with 75 micron is than the downtime less? And is that enough for my face? My face is not sagging the skin I mean. And for exemple 100 micron and more 150 micron more downtime? And also the more micron the more possible pigmentation etc? Please tell me and I am very greatfull to you With greetings from Holland Dorothe

  Answer:  the downtime for a 75 micron peel should be about 10 days but the improvement in pores is temporary there is nothing that will shrink the pores on a permanent basis. The more micron depth the greater the potential of pigment loss, correct. Hope that helps. JG 8.30.08

• Hi Dr. Garcia, I want to ask your thoughts on something my derm suggested. This is about the sebaceous hyperplasia. He is now using a tiny bit of Kenalog or another steriod to shrink them. It is either that or the Erbium laser. Can you think of any negative side effects that could occur from the injections? Thanks as always

  Answer:  I think the kenalog has more negatives with tissue atrophy than any possible good option. I think spot Erbium or a much cheaper hyfercation is equal, but no treatment will be permanent, they will come back and need to be treated again. JG 8.29.08

• dr garcia, i have sensitive area on my beards along with rosacea. I have sudden increase in redness near the junction. Is it rosacea or dermatitis. Can I apply hydrocortisone on it. Can I shave lightly at least besides moisturizing. Thanks.

  Answer:  could be eihter, no way for me to tell, topical steroids are certainly a worthwhile thing to try. I think carefully shaving and moisturizing is OK also. JG 8.29.08

• Does using 5FU topically get rid of freckles?

  Answer:  I have not seen it do that. JG 8.29.08

• dr garcia, i am an olive guy who has rosacea. I had nearly 25-28 IPL with 60% reduction in redness. Now at least I am applying a moisturizer, which i could not apply before. Its been 3 months since my last IPL. I want to control my redness further. Should I go for a V-Beam (low setting) now or should i wait for a while since my face underwent a beating after these many IPLs.Please advice. Thanks

  Answer:  give it a break until the skin feels better. JG 8.27.08

• thanks, also I am using the Mild Cream Wash by Glytone with Glycolic acid...should this be okay to continue to use with the Differin and the Copper Peptide cream? Also I was thinking about trying Neutrogena`s Visbly Firm cream with Copper Peptide. Any feedback on this product? Thanks so much for your quick response!!

  Answer:  yes, should be fine to use all together. I think the Neutrogena is likely OK, not too strong though compared to what doctor`s sell. JG 8.27.08

• Hello, If my dermatologist has me on a prescription of Differin cream, is it ok to use a copper peptide cream at night as well with the Differin? I am trying to avoid adverse reactions!+

  Answer:  yes, OK to use it, just wait ten minutes after the Differin before the pepetide cream. JG 8.27.08

• Dr Garcia, My skin on my cheeks are flaky. They do not itch. I thought it might be sebborheic dermatitis. tried a course of itraconazole. It did not clear it. So i assume its dry skin since my skin my face also feels tight. I use a drop or two of emu oil (only moisturizer) i think i can tolerate, rub it in my hand and then apply it on my wet face after cleansing with aveene exterme cleanser.What am i doing wrong. How can i get rid of the flaky dry feeling on my face. Please advice.Thanks so much.

  Answer:  try applying it more often and on your skin when it is dry and see what happens. Or you can try squalene oil the same way, frequently and on dry skin. Best of luck. JG 8.27.08

• Is Isopropyl Methylphenol an astringent?

  Answer:  very mild astringent properties at best. JG 8.27.08

• Dr. Garcia, which one is stronger for acne / pores problem : Retin a 0.01 gel (the weakest retin a, not the 0.1 one) or Adapalane 0.1 gel

  Answer:  similar but will likely need 0.3% gel for the acne if using Adapalene. JG 8.27.08

• Just wondering how your progress with the undereye dark circle cream is developing? Pls keep me posted on it! Thanx

  Answer:  should have it in the next 4 weeks. JG 8.27.08

• dr garcia, my beard area and some parts of the cheeks have suddenly become irritated, more red than usual(since i have rosacea and very sensitive skin) and itchy. Is it dermatitis. I am applying emu oil to it and taking antihistaminics. I am afraid to apply any steroid for making my rosacea worse. How long before It gets resolved. Can i at least apply mineral makeup and wash with water.Please advice. Thanks.

  Answer:  it likely is a dermatitis, yes, might need topical cortisone, like Cortaid 10 for a few days, that is a pretty weak one as it is OTC and shodul not flare up the Rosacea, also increase your Omega 3 fish oils to at least 2000mg per day. JG 8.26.08

• Dear Dr. Garcia, I have melasma all over my face and red sundamage on my cheeks. I have always had IPLS and have been on HQ4% over a year. I have had the Fraxel restore one time and it just seemed to leave me redder. First Question: How long should I wait to get an IPL for redness after a fraxel treatment? Second Question: I have been off HQ 4% for 3 weeks, will I get rebound darkening, and would the next Fraxel cause hyperpigmentation since I am off it? Third Question: My melasma looks very gray in a couple of patches, and seems to be spreading. Is this dermal melasma spreading, or has the HQ caused the greyness? Can dermal melasma spread like this, and why? Thank you for letting me bombard you with questions, but this is ruining my life. I use Obagi sunblock even in the house.

  Answer:  I think a week or two before the IPL after the Fraxel is fine. I think once you are re-epithelialized after the Fraxel I would restart the hydroquinone to avoid post-inflammatory hyperpigmentation. I think the grey is likely the melasma spreading I am afraid. Best of luck and keep up the sunblock. JG 8.26.08

• In general, can a very sensitive skin tolerate obagi c rx system? (not the nu derm i mean, but the one with vitamin c in it)

  Answer:  not always. JG 8.25.08

• Dr. Garcia, you always suggested to take a break for prescription retinoid such as retin a, every year for about 3 months. During that break period, is it ok if use OTC retinol products, or do you mean to take a break completely from retinol also,

  Answer:  no, you should avoid those too. JG 8.25.08

• About isopropyl methylphenol again. Generally speaking can it prevent acne, how does it work in brief,

  Answer:  I cannot say that it will totally prevent acne. JG 8.25.08

• Is it ok to use sunblock that has isopropyl methylphenol 0.1% in it while on retinoids? or better dont?

  Answer:  if you tolerate it, it is fine. JG 8.25.08

• Dr. Garcia, i always break out from using sunblock, they always too heavy or irritating or clog my pores. I have oily skin and using retinoids at night so i know sunblock is a must. A friend of mine suggest to put something first on my face before the sunblock to avoid the pimples and clogging pores. What ingredients to avoid the pimples and pore clogging that you feel i can put on my face before the sunblock, and where should i look that ingredient, any suggestion?

  Answer:  I am sorry but no cream or application will avoid the plugged pores in that way. JG 8.25.08

• In general, for a very sensitive skin, does Isopropyl Menthylphenol considered a possible irritating ingredient?

  Answer:  it can be. JG 8.25.08

• Generally speaking, which has the stronger retinoid, differin gel 0.01 or OTC retinol products such as Avene, which has stronger retinoid generally speaking?

  Answer:  Differin.JG 8.25.08

• Dr. I have redness on my chest where sun over the years have damaged the skin. I have had IPL treatments which are great for sun spots but not for redness..any suggestions? Thank you....

  Answer:  can try a VBeam laser. JG 8.25.08

• dr garcia, you suggested going for vbeam for rosacea after my 25 IPL which was effective in reducing rosacea, in the sense now i am able to apply moistuirization. Should i wait for some time for my face to heal and moisturize and see whether my redness subsides, or go for V-beam now. How long should i wait. Its been 4 months since my last IPL. Thanks.

  Answer:  sure, that is a reasonable thing to do. JG 8.25.08

• dr garcia, i am tired of looking red from rosacea. my rosacea redness has gone down by 60% after 25 IPLs. My skin is olive in nature. I am taking a break for 6 months. Should I continue wit IPL or go for a V-beam or Yag lasers to get out the red significantly. What would you advice.Thanks. A frustrated red face guy

  Answer:  The VBeam will likely be more effective than the IPL but might have some downtime too. JG 8.25.08

• Hi, Dr. Garcia. Reading your Q&A`s and your responses to my own questions has been profoundly educational and has made me more confident in selecting appropriate skin care regimens. Thank you so much :) Now my question is about copper peptides. I understand that they help skin wounds heal and also helps normal skin with not enough copper. I see blogs that promote skin remodeling using copper peptides, but it seems that you advocate using it only to promote healing. I have been using retin a, the dmae cream, and sometimes the peptide. Since the retin a causes irritation, would a copper peptide play some type of helpful role in my skin regimen? I am really confused. If it will help, I want to use copper where appropriate. Thanks!

  Answer:  in cases where Retin-A or any other product has irritated the skin, yes, the copper peptides will be helpful in reducing that. Once the irritation and redness is gone you can stop the copper then. Hope that helps. JG 8.25.08

• Hi Dr. Garcia, I was wondering if using serums and moisturizers(some w/ active ingredients)over Retin- A after a wait period of 30 minutes will affect the efficacy of Retin-A? I read conflicting ideas about the usage procedure of Retin A and other products for anti aging benefits. Thanks so much .

  Answer:  as long as you allow 10-15 minutes after the Retin-A it should not dilute the Retin-A effects. JG 8.25.08

• dr garcia, i have a 30 yr old male with rosacea redness on cheeks and sensitive skin on beards. Recently, I have noticed my beard area have become red and irritated and itchy even if I shave it lightly. So I am just cleansing it with water, applying aloe vera gel and am planning to shave very gently. What else can i do to reduce this sudden shaving issue. Thanks.

  Answer:  might want to try some squalene oil too. JG 8.25.08

• Hi Dr. Garcia Is there any OTC eye cream that can reduce dark circles? If not, what options are there that you`d recommend? THanks

  Answer:  nothing I have seen right now. JG 8.25.08

• Do you think the weakest retin a ( 0.01%) is still stronger in tretinoin percentage or the same compare to popular retinol products such as ROC?

  Answer:  yes, it is. JG 8.25.08

• After trying a cream consisted of AHA, retinol and hydroquinon, ( i dont know the exact percentage of each in that cream), the redness at my cheek went away. Before using the cream, the redness have been there for years at my face, they are left from acne that i had when i was teenager. I dont have the acne now, but the redness were always there until i use the cream (AHA, retinol and hydroquinon) for 2 weeks. Every day it reduce the redness obviously. Between those 3 ingredients (AHA, retinol, hydroquinon) in that cream, which ingredients do you think help the fade of redness the most?

  Answer:  likely the AHA. JG 8.25.08

• Dr. Garcia: This may be more of a dermatologic question but thought I would ask your opinion until I can schedule an appt. with mine on Monday: I have a couple of tiny pencil-point sized bumps on my face...at a glance looks like a pimple but they are fluid-filled. If they burst I can see a small dip in the center, it swells a little, and then they crust over.I`ve had a few in the past and they seem to heal over on their own in a week or two. Do you know what this might be? Maybe something eczema related? Thank you kindly.

  Answer:  hard to say, sounds like cysts of some sort. JG 8.25.08

• Dr. Garcia, i use a tinted sunblock every morning, and i dont reapply until night when i wash my face. At night when i use make up remover to take off the tinted sunblock, it is still as if i just apply the tinted sunblock, the color is still thick just before i remove it. If the colour from the tinted sunblock is still there, does it mean the protection of the sunblock is still there also? The more difficult to remove with make up remover, the longer protection we get?

  Answer:  I cannot say that the tint is the same as the sunbock as they are different components of the lotion. JG 8.25.08

• for skin resurfacing techniques..I have been reading that they remove layers of damaged skin...what is classified as damaged skin? I just figured scars are the only type of damaged skin..what else do they treat besides wrinkles and scars?

  Answer:  sun damaged skin that has spots or wrinkles are removed too. They treat scars, wrinkles and spots is about it. JG 8.23.08

• I was actually wondering if dermabrasion could be used on the tip of the nose to be more specific.

  Answer:  yes, it can. JG 8.23.08

• Can dermabrasion be used on the nose?

  Answer:  yes,it can. JG 8.23.08

• I have been noticing that some older women on TV have little dimples below the corners of their mouths, on the chin area. I started noticing it awhile ago and now see it often --- but the dimples only form when the person is speaking. One thing the women all have in common, besides being older than say, 40: there are no wrinkles or folds by the corners of their mouths. So I`m wondering if this dimpling could be a side effect of juvederm injections, or some other filler. It looks kind of unnatural. What do you think? Just curious .... thanks, Doc!

  Answer:  it could be from fillers being injected but it also could be from not enough fillers being injected too. JG 8.22.08

• Dr garcia, does flaky dry skin in rosacea means that the skin is dry and needs more moistuirization. Can I expect skin to look less red when adequately moisturized. Thanks for yr advice.

  Answer:  yes and yes. JG 8.22.08

• dr garcia, i have rosacea redness for 3 years. Being oilve skin type 3b, i underwent IPL series (25) for 2 years during which my redness reduced but my face sure took a beating. Now I have decided to give my face some time to heal by applying a simple moisturizer and taking antibiotics. Is this a good strategy. I am thinking for waiting for 6 months to see how my rosacea redness settles after this, and then go for Yag or V-Beam. Do you think I am doing it right>thanks

  Answer:  I think that is wise and I agree with your tentative plan. JG 8.22.08

• Dr. Garcia, my sister wants to combine lactic acid moisturizer with retin a to minimize irritation, and i already told her (based on your opinion) that adding lactic acid cream will increase not reduce the irritation. But she insist that the lactic acid could function as moisturizer so it will decrease the irritating effect of retin a. Could her opinion be true or perhaps she had wrong information?

  Answer:  I feel she is incorrect. JG 8.22.08

• dr garcia, after 25 IPLs for my vascular rosacea, i can finally tolerate a moisturizer in the form of squalene oil. I use 3-4 drops, massage it when my face it wet and apply it over my cheeks. However, when its drys it becomes flaky. Why does this happen. Is it because my skin is dry and I need to apply more, because I cleanse my skin everyday well or is it something other than dryness. What should I do.Thanks.

  Answer:  try applying it when ry, not wet. It becomes flaky again because the squalene has been absorbed and you need more is all. Also look at using a less irritating cleanser too. Best of luck. JG 8.21.08

• Still regarding below question. Generally speaking, do you think it will more irritating if combine retin a with lactic acid cream at night, or not irritating?

  Answer:  it will increase the irritation if you combine it with lactic or glycolic acid, yes. JG 8.21.08

• Hi Dr Garcia, Is sunless tanning lotion at all ageing or harmful to the skin on my face? Thanks for your expert advice!!

  Answer:  no, it does not age the skin, but the artifical tan does not protect you against the sun. JG 8.21.08

• Dr. Garcia sorry to bother you, still about the question regarding my sister as 1st time user of retin a just 2 questions below this. I mentioned she wanted to try retin a 0.01 gel combine with lactic acid cream at night, and glycolic acid cream plus sunblock at morning while she had a very irritated skin 2 months ago after trying OTC retynil palmitate. You respond to use 0.025 instead, while actually what she want to try is weaker, which is 0.01. You thought it is 0.1 in your answer. So do you think her regimen will be okay or it still will to irritating for her, consider her reaction to OTC retynil palmitate?

  Answer:  even better to start there if it is 0.01% and not 0.1%. JG 8.21.08

• dr. Garcia regarding question below, she plan to use retin a gel 0.01%. But two months ago she had a very bad irritation and the red spots are still there, due to using cosmetic well known brand product containing retynil palmitate, even she only use the product seven times during 2 weeks. Do you think it is safe for her to do regimen that i describe below?

  Answer:  if she reacted to OTC retinol she is going to really react to Retin-A 0.1% gel. She might want to try something much weaker, maybe 0.25% every other night to start and then advance as tolerated. JG 8.21.08

• Dr. Garcia, my sister is first time retin a user. She wants to start using retin a this way : At night, aply lactic acid cream after cleansing, then retin a after the lactic acid cream. In the morning, apply glycolic acid cream before sunblock. Do you think this regimen will reduce the potential irritation or vice versa?

  Answer:  it might as all people`s skin is different, it depends on her skin and the strength of the Retin-A. JG 8.21.08

• Hi Doctor I posted the previous question regard my melasma and i forgot to write that im also using sunblock (Cotz) protection even inside my home.

  Answer:  OK. JG 8.21.08

• Hi Doctor I suffered from melasma and my doc prescribed me Retin-a since then my melasma is spreading and getting really dark. I DIDNT HAVE ANY PEELING NOR MY FACE IS IRRITATED by the retin-a so my worsening is not possible to this two reasons. It is possible for this condition to get worse with the use to this med and then gets better? I hear the It has to get worse before gets better For acne not for melasma. If this is possible can you explain me why is that happenning and when ill see results? Im about to quit this treatment i dont want to end up with a permanent full face mask of melasma !! And i see it comming.

  Answer:  it should not get worse before getting better, I assume your doctor told you to use complete sunblock at the same time as if that was not done it can get worse due to the irritation allowing worsening of the problem. Might need to add a hydroquinone also to help fade it but I wil say that it will ever be gone totaly with just topica treatments. JG 8.21.08

• What do you think about Revitol skin products?

  Answer:  have not had a patient use them so I cannot say, sorry. JG 8.21.08

• Can you please tell me what you find most helpful for slight acne scar some are pits and some are indentations. I dont have a whole bunch they can be counted but some are VERY bothersome to me. I have olive complexion. Thank you I had a consult for profractional> What do you think. Thank you for all your help

  Answer:  I am not a fan of fractional treatments,especially for olive skin, could do subcision and fillers or direct punch floats, if small they can be cut out too. JG 8.20.08

• Hi Dr. Garcia I had 1 Fraxel TX at 14-18 mj a year ago. I am of indian descent with brown skin. Around November 07 I began noticing pockmarks and a loss of depth in my skin on the left side of my face (cheek area close to sideburns primarily). After I wake up from sleeping this area tends to look much fuller. I`m assuming that it is due to the blood rushing to my head while lying down for long periods of time. I can tell where the level skin is and the lower level skin is. Strangely the rest of my face has normal depth. Is there a reason why only the left side of my face in that specific patch/area was affected? Also, can anything be done? I have been reading up on needling. I`ve seen some amazing before and after which showcase 3 stages of improvement. If anything, can needling be good in theory? Is there anything else to get my skin level again? The normal skin also has a consistent look to it, while the lower level area skin is more drab.

  Answer:  not sure what has caused that and I seriously doubt the needling will fix it, hard for me to offer any other suggestions without seeing you in person, I have never heard of that happening with the Fraxel though. JG 8.20.08

• Hello Dr. Garcia. I`m 50 years old with relatively good skin, but it`s not as smooth as it used to be and has a generally dull appearance. I have some fine wrinkles around the eyes, some folds by the corners of my mouth and slighly sagging jowels. I`m not ready for fillers and the thought of surgery scares me to death. I have a skin care regimen that includes a weekly mild glycolic peel, a daily alpha hydroxy gel, sunscreen and an evening anti-oxidant rich moisturizer. I`m thinking of trying microdermabrasion and/or RetinA to help improve the texture and tone of my skin. Is there anything I should know about microdermabrasion?I`ve seen you recommend diamond over crystal . Is that something you feel strongly about? And is it worth it to do just one microdermabrasion every 6 months? Thanks for your response.

  Answer:  I like the diamond over the crystal version, I think the combo will help get the dullness off of your skin but will not do anything for the folds or jowls though. For the microdermabrasion to be worthwhile it will need to be done every 3-6 weeks at least. Best of luck. JG 8.19.08

• Hi Dr. Garcia. Which of your products would you recommend for crepey skin under eyes? I am 43 year old female. How much of a difference do these products really make?

  Answer:  I think they make a nice difference and I would suggest the eye booster cream. JG 8.19.08

• I have been reading alot about scars....and I keep reading between two verdicts. I`ve read that SOME scars can be completely removed, and I`ve read that no scar can be completely removed...I dont know what to believe. Is there ANY WAY, or ANY scar, or any type of way that a scar can be completely removed...i was guessing that if a scar is superficial enough, then complete removal may be possible

  Answer:  well, any scar can be removed, temporarily, but it will be replaced by a new scar, which can be better or worse than the original. There is absolutel no way at the present time that a scar area of skin can be made scar free.Sorry. JG 8.19.08

• Sorry, regarding your neuropeptide cream again, how do I apply it in my face, thinly or generously? Thanks.

  Answer:  just thinly is all. JG 8.19.08

• Hello Dr. Garcia. Im planning to buy your neuropeptide cream, my question is, can I apply it only to the areas of my face that I feel that is damaged and not the whole face? Or is it better to put it all over my face ta have an even effect? And do i apply it thinly or generously?

  Answer:  yes, it can be spot applied if you wish, although there is likely underlying damage on the entire face that will benefit from it, it is unlikely the sun damage occured in only some areas, it is just seen earlier in some but will show in all areas with time. JG 8.19.08

• If we get acne while on retin a, can we use benzoil peroxide only on acne spots (at night) and use retin a at whole face other than those spots at the same night?

  Answer:  yes, OK to do so. JG 8.19.08

• Dr. Garcia, when trying to use the irritation effect from retin a, people always said to use a plain moisturizer. Does a moisturizer containing glycine soya as active ingredient is considered a plain moisturizer that is safe to combine with retin a, or it is not a plain moisturizer cause it has glycine soya as active ingredient?

  Answer:  I do not think there will be much difference between them. JG 8.19.08

• Hi Dr.Garcia, 1. Can I wash my face with the product that contains salicylic acid 2% before doing a glycolic peel ? 2. Does differin help with pitted scars ? Best Regards

  Answer:  I think the cleanser is fine ad I do not think the Diffferin will do much for scars, about the same as Retin-A at best, very mild. JG 8.19.08

• Hello Dr. Pierce, Are you familiar with Argan Oil-now touted as an anti-aging oil for the skin? Or, is a lot of hype and probably as effective as Vit E oil? What do you think the best oil product for dry skin? thanks. Thanks

  Answer:  I think it is lots of hype, likely Vitamin E and squalene is just as good, they are both parts of Argan oil. JG 8.18.08

• Dear Doctor, a well known brand (RoC) is now selling the Protient Lift cream that contained DMAE with a different composition. It contains now a substance called tetrahydroxypropyl ethylenediamine. I had never heard of it and looked online. There is only one study, but done by the manufacturers (so it could be biased?) whichs reference appears in a supplement of the Journal of the American Academy of Dermatology http://www.aad.org/meetings/previous/_doc/Posters_2008%20Annual%20Meeting.pdf What do you think? Is it scam? Can it eventually work as DMAE?

  Answer:  can`t say that it is a scam but I think whenever the only research is done by the manufacturer, I become suspicious, the thing is DMAE is not cheap, so many companies put in very small amounts in their products to increase profit margin but they can still say it is in the cream, yet not too effective. JG 8.18.08

• I had saline implants for 11 years, due to rupture, had them replaced with silicone. In March/08 I had a tx of Trombovar on my great saphenous vein and others. The inside of my leg went brown and floppy. 4 days later It was hard to wear anything tight on my upper legs and hips. I went to ask an MD and ended up leaving with a Levulan and IPL tx on my face. My face was badly burnt and they didn`t tell me until the next day to stay out of the sun. I didn`t even know what I was getting (stupid)I thought it was a mild facial tx for blackheads. (I liked my freckles!) I was horrified to learn what levulan was! I wore sunscreen for 20 years everyday and would never have something that would make me photosensitive. I drove home 1/2 in the sun after the tx. I had itching, stinging, extreme swelling, redness and extreme dryness on my face. I started to get swelling and joint pain in my legs too. 9 days later I had a ct scan of my sinuses. Within hours, I was itching all over my body. I lost alot of the fat tissue in my face within 2 days and this also happened on my body. My skin all over my body started going tanned even though I wasn`t in the sun. It has aged too alot and has gone loose all over. I was going through a 600ml bottle of cream a day for a couple of weeks at one point. I was getting violent rashes all over my body. (they started were the leg tx was, my upper thighs were going purple from the capillaries for some reason). I was in such excruciating pain in my skin, I had to take a leave of absence from work as a nurse. My skin is still very, very dry where it used to be oily. My point telling you about the implants at first was they removed them because they didn`t know why I felt so bad. How long does the effect of levulan slowing down your sebaceous glands last for? combined with the radiation? I am so ugly now..I used to be so confident. I had just started dating again after a long time as I had other priorities. I can`t date ever again. I`m still not back working, I am petrified of the sun how else would my skin age so badly? How crazy is that? I was a functioning, efficient normal person before this. Every doctor has written me off saying they can`t help because they have never seen this reaction before. Please help. Thank-you for your time.

  Answer:  I have not seen Levulan last more than 6 months. When combined with radiation I do not think it lasts longer, just more dramatic decrease is all. Wish I had more to offer. JG 8.18.08

• I am 35 yr old female, loved to sun bath as a teen and early 20`s. I always tanned nice and even, got a couple bad burns when i over did it on vacation a few times. Finally at about 25 I started to get sun spots and freckles on my chest and arms. I`ve avoided the sun and use sunscreen religiously if i have to be outside for the last 10 years. I have managed to get rid of most the sun damage through laser and exfoliation- Mama Lotion works great. My question is, once i am able to remove all the damaged skin, will i then tan even like i used to, or will i always get sun spots and freckles now? if so, why?

  Answer:  you will likely get the freckles back as the skin melanin cells have memory and will go back to the way they were. JG 8.18.08

• Hi Dr Garcia, Thanks for your previous response. I had one more follow up question if you don`t mind. Can Benzoyl Peroxide help dissolve blackheads and unclog pores overtime?

  Answer:  it can open the top part of the pores and help allow it to be cleared but it might need something in addition like microdermabrasion to extract the plugged oil that is in the pore. JG 8.17.08

• Is there any benefit to galvanic stimulation to reduce old acne scars. I saw research with retin A gel and galvanic, supposedly reduced scars quite a lot over 3 months. Nuskin has come up with a home unit--any differences in clinical models versus this unit. I have atrophic scars. I so appreciate your honesty when I looked on your site. Thank you so much.

  Answer:  I do not see how it would help. There are galvanic systems avaialable in doctor`s offices that enhance penetration but I doubt the home units would have the needed energy. I would save your money. JG 8.17.08

• Hi,my name is tanja hernandez.I had a really bad staph infection on my lower leg about two years ago.It left a dent in my leg that is very noticeable.Is there anything that can be done about that?To fill out the dent or something.Any advice is greatly appreciated!

  Answer:  might try fat injections or Scupltra. JG 8.17.08

• Greetings Doctor, I am having V-beam treatments done for post fraxel redness along with hyperpigmentation. I am using metrogel every night and the doctor also said I should use a hydroquinone (Lustra Ultra) every night for two weeks before the Vbeam. treatments. Do you know which topical I should put on first, the metrogel followed by the Lustra or the Lustra followed by the metrogel. Thanks for your time and generosity.

  Answer:  I see no reason for the metrogel unless you are treatng something else but it is not required and will create more skin irritation than needed. We usualy use Retin-A and hydroquinone for prevention of hyperpigmentation related to resurfacing procedures. JG 8.17.08

• Hi Dr. Garcia Is it possible to excise an existing scar (hypertrophic) with minimal new scar formation if the width and overall size is very small and thin?

  Answer:  it can vary, but there is usually a 50% chance of it coming back exactly the same or worse unless it was hypertrophic due to a wound infection and then healing by secondary intent. JG 8.16.08

• Have you heard of a fern plant extract, Polypodium leucotomas? It is supposed to protect the skin from the sun. I have been looking for an oral supplement without any unnatural additives. Would you know where I could find out about this? Thank you, JL

  Answer:  too early to tell, if it does work is will be likely all other anti-oxidant anti-inflammatory agents. I am not sure where it is available yet. JG 8.16.08

• Hi Doctor,I have melasma for few years now and i had it under control with hydroquinone 4%. about a month ago my derm presccribed me Mynocycline for some pimples i was having due to exercise. Apparently the antibiotics plus hydroquinone was a bomb now my melasma is coming back like never, everyday is bigger and darker. I stoped taking the mynocycine and i kept putting hydroquinone for five days after i stopped the myno but it never stoped to coming out. For some reason now hydroquinone is not working anymore. I went to my derm last week and he prescribed me Finacea (azelaic acid) day and Tazorac (retinoid) night but they still coming out. I know it could take months to clear my melasma and im not pretending to clear in few days but i was wondering if a medication will help at least it should stop the melasma to coming out right away? I remembr when i started to use hydroquinone 4% my melasma was in process of comming out and its stop right away. Or beacause i use to use something like Hydroquinone wcich is suppose to be stronger than azelaic now my skin dont react even though they are different compounds? I apologized for my English... Hopefully you can understand my message.

  Answer:  minocycline sensitizes skin to sun effects is the problem, keep doing what you are doing now and use complete sunblock, even under flourescent lights. JG 8.16.08

• Hi Doctor, I hope you are well. I use 10% Benzoyl Peroxide twice a day on my problem areas for acne, but I`ve read recently that BP can promote skin cancer. Is this true, and do you know what the word is in the medical community about this? Thanks much

  Answer:  I think the evidence of that is lacking, especially in humans, it is assumed since it can cause the formation of free radicals, but even sun can do that and likely to a greater extent. No product is totally without side effects, one should use it for he shortest period of time possible. JG 8.16.08

• Dear Dr. Garica, I used Auriderm clarifying gel on a scar on my arm (not an open wound) and today have blistering and rash! I am allergic to Neosporin and this rash appears the same. Is it OK to apply some steroid creme, or better if I just leave it alone? Thanks for your help!

  Answer:  leave it alone and keep it out of the sun I think is best. JG 8.16.08

• Hi Dr. Garcia, Last question about sebaceous hyperplasia. Regarding removal with either erbium laser or cautery, did you mean they will come back in the same place they were, or did you mean a person will likely continue to get new ones? Thanks again.

  Answer:  both, sorry. JG 8.15.08

• dr garcia, i have not applied any moisturiztion on my skin for the last 3-4 years since i had vascular rosacea. In addition, I had numerous IPL which were helpful but drying in nature.however, finally I am able to tolerate emu oil without irritation. Can you give me an estimate (which I know varies) as to how much time will it take for my skin to benefit from my moisturization (6 months, 1, 2 or more years) before I start my IPL again.Thanks. I am a`male 30 yrs old.

  Answer:  it will be between 2-6 months, the older one is the longer it takes. JG 8.15.08

• Regarding the sebaceous hyperplasia. Which laser would you recommend, and what does hyfercated mean? Thanks

  Answer:  I would use either a CO2 laser or maybe an erbium. Hyfercation is a burning wth a cautery machine. JG 8.15.08

• Hello Dr. I am an african american woman with dark spots on my face, neck, back and chest from acne.I`ve been turned away from dermatologists because they say my skin is too dark for laser, and I`ve tried every product known to man.I`m so tired of wearing foundation all over my body. Is there laser treatment to remove these dark spots for women with dark skin like mine? If so, do you perform this procedure?

  Answer:  maybe a YAG laser for the face but I would not treat the other areas with a laser, sorry. JG 8.15.08

• Do you have any thoughts on how best to treat sebaceous hyperplasia? Do you remove them, and if so, how? Thanks you.

  Answer:  they can be lasered or hyfercated but will return in a short time, nothing permanent. JG 8.14.08

• Its me again Dr. I was given the Neocutis & Triluma immediately after receiving 2 syringes of Radiesse filler for my hands. This regiment was to help with crepy skin after fill. Will this help? Would Retin A have been better?Thank you

  Answer:  for the hands I think the Retin-A alone is enough, but not dramatic. JG 8.14.08

• Hello Doctor,could you offer your opinion on how effective triluma is and how about neocutis cream. I just started using them, 1 cream at night....the other in the a.m. Waste of money?? thanks

  Answer:  I like them both, think they are both good. JG 8.14.08

• mandelic acid question. i used this on my nose for blackheads and it made my nose really swollen. i had rhino 3 years ago. the swelling from mandelic acid is staying in the tip area longer. is this something to worry about? should i not even be using this on my nose. is mandelic acid capable to damaging graft in tip of nose or dissolving it?

  Answer:  probabaly too irritating but should not cause any long term negative effects. JG 8.13.08

• dr garcia, does omega 3 capsules help in dry rosacea skin. what is the usual dose.Thanks

  Answer:  not a for sure thing that it will help. JG 8.13.08

• dr garcia, what the best way to eliminate flaky cheeks with my sensitive rosacea skin without irritating it/ or breakouts. I use a drop of squalene oil on wet skin for moisturization.Any, Any advice will be helpful.. I am tired of looking flaky. Thanks

  Answer:  I think try using the squalene more often on the face when it is dry. JG 8.13.08

• hi there again, I asked about the mary kay prodcuts. Yes understande what you mean. So nothing like shiesdo and big brands like that are probably not any better? Would brands from actually beauty thearipists be any better like La clinica or murad? Also are using a sereum t vitimin c do I put that on first the my moisturiser with sunblock or does it matter. Lastely starts that have had moles removed how come you can`t always see I scar I have a couple of little ones that look raised in certain lights. Have some one`s that are little and flat I don`t mind them but the raised one`s I hate any suggestions. Thanks once again for your help.

  Answer:  moisturizer goes on last , and yes,I think the difference in the OTC products is relatively small. See the dermatologist for the small moles, all the best. JG 8.13.08

• dr garcia, i am a pale asian with rosacea redness. I had 25 IPL`s which made my skin less red but dry. I could never apply any moisturzer uptill now. Should I expect the redness to go down once healthy moisturization sets in or should I directly go for a v-beam to tackle the redness now.thanks

  Answer:  I would moisturize and let the skin get back to normal with no more irritation. JG 8.12.08

• dr garcia, i use emu oil as a moisturizer for my dry rosacea skin. I use a drop of oil when my face is wet.My skin is still flaky. How do get rid of this flakes without irritation?

  Answer:  migth need more Emu oil with a dry face, or try squalene oil instead. JG 8.12.08

• dr garcia, i have rosacea redness and dry skin. For two years I did not apply any moisturizer and had numerouos IPL which stripped my skin all the oil, even though it helped my redness . The remaining redness , is it due to rosacea or my dry skin. If I apply a moisturizer, which I can now, can i expect the redness to calm down say for eg squalene oil. Thanks

  Answer:  I think so, go with the squalene. JG 8.11.08

• I am the one who asked you about reducing visible pores at nose and cheek using OTC product below. You answered i should use retinol. Is it ok if i use product containing retynaldehide instead? the product combining retynaldehide with hyaluronic acid, do you think it is worth to try using that product to minimize my visible pores, (it doesnt say anything about reducing pore size, it is an anti wrinkle product, it promises to minimize fine lines etc)

  Answer:  I have never used that product mix so I cannot say whether it will help. JG 8.11.08

• Dear Dr Garcia, I`ve been reading that products containing tripeptide-1 plus soy and wheat proteins and xanthan gum which makes up something called Aldenine is supposed to boost production of collagen by 300% in seven days. Is this hype or the truth and if it`s true, do any of your products carry all of these ingredients? Sincerely Linda

  Answer:  I have not seen anything in the peer-reviewed medical literature to back that claim. JG 8.11.08

• I have large visible pores at my nose and cheek, yet i dont have any acne, i am 33 years old. my skin is not too oily nor too dry, it is normal to combination i guess. So when choosing OTC product to adress my visible pores in order to minimize pores, should i look for anti blemish product or should i look for anti wrinkle product?

  Answer:  use retinols. JG 8.11.08

• Hello, Hope you are fine. I am trying to find the right face cream with the right ingredients for very dry skin that is sun damaged. I understand you may not be able to recommend a specific brand. But can you guide me to what may be best for my skin? I am tired of buying things that DON`T work. I need a face cream that moisturizes, firms skin, helps collagen, fine lines, and wrinkles. What kind and Brand do you recommend? Thank You

  Answer:  try the creams on our shoppig cart, they are formulated by myself. JG 8.11.08

• Hello, Sorry, I pushed the submit button too many times for that question. Sorry.

  Answer:  OK. JG 8.11.08

• Hello, What ingredients should I look for in a good face cream? Hyaluronic acid, peptides, copper, retin a, vitamin e? What ingredients are in a good face cream that has good benefits? What do you recommend?

  Answer:  the Retin-A is a good choice. JG 8.11.08

• Hello, Hope you are fine. What cream and products should I use on the neck since face cream doesn`t work as well on the neck?

  Answer:  nothing will work as well on the neck as on the face. JG 8.11.08

• Hello, Can you recommend a hydrating cleanser for dry skin? Cetaphil seems to dry my skin a bit.

  Answer:  no such thing as a hydrating cleaser, need a moisturizer afterwards. JG 8.11.08

• Hello, Hope you are fine. How do you reverse sun damage? Is it really possible?

  Answer:  Retin-A, DMAE and Vitamin C help to some extent. JG 8.11.08

• Hello, Hope you are fine. You said in an earlier answer that vitamin c and copper help with collagen, elastin, & firmness. How does copper help? What kind and can you buy it at a dermatologists office?

  Answer:  it helps create stronger skin by speeding the healing process after an injury. Copper creams are commony sold in dermatologists office and can also be found on the internet. JG 8.11.08

• What can you use for the hands to fight aging and the crepe paper skkin look?

  Answer:  Retin-A. JG 8.10.08

• What is the difference between copper peptides, cream peptides and poly peptides? What is the difference and what do they do for the skin?

  Answer:  you are not giving me enough information in terms of ingredients to tell, sorry. JG 8.10.08

• dr garcia, i developed rosacea due to application of benzoyl peroxide. Once i was diagnosed with it i underwent 25 IPL for removing burning and redness. I had to go with IPL since I am an asian. Finally, my redness has subsided and I can use topicals. My question is how do I know whether the redness is due to my rosacea or due to the inflammation caused by lasers ( especially mear my beard areaes which are not typically affcetd by rosacea but I had IPL on them). Can I expect my redness which is not due to my rosacea but skin inflammation induced by IPL to reduce once I start using moidturizers and antibiotics to calm my skin? Sorry for the long post.Thanks

  Answer:  redness from an IPL should be gone within one month once the IPL is stpped. The moisturizers will help but the antibiotics can in some individuals cause slight redness though. JG 8.11.08

• Hi there I recently was at my local beauty salon and had a new girl who had just come over from calafornia. I was asking about creams etc.. I am using mary kay at the moment and she said while bout 20% was good stuff about 80% wasn`t that its sort of just a filler its that true? Would I be better off using nivea or a supermarket brand? I have friends that use mary kay and I have always found it good? Also she said an eye that has vitimin c in it, could you suggest a reasonable one. I am in new zealand so I don`t think we have as much of a choice. Also thinking about botox for around my eyes when I get older don`t need it yet. What are the side effects. Thanks for your valuable time.

  Answer:  most OTC cream are like that, only small amount of active ingredients in order to keep costs down. Skinceuticals has a good Vitamin C eye cream. JG 8.11.08

• Is there a good foundation that will not plug pores? Can you recommend one to me? What kind, brand, for dry skin that is lacking oils and moisture? Thank You

  Answer:  nothing is 100%, it is all a matter of trial and error. JG 8.10.08

• Is there a good foundation that will not plug pores? Can you recommend one to me? What kind, brand, for dry skin that is lacking oils and moisture? Thank You

  Answer:  there is nothing 100%. It is a trial and error thing. JG 8.10.08

• What is a good concealer that does not settle in lines?

  Answer:  I am sorry but that is a trial and error thing. JG 8.10.08

• What is a good moisturizer for dry skin (not dehydrated) that is lacking oils? Does Kinerase, Skinceuticals or Neocutis make something that would help put the oils back in my skin? Can you please recommend one

  Answer:  I think those three are all good products. JG 8.10.08

• Dear Dr. Garcia, I knpw you recommend Scarguard for scar treatment on newer scars but I just saw their commercial and they said to use on old as well as new scars. Do you agree? If so, how old can the scars be before using this stuff is a mute point in your opinion? I hope you are having a wonderful weekend. Thanks for sharing all of your usual great knowledge and honest opinions. It is much appreciated as I wade through all of the information available to consumers now days.

  Answer:  I have not been impressed with its effects on scars past one year. Thanks also for the kind words. JG 8.10.08

• okay- I see more now I guess about Differin. Thank you for explaining so well. I was given it for whiteheads. But if I`m not mistaken, you ARE saying then that if I stop (or take a break) my skin will go back to what it was before the Differin use? B/c it was like all of a sudden I noticed my skin was scaley but now I think it`s going away? Hope that is the case.

  Answer:  should be, best of luck. JG 8.10.08

• For acne prone skin that using clindamycin topical daily, for how long at maximum clindamycin topical can be used on daily basis?

  Answer:  clindamycin does not have to be stopped, it can be used to control acne long term. JG 8.10.08

• I saw question from other reader below, saying that differin should be used only during short period. So for how long at maximum do you think differin should be use, and what to do next,

  Answer:  I do not tink prescription exfoliants should be used for more thna 9 months without a break of at least 2-3 months. JG 8.10.08

• Hi there. I love this site b/c it`s so interesting learning all this stuff that noone tells you- not even dermatologists. So thanks for that. So- recently you mentioned that Differin should only be used for short term b/c otherwise it can lead to yucky, crepey skin. So- the fact that I`m off of it now, does this mean my nicer skin will come back?? I think it might be getting better or is it just my imagination?? So why would anyone prescribe something that makes skin worse after a certain point?? That is what confuses me and makes me nervous about using retinae under the eyes b/c i have sensitive skin. I used to use that when I was a kid for pimples so it`s confusing. Thanks-- I`d love your answer about Differin and this.

  Answer:  Differin is intended for the control of acne, some peoeple use it for reversing skin damage, like Retin-A, and it accomplishes it by exfoliation and creating new skin cells but it is always good to take a break from the product, even with Retin-A. The dryness can in many cases get better as your skin adapts but it also might need a lower dose if your skin is too sensitive. Eye skin is especailly sensitive and migth not tolerate it, Retin-A has different strengths so one can use a weaker version if needed, you can also apply a moisturizer ten minutes after the Retin-A to help miminmize the flaking. All the best. JG 8.8.08

• I wanted to get your opinion on long term hydroquinone use. I read somewhere that long term use could cause cancer. If you use the obagi clear products for 3 mos and it showed improvement . Do you then completely stop. what is the maintance plan after 3 mos.?

  Answer:  once pigemnt problems are resolved, the hydroquinone should be stopped, there is no advantage to longer term use, it can always be used again if some of the pigmentation returns. The bigget issue with the hydroquinone was that people were treating brown spots with the product and they were not checking with their doctors first to see if the spot was cancer so they delayed the treatment. You always need to see a doctor beofre using a prescription medication. JG 8.8.08

• Can vitamin c serum (in a high dose) applied topically minimize the visible pores at nose?

  Answer:  not to any significant degree I feel. JG 8.8.08

• I am having large visible pores at nose and cheek near the nose, and no pimples / acne at all. why doctors usually prescribe acne medication for my goal to shrunk the pores, since my large pores never have acne?

  Answer:  The pores are large becasue they do not close because they have oil stuck near the bottom and the acne medications will help clean the pore out so it can close and look smaller. JG 8.8.08

• Some studies indicated that in 12 weeks of trial period, 0.1% adapalane (gel) is as effective as 0.025% tretinoin (gel). What is your opinion on this? Can adapalane function as anti aging as well?

  Answer:  I have never used it for evering skin damage so I cannot say. JG 8.9.08

• My teenage daughter recently bruised the left side of her face near her nose from squeezing a pimple. What is the best way to get speed up the healing of the black and blue mark. Will she get a scar?

  Answer:  do not think she will get a scar, I suggest warm moist heat a few times per day and she can also apply Arnica Montana gel to the area and take it orally at the standard dose shown on the bottle, it is sold at most good health food stores. JG 8.8.08

• dr garcia, i have numerous IPL to control my rosacea. I have started with emu oil, the first topical moisturizer to help heal my dry rosacea skin. I still get some 3-4 bumps all the time. What is the usual dose of doxycyline for rosacea.Thanks

  Answer:  many doctors use 100mg daily. JG 8.8.08

• DR Garcia I really appreciate the time you take for us all here at your site! Thank you! I,now would appreciate some specific ansswers to specific questions. I know>> no one else really knows (I believe this) this industry better than you. OK 1)about 4 months I had the botox lid droop thing > well its MUCH better now however it has never quite resolved complletely> it still droops> no one would know but me> IS this now permanent? If so what can I do to get mt eyelid back up 100%? 2) I have red veins on my face (I am of hispanic descent olive)> what 2 lasers do you recommend? 3) Brown spots on cheeks Again what lasers doyou suggest for me? 4)acne scars> what procedure do you reccommend? THANK YOU!!! I feel as though I should pay you for your time> YOU Are 1 Generous Professional

  Answer:  As to the Botox side effects, it is not permanent, it will get better as the Botox wears off but it can take some tmie, especially if the forehead was injected along with the galbella too. There are eye drops that your doctor can prescribe that will help until it wears off. For the red veins on your face I suggest IPL on a mild setting to try to avoid any skin irritation. Same option for the brown spots too. No need to pay though, just do better, I learn much from the questiosn and you all keep me thinking. Best of luck. JG 8.8.08

• What amount of retinol concentration (in percentage) to be equal to 0.025 tretinoin?

  Answer:  it will never be equal I feel. JG 8.8.08

• in general, 0.1 adapalane is equal to what percent of tretinoin (retin a)?

  Answer:  I do not feel it is .JG 8.8.08

• Dr. Garcia, although i dont have acne, sometimes people told me that i have clogged pores, and i dont quite understand why because they dont explain it well. So if we dont have acne, how do we identify whether or not we have clogged pores?

  Answer:  plugged pres are basiclaly pores that have closed off from oil in the eskin, if they become infected they can become acne, IPL, microdermabrasions and Retin-A will likey help the plugged pores but there is no permanent remedy. JG 8.8.08

• what changes do you see with people using obagi rx system, including cleansing gel, exfoliant, sunscreen moistrizer, vitamin c serum and the nightcream? what do you see in their skin and what should i expect with these products?

  Answer:  less pigment problems and smoothing of tiny fine lines, in general a healthy glow so to speak. JG 8.8.08

• I am 45 years old and have the following skin care regimen: am-B5 gel, your DMAE cream, moisturizer, emu oil and sunscreen. I let this soak in for at least an hour before I apply my makeup. In the evening, I wash with a good soap, apply a B5 gel and then put on a moisturizer. I am considering purchasing your neuropeptide cream. Would it be okay to use the neuropeptide cream am/pm or should I use it at night and use the DMAE cream during the day. I have extremely dry skin. What do you think of SkinCeuticals B5 gel? FEC

  Answer:  The B5 is good, I think the DMAE during day and peptide at night and I trust you are using a facial cleanser and not a soap, that would be too harsh and drying. JG 8.7.08

• Dr. Garcia, I have heard much hype about a B-12 shot. People say it`s excellent for alot of things but what interests me is it`s claim for glowing skin! I`m 45, will this do anything for me? Thank you

  Answer:  it is water soluble and lost from the body in less than 24 hours, save your money. JG 8.7.08

• Dr Garcia, Which Brand of squalene oil do you recommend for rosacea.Where can I find it.Is it squalene or squalane? Thanks

  Answer:  no special brand on that. JG 8.7.08