Ask Dr. Garcia - The Archives

• 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: 

• 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