Question:

I`d like to try a oil on my face around my mouth. Do you recommend any? My skin feels like I have a mild sunburn all the time. Thank you.

Answer:

squalene oil is my favorite. JG 1.16.14

Question:

What is your opinion of the IS Clinical line of skin care products? In particular, I`m interested in their Active Serum and their Youthful skin cream. I hear that their products are very good for highly sensitive skin. Thank you for your honest opinion!

Answer:

seems OK, they do not clearly give the list of ingredients and that makes it hard to evaluate. JG 1.13.14

Question:

My daughter asked my opinion of this product, but I sure don`t see it`s worth $500. Not even $20! What are crushed diamonds suppose to do for your skin?? Aqua, Helianthus Annuus Seed Oil, Isopropyl Palmitate, Diamond Powder, Cocos Nucifera Oil, Glycerin, Propylene Glycol, Cetearyl Alcohol, Glyceryl Stearate, PEG-100 Stearate, Ceteareth-20, Stearic Acid, Myristyl Myristate, Cetyl Alcohol, Retinyl Palmitate, Tocopheryl Acetate, Ascorbic Acid, Camellia Sinensis Leaf Extract, Calendula Officinalis Flower Extract, Aloe Barbadensis Leaf Extract, Laminaria Japonica Extract, Olea Europaea Fruit Extract, AHA Multifruit Blend, Citrus Medica Limonum Fruit Extract, Saccharum Officinarum Extract, Citrus Aurantium Dulcis Fruit Extract, Acer Saccharum Extract, Malic Acid, Lactic Acid, Dimethicone, Beta-Glucan, Souble Collagen, Sodium Hyaluronate: Thank you for your time and input

Answer:

crushed diamonds are used in a microdermabrasion to exfoliate the skin but unless propelled at high speeds, they do noting. As to the evaluation of the worth being $20, I would say that is still likely on the high side when you subtract points for hyperbole. I think Oil of Olay is a good produce line at a reasonable price. I wish her the best. JG 1.10.14

Question:

Hello Dr. Garcia. I have a dark acne mark very close to my lips. Is it safe to apply tyrosinase inhibitor cream on it to lighten the acne mark? Thanks.

Answer:

Yes, safe to use. I wish you the beat. JG 1.9.14

Question:

Hi Dr. Garcia. Happy New Year! I had 2 quick questions: Do you think a low cal diet with more fruits and veggies would improve skin health? What are you thoughts on the efficacy of electroylsis? Thank you

Answer:

Both excellent options and recommend them both. JG 1.4.14

Question:

What is your opinion of the new topical product Fill and Freeze, marketed by Odon?

Answer:

I think it will help make your skin smoother as a moisturizer but legally no topical OTC product can have an effect on muscles because it then becomes a prescription drug, so there is really no freezing. As to filling, it will fill from the outside like putty, so not a true filler in what the public thinks of fillers such as Restylane. I think they are using the terms in an inaccurate way to plump sales rather than skin. JG 1.3.14

Question:

Hi Dr. Garcia, I recently threw out my back and have been taking a lot of long hot baths to help ease it. Apparently I`ve been spending too much time in there, as several days ago I developed a dry skin rash in the area between my thigh and scrotum. It`s red, and pretty itchy. I was wondering if you could tell me how long these usually take to go away? Also, what`s the best treatment for this, Neosporin? Aloe Vera? Hydrocortisone cream? Thanks!

Answer:

Should get better in 5-7 days, as silly as ut sounds the cream that is used for diaper rash works well. JG 12.31.13

Question:

So does VelaShape actually achieve localized fat loss or does i it, like VelaSmooth, only provide a temporary improvement in the appearance of fat? Thank you.

Answer:

they claim it is permanent but I do not believe it. JG 12.20.13

Question:

Is the VelaShape machine the same as VelaSmooth?If not, which is more powerful in your experience? Thank you.

Answer:

Smooth is for cellulite and Shape is to attempt localized fat loss, so they are totally different. JG 12.19.13

Question:

What is your opinion of those gel/gauze masks that can be applied to the face and left on for an hour -- e.g., the Peptide Aqua Gel Mask, Skinceutical`s Biorestorative Mask, and SK-II Gel Masks. I like how they leave my skin appearing, but are they doing any actual good for my skin? Thank you, Dr. Garcia. Happy and healthy holidays to you and your family.

Answer:

just a superficial short-lasting effect of closing pores and hydrating the skin.Best of the Holidays to you too! JG 12.16.13

Question:

Thanks for the answer about TNS Essential Serum. What exactly does it aim to do aesthetically? I might consider purchasing it if I understood better its benefits -- beyond its marketing claims. That is, what do you think it actually does? Thanks so much!

Answer:

it aims to hydrate the skin so the fine lines will not show as much. That is about all. That is why the marketing uses such vague terms. JG 12.9.13

Question:

Several friends are singing the praises of SkinMedica`s TNS Essential Serum. What do you think of it? What can its ingredients actually do for one`s skin? My friends look great, but it`s hard to know if it`s the serum or just their genes. It`s a very pricey product, so I`m not sure it`s worth the investment. Thank you for sharing your opinion, Dr. Garcia.

Answer:

It is a good line, similar toany others. I think it is her genes to a greatet extent. JG 12.8.13

Question:

Hi Dr. Garcia, I got two cortisone injection for a cyst on my face a month ago. The cyst has been slowly decreasing in size and is nearly flat now. If I haven`t developed a dent in my skin by now, is it likely that I won`t, or is it still possible to develop a divot in the skin a month after a cortisone injection? Thanks

Answer:

those effects can show u in the first 3-6 months. Not over the hill yet. JG 12.5.13

Question:

Hi Dr. Garcia. Can I put sunblock around the eye area or it`s too heavy?

Answer:

OK to use it. JG 12.1.13

Question:

What is your estimate of Philosophy`s Time in a Bottle serum and Hope in a Jar cream?

Answer:

Keep hoping and don`t waste your time.Sorry. JG 11.30.13

Question:

Hello Dr. Garcia. If I`m using retin-a regularly for more than a year and decided to switch to Obagi Nu-derm system, will I still experience heavy peeling even if my skin is already used to retin-a? Thank you.

Answer:

the only thing that might cause some new peeling is if you add the Obagi Clear, which is hydroquinone. If you have been using Hydroquinone, there should be no problem, but if not, you might have a short period of irritation. JG 11/26.13

Question:

I recently moved and have found a new dermatologist who comes highly recommended. My former dermatologist used Juvederm Ultra Plus for my lips and nl folds. My new doctor uses only Medicis products and says he uses Perlane in lips and nl folds. Are the two products (Juvederm Ultra Plus and Perlane) similar? Is Perlane safe for these areas? If so, might it last longer than the Juvederm or about the same? Also, an unrelated question: I know that retinols aren`s as effective as Retin-A, but what is your opinion of the newer lines of retinols such as SkinMedica`s Tri-Retinol Complex? Is that product pretty effective? I`m thinking of alternately it with Retin-A to reduce the irritation but to continue the benefits. Thanks so mcuh for all your help, Dr. Garcia. A happy and grateful Thanksgiving to you and your family!

Answer:

Yes, they are very similar. Perlane is safe for those areas although I prefer Restylane for the lips as it is a bit softer. I personally do not use Juvederm Ultra or Ultra Plus in the lips for the same reason. Nasolabial folds of moderate in depth I use Perlane or Juvederm Ultra Plus or Ultra, for the lips I use Restylane or Juvederm only.I think the longevity differences between the similar products is not perceptible clinically. I think the SkinMedica product is good but not as strong as Retin-A, so less irritating but less effective I am afraid. And a Happy Turkey day to you also. JG 11.24.13

Question:

Hi Dr. Garcia, I had a small cyst on my face and got a cortisone shot one week ago. The cyst is 90% gone, but there is still a small bump and a lot of redness. Hydrocortisone cream (1%) has worked really well for me in the past. Would it be safe to use the hydrocortisone cream for 2 or 3 days to speed up the healing, or given that I got a cortisone shot one week ago, would it increase the chance of developing a dent/skin thinning/hypopigmentation? Thanks

Answer:

I do not think the hydrocortisone cream will help in this particular instance and would advise against using it as the redness is coming from a source that will not be aided by the cream. The cream will not help in preventing skin thinning or a dent, if anything it might make it worse. I wish you all the ebst. JG 11.16.13

Question:

Hello doctor, I am 30years old. I have heard a lot about olay regenerist line and i intend to buy the olay regenerist micro sculpting cream. What do you advise me? Is it not too advanced for my age since i have a normal skin? Thanks

Answer:

OK to use it, prevention is better than treating wrinkles once they form. JG 11.13.13

Question:

Thanks so much for you answer below. I`ll try the Fraxel again. I forgot to mention that I also have microdermabrasion every four weeks along with Genesis -- and IPL. So it looks like there`s not much more I can do to help with my pores. Very grateful to you for all your kind help!

Answer:

Best of luck. JG 11.11.13

Question:

I had and aggressive Fraxel Repair treatment 3 years ago (8 passes) when I was 48, which I loved, but 2 years later by last November, my skin was back to its fine wrinkles, especially on my cheeks. So I had a fully ablative CO2 (2 passes with wiping after each pass). That took 6 months to heal and the results of the Fraxel were much, much better. I`m now 51 and wondering if I should do another Fraxel Repair or opt for (diluted) Sculptra in my cheeks just to improved the texture of the skin. My cheeks are already full from implants and a fat graft, but the epidermis lateral to the nose on each side is wrinkly, sagging and has enlarged pores. By the way, I get chemical peels several times each year, received laser Genesis every four weeks and use Retin-A 10 months/year and broad spectrum sunblock every day. Thank you for your help.

Answer:

I personally feel the texture improvements from Sculptra are overhyped. I will say that no matter what laser is used, the results will last less time the older you get. Both the CO2 laser and the Fraxel repair will also enlarge the pores as when it tightens the skin, it will pull the pores more open as neither one corrects the problem causing the open visible pore, which is oil stuck deep inside that needs to be taken out with microdermabarasion. I think I might suggest the Fraxel as you had a better experience with it but not knowing the settings used for the CO2 I cannot say if it was done in an equal fashion to achieve the same results. I wish you the. JG 11.10.13

Question:

I just wanted to thank you for the tip about tea tree oil to for superficial burns. I put some on my hands and arms and within hours, the open, weeping wounds had shrunk and crusted over. It was like magic! Thank you so much, Dr. Garcia! I also read your reply to the person who has been using CE Ferulic Acid, and have a question for you. You say that IPL and peels will treat any visible damage, but you don`t say if you think that serum (which I use too) is valuable and does any good. My dermatologist and ps claim that vitamin C especially is indispensable, but I don`t see much difference from using it. It`s pretty expensive, so I`d hate to just be throwing my money away. Do you encourage your patients to use topical vitamin C - and E? If so, why? If not, why not? Thanks for everything. You`re awesome.

Answer:

The topical Vit C is mild at best, save your money.JG 11.4.13

Question:

Good morning, Dr. Garcia! I had a UV photo taken a few months ago and it revealed a great deal of damage beneath my skin. I regularly have IPL`s and have had 2 CO2 resurfacings in the past 6 years. My aesthetician also does a VI Peel every 3 months for me. Of course I also always use sunblock every day too. Unfortunately, sunblock didn`t exist when I was a kid, which is why my skin is so damaged! I have been using SkinCeutical`s CE Ferulic Acid for the past 5 years. My question is, will constant use of the CE Ferulic product help to heal that damage beneath my epidermis? SkinCeutical`s advertising implies that it will. Is there anything else you can suggest to me that would help with this problem? If I understand this situation correctly, all that damage will eventually surface and be visible. Thank you for your help. Have a great week, Dr. Garcia!

Answer:

All of what you are doing will take off superficial damage, the deeper damage is almost impossible to remove and will surface slowly over time and can be visually improved temporarily but not in true fact as evidenced with the UV photos. You cannot get back to pure unadulterated skin with any treatments available at the present time.Sorry. JG 11.4.13

Question:

How does Nerium AD compare to TNS skin Medicus? for wrinkle fighting/youthful appearance?

Answer:

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Question:

How does Nerium AD compare to TNS skin Medicus? for wrinkle fighting/youthful appearance?

Answer:

maybe, but it costs more because it is part of an MLM selling opportunity. JG 13.3.13

Question:

Hi Dr. G, Ty for the reply. I am a Fitzpatrick IV or V. I have previously had Lightsheer LHR 10 years ago and 1 Fraxel treatment 6 years ago. The Lightsheer Laser was not appropriate for my skin type and I recall being burned by it (but I healed without scarring or hyperpigmentation in the affected area). The hyperpigmented spot in question has been present for several years but it was not until 2 months ago that I began using Obagi.

Answer:

I would continue with what you are doing and totally avoid lasers of any kind. JG 10.31.13

Question:

Hi Dr. G, Do you think any topical treatments can effectively lessen the intensity of dermal hyperpigmentation? Such as Obagi or Retin-A by itself? Secondly, do you believe that hyperpigmentation that persists over 1 year is dermal hyperpigmentation? If it was not treated, it may simply be untreated epidermal hyperpigmentation? Thank you.

Answer:

The more recent the spot has come up, the more effective those creams and products are. I think the definition of dermal hyperigmentation is quite confusing and simply giving it a name does not change what it is and what can or cannot be done to improve it. I feel if the year of creams and light peels has proven ineffective, then the move to lasers is warranted, but remember that any improvement is temporary and in time, the spots will come back with sunlight and flourescent light exposure. JG 10.31.13

Question:

Hello Dr! Just a general Botox question. After injection does the Botox get absorbed into the system or is it secreted by the body? I have e been having Botox for over ten years and concerned about the cumulative effect and if this could create long terms problem. Thank you

Answer:

it is digested by enzymes in the body and eliminated in their broken down inactive form, bound to the nerve ending proteins, in the urine. There is no evidence of a cumulative effect although in rare cases a patient becomes resistant and needs larger doses to get the same effect. JG 10.31.13

Question:

Hi Dr. what do you think about Cold Plasma Sub-D a proven, effective, neck rejuvenation treatment formulated to provide a visibly firmer appearance to the chin, jawline and neck areas. Thanks

Answer:

I would not recommend it. Sorry. JG 10.9.13

Question:

Hi Dr. Garcia, I`m trying to narrow the field down when it comes to finding a good skin care line. Is there any truth in the claims made by Algenist or is just a lot of hype? Thanks for your truthful responses....

Answer:

Sorry, hype. JG 10.4.13

Question:

Hi, Dr. Garcia. I have PIH from 4 acne marks on my cheeks. They are more red than brown, though they have a brown undertone. Will IPL help? Hydroquinone and Retin-A? Both? Thanks so much for your help and advice.

Answer:

All three will help and can all be done. JG 9.28.13

Question:

Hi Dr. Garcia, After taking a hot shower which I imagine loosened the skin, a thin layer of skin peeled off on a small patch of my nose. The area is a little redder and the skin looks more raw. Around how long will it take the skin to heal? Thanks!

Answer:

3-10 days possibly. JG 9.24.13

Question:

hello: follow up to chest fold from irritation. i just realized i was using body wash by oil of olay as a moisturizer..hence the irritation adverse reaction.. causing the skin fold due to feeling like I am on fire.. will this wrinkle go away once i stop..I thought it was a moisturizer, and didn`t read the label on the bottle

Answer:

Yes, just stop the cleanser and use some squalene oil. JG 9.19.13

Question:

Hello, I am 41... I did lay out in the sun on (only exposing my chest to feet, as I never get my neck or face in the sun.. I did this on Tuesday.. but didnt notice a burn until today (thursday) been using lots of creams to the chest area, causing irritation... I have noticed after I woke up this morning there is a crease /fold to my left collar bone. If this was a permanent wrinkle or crease I am unsure this crease would come on so suddenly. I am wondering if irritation from the creams I have been using on my chest has caused this crease to my collar bone area near my neck...and sleeping wrong imbedded this fold /crease... My chest is very irritated... wondering if you feel this is irritation with a wrong sleeping position that has caused this crease... just hoping it will go away. Your thoughts please..

Answer:

Although there is likely some small permanent damage, the majority of what you have is due to skin irritation and dehydration and will get better with time. JG 9.19.13

Question:

I was just wondering how you feel about neocutis products? I was looking for a change and I heard these were good. Don`t want to waste money on another so-so line. Any other suggestions for 60+ normal to oily skin Thank you

Answer:

Good product line. Good for mature skin. JG 9.14.13

Question:

I use SkinCeutical`s CE Ferulic Acid in the morning before I use sunblock. I find that the ferulic acid can leave my skin a bit tacky. I know you always say that whatever one applies to skin is usually fully absorbed somewhere between 20-60 minutes. If I apply the SkinCeuticals product an hour before I leave the house, will I lose its benefits if I rinse my skin lightly with cool water just before I leave and apply the sunblock? Thank you.

Answer:

I think that is fine to do and gives you the best of both.JG 9.14.13

Question:

Thanks for answering my question about the post-scab indentation on my nose filling in. I`m scheduled to get vbeam tomorrow, is it safe to so before the indentation fills in, or should I wait until after it does? Just to clarify, it`s not an open wound, the scab`s had two weeks to heal. Thanks!

Answer:

I do not think the VBeam will hurt the filling in process. All the best. JG 9.11.13

Question:

Hi Dr. Garcia, I had a small scab on the tip of my nose. I went to my dermatologist and he picked it off before it was fully healed underneath. It`s two weeks later now, and there`s not that much of a scar color-wise, but there`s a small indentation. Will this indentation fill in over the next few weeks? Thanks.

Answer:

should fill with time, yes. JG 9.10,13

Question:

Hello Dr,
I have been reading a lot about the risks of botox with regard to eyesight. I understand there are risks it can cause blurred vision or double vision. After having botox for over 15 years now, is there any possibility that botox can contribute to degradation of eyesight in general as it obviously enters the blood stream when injected for crows feet?
Many thanks

Answer:

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Question:

Hi Dr. Garcia,
Happy Labor Day! You put in a lot of hard hours, just on this board. It is appreciated.
I have a different question about post erbium laser for sub h. I had many removed in July. Some of them have a brownish
tint, is this hyperpigmentation? And what can be done about it? If they are going to fade on their own, how long may it take? Thank you very much. kp

Answer:

' '

Question:

Hi Dr. Garcia,
Happy Labor Day! You put in a lot of hard hours, just on this board. It is appreciated.
I have a different question about post erbium laser for sub h. I had many removed in July. Some of them have a brownish
tint, is this hyperpigmentation? And what can be done about it? If they are going to fade on their own, how long may it take? Thank you very much. kp

Answer:

' '

Question:

Dr. Garcia, Hope you are well. I am sorry to ask another question about post laser care with erbium laser spot treatment for seb h. I know the Bacitracin is for infection, but what purpose does the band aid serve? What prevents a scab from forming? That really is my question. Either of these, both or neither? I promise I will remember the answer. As always, thanks again for all your help. kp

Answer:

It is more to keep the area from drying out as that will allow the scab to form and worsen the scar. Should only need it for a short period if time. JG 91.13

Question:

Hi Dr. Garcia, I understand the importance of using BHA and/or AHA products in skin care for purposes of exfoliation. If I am using Retin-a every night, do I still need to use an AHA or BHA product?.

Answer:

no need to use them as the Retin-A is much stronger and does the same thing but more. JG 8.30.13

Question:

Hi Dr. Garcia, I have a question about blending two different antiaging serums in my hand before applying them to my face. When I do this, am I cutting the effectiveness of each in half? On the one hand, I am decreasing the concentration of all ingredients by 50% when I do this, but on the other hand, a blob of each gets absorbed into my skin whether I blend then apply or apply each one at a time. What are your thoughts?

Answer:

apply them in sequence allotting at least 10-15 minutes between for the active ingredient to absorb. JG 8.30.13

Question:

Hi Dr. Garcia, I understand that tretenoin cream has excellent antiaging benefits. As far as topical options go, do you feel that it is the most effective antiaging option? Or do you feel that other (less irritating) options such as peptides, BHA acids, and antioxidants can be just as effective? I guess I am asking if tretenoin cream is the gold standard wrinkle and antiaging cream?

Answer:

It is effective and the one with the longest track record and good science behind it. It is also affordable as the generic is a fine option. I do think peptides have a place, especially in people with sensitive skin and during those three months per year when I advise stopping the retinols to avoid chronic irritation. I personally use peptides and not Retin-A myself. I think the other creams are always compared to Retin-A for efficacy so it is by definition the gold standard, yes. JG 8.30.13

Question:

In the past week, the white ends of my nails have begun to extend downward toward the cuticles. It doesn`t appear to be a fungal infection. What could be the cause of this? Anything I should/can do to address it? Thank you, Dr. Garcia.

Answer:

I must say that honestly I am not sure, might want to see a dermatologist for an evaluation. Sorry. JG 8.28.13

Question:

Hi Dr. Garcia, I had 2 questions: 1. if I`m walking around in the sun for like 5 to 10 minutes at a time (walking to class), do I need to wear sunscreen? If we`re not in the sun much in general throughout the day (short intervals basically), is it necessary to apply sunscreen? 2. Do you think boxcar acne scars can (potentially) respond well to a dermal filler? Thank you.

Answer:

I would wear the sun block still as there will damage done in-doors when under florescent lights. I think fillers for the boxcar type scars work fairly well as long as the skin is released from the underlying tissue first, a procedure named subcision and then the filler placed into that space. without the space being created the filler moves to the surrounding area rather than staying where you want it to. JG 8.26.13

Question:

Hello doctor, summer is approaching in my country and i intend to buy the "creme de la mer moisturiser". But, many time i found that you suggest your customer to buy oil of olay instead of creme de la mer. Could you suggest to me, which oil of olay cream should i take since there are so many. Please advise. thanks

Answer:

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Question:

Hello doctor, summer is approaching in my country and i intend to buy the creme de la mer moisturiser . But, many time i found that you suggest your customer to buy oil of olay instead of creme de la mer. Could you suggest to me, which oil of olay cream should i take since there are so many. Please advise. thanks

Answer:

I like the Regenerist line form Oil of Olay. Enjoy your summer! JG 8.26.13

Question:

Hi Dr. Garcia. I have been mixing equal amounts of .05% tretenoin cream and 4% hydroquinone cream in my hand and applying to my face every night. This is effective for my melasma. My understanding is that by mixing them this way, I am cutting the strength of the tretenoin cream in half. So my question is, when I am cutting the strength of 5% trenenoin cream in half like this am I still getting antiaging benefits from tretenoin, or do I have to apply it straight (not blended with anything) to get the full antiaging benefit?

Answer:

yes, but if you desire you can increase the concentration to the 0.1% if you desire but it might be more irritating.The benefits from Retin-A max out at 12 months and after that it is merely maintaining more than anything else. I also thin taking 2-3 months off every year is a good idea as constant irritation from the Retin-A is not desirable. JG 8.25.13

Question:

Hi Dr. Garcia, I realized that what I thought was hypopigmentation on my nose is actually the beginning of a small blister. I`m assuming that it`s an adverse reaction to the ziana, since I started developing another one on a different part of my nose (and have no history of blisters before starting ziana a month ago.) I`ve stopped the medication of course. Do you know how long it might take for my skin to return to normal? (A week? A month?) And might hydrocortisone cream help speed the process? Thanks!

Answer:

No wat to tell how long it will take but more like a month or more than days. Hydrocortisone will make it worse. JG 8.24.13

Question:

Hi Dr. Garcia, I have rosacea and got a red, almost crater-like spot on the tip of my nose. It healed after a couple weeks, but left a circular spot that is much is whiter than the surrounding skin. (Post inflammatory HYPOpigmentation?) Is it likely that this spot will regain its pigment over the next several months, or is hypopigmentation after a blemish a more permanent condition?

Answer:

it will take time but it will likely return to pretty much the same color, could take months to do that though. Best of luck. JG 8.23.13

Question:

Hi Dr. Garcia, I just asked you a question re: hyperpigmentation. On Monday, I was planning on going to my next laser hair removal appointment as well as seek consultation from an aesthetician re: Obagi. Should I forgo all future laser hair removal appointments? Could Obagi help/worth a try? Ty

Answer:

The way you have reacted I would avoid laser hair removal and Obagi should help. JG 8.17.13

Question:

Hi Dr. Garcia, I have another question re: hyperpigmentation. If hyperpigmentation is surrounding the healed skin and/or the vicinity of the healed skin, is it PIH and will resolve in time? This upcoming week will be the 3 month mark for me (`is it a scar` guy). The injury site has improved a lot and the texture, while not exactly like my normal skin, is very close. the issue now is that *surrounding* the wound-site is hyperpigmentation. It`s not simply on the border. It`s like all around the injury site in a `diameter` that wasn`t affected by the original scratch/wound. it`s strange because the hyperpigmented skin was never injured.

Answer:

It will require treatment and will not resolve on its own. JG 8.17.13

Question:

Hi Dr. Garcia, What type of laser would be able to treat hyperpigmentation in dark-skinned patients (if that is possible at all)?

Answer:

I use a Q switched Nd:YAG in those patients. JG 8.16.13

Question:

Hi Dr. Garcia, If hyperpigmentation persists in an area on the face for years, can it still be treated with topicals like Triluma or the Obagi product line? I have residual hyperpigmentation from laser hair removal done 9 years ago.

Answer:

Likely not, will probably need lasers. JG 8.16.13

Question:

Hi Dr. Garcia, I just wanted to update you. This is the `scar` guy. Since I last commented here, the wound area has improved a lot. I`ve come to terms with the fact that it won`t improve further. That being said, it doesn`t look as bad as I had imagined. My question for you is, can `dermal hyperpigmentation` result from superficial scratches as in my case? There is still residual hyperpigmentation around the scar. One silver lining is that the `scar` itself doesn`t really seem like a `scar` texture-wise at this point (while simultaneously not being completely `normal` looking too). I`ll be at the 3 month mark next week. Is it theoretically possible for this wound to continue to get better? Ty

Answer:

the deeper the injury the more likely some of the hyperpigmentation will be permanent. It can still get better with time, yes. JG 8.13.13

Question:

Hi Dr. Garcia, I have 4% hydroquinone and .05% tretenoin cream to address the mild melasma on my face. Is it more effective to apply the products one at a time, waiting 10 minutes between the layers, or is it more effective the blend the two together on my hand and apply to the face together? I appreciate your advice!

Answer:

blend equal amounts and then apply. Best of luck. JG 8.12.13

Question:

Why does Retin A cause small capillaries in the face to dilate and break? I`ve been using .1% Retin A for years and love what it does for my skin`s texture and thickness, but it causes my cheeks to sport dozens of blood vessels that need to be lasered every 6 weeks. I`ve used a lower concentration of Retin A and used it less frequently than daily, but it always does the same thing. Why does it do this and what might you recommend? Thank you, Dr. Garcia.

Answer:

It is caused by the constant irritation, you should stop it and use non-irritating creams to hopefully maintain the improvements you have acheived. Might want to use Vit C creams for now. JG 8.10.13

Question:

What is the difference between SkinCeutical`s Phloretin CF and their CE Ferulic? Are they both antioxidants? Is one more powerful/better than the other? The Phloretin CF is more expensive than the CE Ferulic. Not sure if that means it`s better. Thank you, Dr. Garcia.

Answer:

The Phloretin has a weaker Vit C conncetration but has Phloretin that is claimed to be an antioxidant, enhances penetration and helps build collagen, studies to that effect compared to their CE have never been made though. I would likely say to use the C E Ferulic. JG 8.10.13

Question:

Hi Doctor, what kind of vitamin C cream would you recommend using? Heard CosMedix Pure C was a good choice. Thanks

Answer:

It is fine, as is Cellex-C. JG 8.8.13

Question:

Hi Dr. Garcia, I accidentally left my prescription tube of 4% hydroquinone in a hot car for about 5 hours. Do you suppose that the hydroquinone is still potent, or shall I get another tube to be safe? Thanks for your help.

Answer:

Should be OK but I would squeeze it with the cap on for a while to mix it all back up as it might have separated. JG 8.5.13

Question:

Hi Dr. Garcia, So sorry to bother you about erbium post surgery again, but I forgot to ask, is it the Bacitracin or band aid keeping air out that prevents scab from forming? Thank you again.

Answer:

no, it is to keep it from getting infected while healing. JG 8.5.13

Question:

Hi Dr. Garcia, I am sorry to ask again the same question about application of Bacitracin ointment and band aids post erbium laser for seb hyperplasia. You mentioned treatment for 5-7 days. I am on day 5, quite an ordeal as had so many done. I am willing to do what it take for the best possible outcome. Based on a celluar or deep skin level, what takes place on day 6 and 7? As I said, I will do whatever it takes for the best outcome. Thanks so much and the very best to you as always. kp

Answer:

usually at that time the epidermis has healed and there is no need for more ointment unless they burned you deeper than average. JG 8.5.13

Question:

Hello Dr. Garcia. Can I use cetaphil moisturizing cream around the eye area (as an eye cream)? Thanks again.

Answer:

it is a little heavy, might suggest Oil Of Olay Regenerist. JG 8.2.13

Question:

Hi Dr. Garcia. I have been using retin-a cream (0.5%) around my eye area every night for the past 8 months without problems like irritation or swelling. But I can see now that more fine lines were formed and my eye area looks more crepey than before. I`m using sunblock everyday. Should I continue using it? Is 8 months not enough to see the benefits of retin-a? Thanks.

Answer:

Might be too irritating and it is drying your skin out. Take a break from it and use a good eye skin moisturizer. Restart in 8-12 weeks at every other day. JG 8.1.13

Question:

Im the one asking about the lip plumper and the cream around mouth...thank you very much for being soo kind replying so quick!

Answer:

I wish you the best. JG 7.31.13

Question:

question about your Lip Plumper... will it plump lips in a very noticeable way ? I`ve tried many others and they just don`t work.. thanks!!

Answer:

Well at best it is mild, noticeable is a subjective thing but it will never be dramatic, for that you need injections. JG 7.31.13

Question:

Hi Doctor Garcia, what will be a best cream to minimize lines around lips and make skin smooth around mouth?

Answer:

Retin-A will be the gold standaed, but its a prescription. JG 7.31.13

Question:

Hi again Dr. G, I am very sorry for my obsessive behavior and spamming the website. You are the only doctor I have interacted with regarding my possible scar. My mom thinks I have irritated you so that is why your answers have become more to the point and contrast to earlier answers. Once again, I am sorry. I only asked the last question because I was afraid that the hyperpigment was permanent too. Thank you for your advice.

Answer:

I wish you the best. JG 7.31.13

Question:

Hi Dr. Garcia, just need to know if there is anything to get rid of freckles and moles on my body? I am embarrassed because of this and do no want to shorts or short sleeved tops. Maybe a fade cream or laser of some sort? Thanks,

Answer:

the best option would be a YAG laser but the results will not be permanent and it will likely take a series of treatments to get them to fade. JG 7.31.13

Question:

Hi, just a follow up question. If tca peel is safe around the eye area but is not effective in minimizing wrinkles, then what would be its benefit? Thanks again.

Answer:

temporarily improving brown spots. many docs use it for wrinkles but it is not effective and any improvement you see will be gone when the swelling of the skin is gone. JG 7.30.13

Question:

Hi Dr. Garcia! Is it safe to have a mild tca peel around the eye area? Is it effective in reducing fine lines and wrinkles (eye area)? Thanks.

Answer:

safe, yes, effective for wrinkles, no. JG 7.30.13

Question:

Hi Dr. G, I am sorry for having spammed you with questions about my scar. It has caused me a lot of distress. But is this a situation where I should just ignore the area for a few months and see what happens? Sometimes it likes fine and others it doesn`t. The texture is still unlike the rest and the color is beige. But you are saying all of this is permanent as well as the hyperpigment halo?

Answer:

All of the quesions you ask repeatedlly have been answered on mutiple occasions previously. You are now spamming the site you are not going to have any further questions answered. JG 7.29.13

Question:

Hi dr. G, this is the scar guy. So no hope whatsoever? Is the hyperpigmentation permanent too? I just dont know why it has become this way....

Answer:

likely so. JG 7.29.13

Question:

Hi Dr. G, this is the `is it a scar guy`. Its now been 2 months. The inflammation seems to have gone down ever so slightly. However, the color and the texture issues remain as previously mentioned. The wound site seems to have a smoother texture than my normal skin. The hyperpigmentation surrounding the wound has also gone down but is still noticeable and creates a stark contrast between the wound site and the surrounding healthy skin. At this point time, should I come to accept that this is a scar? I cant believe it turned out this way when all that happened was a scratch.

Answer:

I think you should accept what you see as permanent. JG 7.29.13

Question:

I bought some Elastiderm cream at my plastic surgeon`s office at the recommendation of the aesthetician. The consistency is like Silly Putty. Honestly, it feels like rubber. It doesn`t absorb into the skin at all; it just sort of balls up on top of the skin. I can`t find any directions with the product on or online about diluting it with some kind of oil or cream; but it clearly needs something. Are you familiar with this product? Is it just me or is this stuff a total waste of money? Thank you for your valuable time, Dr. Garcia.

Answer:

You can try warming it up before applying it but mixing it with other creams is not suggested as it will lessen the effects of the ingredients. I no longer use Obagi products as Dr Obagi has left the company and has formulated his own new line. JG 7.28.13

Question:

I got a tube of 4% hydroquinone for some mild melasma on my face. Do I have to use it twice daily, or can I get decent results by just using it at night? I do layer it with tretenoin at night. And of course,sunblock in the day!

Answer:

It will work with once a day, just slower, and adding Retin-A does help it work faster also. JG 7.25.13

Question:

Hi Dr. Garcia, I`ve had a tiny cyst next to my nose for the past three months that has resulted in a small patch of redness. I put 1% hydrocortisone cream on it for a few days, and it seemed to flatten it out, but the redness increased. I stopped using the cream and the tiny cyst came back. My questions are: A.) What the heck? and B.) Is there anything I can do to heal this? It`s far too small for a cortisone injection and v-beam was ineffective. Thanks!

Answer:

A laser will help the redness but the redness in this case is due to the cyst being irritated and not worth doing a laser. I never recommend steroid injections to a cyst due to the potential tissue atrophy around the area. Topical steroids will not do much and can make the skin thinner with extended use. You need to get the cyst treated by either cutting it out or at least having it drained by a dermatologist.JG 7.24.13

Question:

Hi Dr. G, this is the `is this a scar?` guy. I apologize for my last question. I am just distressed I suppose.
Do you believe that all wounds that heal by second intention will result in a scar?
As you know, my wound did not form a scab. It healed from the bottom-up it would seem.
I promise this is my last question since I think I`ve asked you everything.
After I shower, the skin looks much more blended in but after the day goes on, the texture looks much more different.

Answer:

' '

Question:

Hi Dr. G, this is the `is this a scar?` guy. I apologize for my last question. I am just distressed I suppose.
Do you believe that all wounds that heal by second intention will result in a scar?
As you know, my wound did not form a scab. It healed from the bottom-up it would seem.
I promise this is my last question since I think I`ve asked you everything.
After I shower, the skin looks much more blended in but after the day goes on, the texture looks much more different.

Answer:

' '

Question:

Hi Dr. G, this is the `is this a scar?` guy. I apologize for my last question. I am just distressed I suppose.
Do you believe that all wounds that heal by second intention will result in a scar?
As you know, my wound did not form a scab. It healed from the bottom-up it would seem.
I promise this is my last question since I think I`ve asked you everything.
After I shower, the skin looks much more blended in but after the day goes on, the texture looks much more different.

Answer:

' '

Question:

Hi Dr. G, this is the `is this a scar?` guy. I apologize for my last question. I am just distressed I suppose. Do you believe that all wounds that heal by second intention will result in a scar? As you know, my wound did not form a scab. It healed from the bottom-up it would seem. I promise this is my last question since I think I`ve asked you everything. After I shower, the skin looks much more blended in but after the day goes on, the texture looks much more different.

Answer:

whether there will be a scar depends on how deep into the dermis the injury wen Form what I have sen on you, it will likely not leave a visible scar. The texture changes on the other skin due ot oils and small amounts of dirt that stick more on that skin as it is older and not recently peeled. JG 7.22.13

Question:

Hi Dr. G, this is http://imageshack.us/a/img23/4104/k6qc.jpg yet again. In my last question, you said that the skin of the wound area was that which has not improved. Does that mean it could still improve? I guess my question is, even at the 2 month mark (next week), could the texture continue to `heal` (possibly look like it used to?)? thank you and sorry for my obsessiveness

Answer:

As I gave said multiple times, it will still improve. As to your obsessiveness, yes, it has become a problem for you and I think it best if you take stock and be patient. I wish you the best. Please refer to all my prior answers as your questions have been answered. JG 7.20.13

Question:

One more concern. Dr. G, isn`t it bad that its been 2 months since i initially scratched myself and the texture is more or less the saame? Its definitely not the same texture as the surroundings. At this point in the timeline, wouldnt this indicate a scar?

Answer:

no it would not, it is the remaining skin that has environmental damage that has not been improved. JG 7.20.13

Question:

Hi Dr. G, this is the `is it a scar?` guy again. Thank you for your response. I am worried about the color though still. Is it possible that it may return to my normal tone (brown)? Can shallow abrasions/excorations get their color back? I feel like i am going to be left with this patch of lighter skin.

Answer:

As I have said before, I do think in time the color will likely return. JG 7.20.13

Question:

Hi Dr. G, thank you for your response (I`m the `is it a scar?` guy). Would the beige tone of the skin be an indicator at all? It is looking much better from week to week, but the thing that stands out is the whole `skin lines` thing. All in all, it`s not as bad as when I first began asking questions here. Thank you for your answers. Very much appreciated.

Answer:

beige tone is good as if it were still very red it would point to continued prolonged irritation that would lead to a greater degree of scar formation. JG 7.19.13

Question:

Hi Dr. G, This is http://imageshack.us/scaled/large/856/298n.jpg again. Here is a new picture (today): http://imageshack.us/scaled/large/844/m1r0.jpg I was wondering : are there subtle characteristics of a closed wound that could tell us whether it`s a scar or not. Overtly speaking, this wound does not look like a scar (hypertrophic or keloid). But the skin itself is a bit brighter still than the surrounding skin. The hyperpigmentation surrounding the skin is going down which is good. I`m feeling a bit better in that it seems like it might blend in at the least..

Answer:

there is no way to tell, but even if there were, some amount of scar tissue may occur and at times leave no visible cosmetic trace while at other times it can be seen and/or felt.I think it will be fine in the long term but I might suggest stopping the laser hair removal until it is all back to normal, just to be safe. JG 7.19.13

Question:

Hi Dr. Garcia. Is diamond peel just a temporary fix to make your skin smoother? Will it only last hours or just a few days and your skin will return to normal? Thanks.

Answer:

lasts a few days is all. JG 7.17.13

Question:

Hi Dr. G, This is the most current picture: http://imageshack.us/photo/my-images/22/1fuw.jpg/ It looks good in this pic. In others, depending on the light, it looks worse. There`s a halo of hyperpigmentation. The skin texture is different from the surrounding. One thing I noticed is that the skin arrangement/`lines` are different in the wound area. It`s been almost 7 weeks.

Answer:

it will require more time is all. JG 7.17.13

Question:

Hi Dr. Garcia. Which has longer lasting effect on facial skin, mild tca peel or diamond peel? Thanks.

Answer:

about the same.JG 7.17.13

Question:

Hi Dr. G, thank you for your response. This is http://imageshack.us/photo/my-images/23/k6qc.jpg/ again. I had a follow-up question: does the pale color mean that I am still building new blood vessels beneath the skin? At week 7 almost, the tissue texture is not changing much. Ty

Answer:

correct. JG 7.17.13

Question:

Hi Dr. G, this is http://imageshack.us/photo/my-images/23/k6qc.jpg/ again. Thank you for your previous response. I had a quick question - is it normal if the wounded area is noticeably lighter in the morning? When I wake up, it appears much paler. I think its because my droom is cool. It settles down a bit and gradually gets a little darker throughout the day. The surrounding skin has been hyperpigmented this whole time too - 6 weeks now..

Answer:

yes as since the skin is still healing the underlying blood vessels play a big part in its appearance. The surrounding skin being darker makes the contrast larger and more visible. JG 7.15.13

Question:

Oh, sorry! Dermafiles are handheld instruments that are used for exfoliation. You can see an example of the instruments here: http://www.dermafile.com/ They come in various grade (fine, medium, coarse). What od you think? A good adjunct to microdermabrasion? Thank you!

Answer:

They are a waste of time and money. JG 7.11.13

Question:

Hi Dr. G, This is http://imageshack.us/photo/my-images/23/k6qc.jpg/ again. Thank you for your responses. I did feel a bit of hope when you answered. My mom said it would go away too. I had a question about wound healing. I am now in week 6 since I scratched the black spot. Based on the premise that this may heal and `return to normal`/blend, could my wound still be inflamed? Because right now it`s slightly pink and discolored. The contours/edge of the wound don`t blend in with the surrounding skin. At the same time, it does indeed `seem` like it`s still healing and the pink skin is `new skin`. My feeling shifts between thinking this is the case or that it might be a scar...

Answer:

the inflammation is likely over 50% gone but will take another 2 months for it to totally dissipate. Clinically/ visually there will be changes for that amount of time. I do not think you will have a scar there. JG 7.11.13

Question:

Hi Dr. Garcia, I was just wondering what the active ingredients in your sunblock are. Also,is it appropriate for skin that tends to break out? Thanks for all you help, it is greatly appreciated.

Answer:

it is well tolerated on sensitive skin. Active ingredients are Titanium Dioxide 4%, Zinc Oxide 3%, Benzophenine 4%, Octocrylene 7%, Octinoxate 6%.. All the best. JG 7.10.13

Question:

Hi again Dr. G, This will be the last time I comment here. Not because I have a problem with the website, but because I feel I`m dwelling on this wound. I apologize again for my obsessive questions. I am attempting to `control` my situation as much as I can by learning about it. Here is before: http://img.photobucket.com/albums/v450/NSix/IMG_0396_zpscad31564.jpg After scratching: http://img.photobucket.com/albums/v450/NSix/df85f89a-2d84-4992-a39f-655f... After skin peeled off and 6 weeks later: http://img.photobucket.com/albums/v450/NSix/IMG_0685_zpsbc6b865f.jpg In your harshest/honest opinion, do you think this will ever blend in or `return to normal`? Thank you.

Answer:

Yes but it will take weeks to months. JG7.9.13

Question:

Hi Dr. Garcia, Thanks for the reply. The technician is not treating the area of the wound. She goes around it, so it`s not exposed to the laser directly. I think I have `neurotic excoriation`. I feel really down about this. Thanks for your answers though Dr. G. I actually used to ask questions here often six years ago.

Answer:

It will get better in time, hang in there. JG 7.9.13

Question:

Hi Dr. G, This is http://imageshack.us/photo/my-images/4/ilz8.jpg/ from below, again. I had a follow-up question. I went in for my 3rd LHR today. I spoke with my tech about excoriation. She gave me `Keto-cote`. Not really what I needed though since the skin isn`t hypertrophic. I have some quick questions: 1. I had a question about the texture. The surrounding skin (forming a `halo`-like shape) is hyper-pigmented and has somewhat exaggerated skin lines. Is it possible that it may be somewhat lichenified? 2. Is it possible for the skin to `re-pigment` from it`s current beige-pink color to a `more` brown color (my natural tone)? Ty

Answer:

I do not think there is lichenification on your skin. The skin will most likely correct its pigmentation in time, but as long as you continue having LHR in that area, it will slow the resolution of it. JG 7.9.13

Question:

Hi Dr. Garcia
Do you know anything about arcona skincare?I`ve been told it`s good for post treatment care.
thank You.

Answer:

' '

Question:

Hi Dr. Garcia Do you know anything about arcona skincare?I`ve been told it`s good for post treatment care. thank You.

Answer:

I think it is a good product, nothing special or better than most others though. JG 7.9.13

Question:

This is an addition to the question below: There was no scab during the initial healing process. I moisturized the area and put vaseline or cocoa butter on the wound as it was healing.

Answer:

That is fine as long as you do not get any pimples from the products.JG 7.3.13

Question:

Hi Dr. G, This is the person below again. I have this one question left: does the fact that when I squeeze the area of the wound - it blanches - indicate anything? My normal skin doesn`t do that. In the morning, the area appears pale. Like a baise color. You said it would resolve in a few weeks. But is it normal for a linear area of skin such as mine, with this present texture - to return to `normal`? I guess my distress here has to do with the fact that its color is so different as well as the texture.

Answer:

nope. JG 7.3.13

Question:

Hi Dr. G, This is my last question (I promise). Due to the character/word-limit I was unable to add the following details: - This wound/`potential scar` is around 5 weeks old. - The LHR left a black spot, which I then scratched off. - There was no blood after I scratched the skin off. Does this change anything or alter your opinion? Sorry I did not mention this earlier and thank you for all your help.

Answer:

no, I assumed the things you mentioned. Laser hair removal can cause that if the laser is turned up a little too high but it heals well. If you are still concerned you should go back and the see the supervising physician at the location that did the laser hair removal. JG 7.2.13

Question:

Hi Dr. G, Thank you for your answer, much appreciated. I have one quick follow-up, because the wound in-question looks different in different lighting. Example: http://img4.imageshack.us/img4/7468/ilz8.jpg The healed wound/scar does not seem hypertrophic. However, it is clearly lighter. When I compare the texture, it doesn`t seem the same as surrounding skin as well. This area blanches when I squeeze it. Is that normal? Or can it indicate scarring? Thank you, and sorry for the repeat question.

Answer:

It will look like that for a short period of time as some of the more superficial skin was lost from the heat coming from the laser treatment. That skin is quite resilient and will regrow and smooth out of the next few weeks in most cases. JG 7.2.13

Question:

Hi Dr. G, I have recently started laser hair removal (LHR) again (previously underwent LHR 10 years ago). I have had 2 treatments so far spaced out at 5 week intervals. A week prior to my 2nd treatment, I noticed a small black spot on my jaw-line. I have brown skin and am of Indian descent. So this spot stood out on my face. After a few days (so the 1 month mark after treatment #1), I began scratching this spot repeatedly. I dug into the skin and peeled off the area where the spot was... There was no blood and it seemed superficial. I know this was stupid though. Here is the before: http://i.realself.com/full/601b9155a93d60a928434d6ff8009904/1013259-1834... Here is the after: http://i.realself.com/full/601b9155a93d60a928434d6ff8009904/1013259-1834... Is this a scar? Or is the skin still healing? When I squeeze the area of the healed wound/scar, the tissue blanches white. Does normal healthy skin do that?

Answer:

please see adjacent answer, I was able to access the photos on this question.

Question:

Hi Dr. G, I have recently started laser hair removal (LHR) again (previously underwent LHR 10 years ago). I have had 2 treatments so far spaced out at 5 week intervals. A week prior to my 2nd treatment, I noticed a small black spot on my jaw-line. I have brown skin and am of Indian descent. So this spot stood out on my face. After a few days (so the 1 month mark after treatment #1), I began scratching this spot repeatedly. I dug into the skin and peeled off the area where the spot was... There was no blood and it seemed superficial. I know this was stupid though. Here is the before: http://i.realself.com/full/601b9155a93d ... 834648.jpg Here is the after: http://i.realself.com/full/601b9155a93d ... 834649.jpg Is this a scar? Or is the skin still healing?

Answer:

It appears it is just healing and should not leave a scar. Stay out of the sun or use sunblock until it has totally healed. JG 7.2.13

Question:

Dr. Garcia, I am using the Obagi line, Vitamin C Serum and of course sunscreen. What do I use first the Vitamin C Serum or the sunscreen or sunblock?

Answer:

Vit C first and then the sunscreen. JG 7.2.13

Question:

Hi, Dr. Garcia. I know you`re not a fan of fractional resurfacing -- ablative and non-ablative -- but I wonder if you think Solta`s Clear and Brilliant (their Mini-Me version of Fraxel Restore) is good to use a few times a year to maintain skin`s tone and texture. It seems like it might be equivalent to a strong peel and microdermabrasion. Would you agree? If so, worth the $250/tx that my derm charges? Thank you for your opinion, as always. Have a great weekend!

Answer:

I think you would get the same or more with regular microdermabrasions at a lesser price. JG 6.28.13

Question:

Hi Dr. Garcia. Have you heard of Hydrapeel? Is this effective? Thanks. --- The Hydrapeel treatment is a new breakthrough in aesthetic technology. It takes its name format from the root word hydrate, to cause to take up moisture . This ability to moisturize the skin separates Hydrapeel from all other skin resurfacing procedures. The Hydrapeel treatment removes dead skin cells and impurities while simultaneously bathing the new skin with cleansing, hydrating and moisturizing serums. The treatment is soothing, refreshing, non-irritating and immediately effective. This revolutionary procedure offers a non-invasive, non-irritating exfoliation alternative to other ablative treatments currently in the market.

Answer:

It is less effective than traditional microdermabrasion. JG 6.28.13

Question:

hi dr. garcia. im using retin a everyday. is it ok to skip using sunblock after 5pm in the afternoon? thanks.

Answer:

As long as you avoid the sun, yes. JG 6.25.13

Question:

Is there anything in these ingredients that would do battle against sagging skin and double chins? reverse osmosis water, Relistase (glycerin, acetylarginyltryptophyl diphenylglycine, Syn-Hycan (tetradecyl Aminobutyroylvalylaminobutyric urea trifluoroacetate, magneisum chloride, glycerin), Syn-Tacks (glycerin, palmitoyl dipeptide-5 diaminobutyroyl hydroxythreonine, palmitoyl dipeptide-5 diaminohydroxybutyrate), Matrixyl 3000 (glycerin, butylene glycol, carbomer, polysorbate-20, palmitoyl oligopeptide, palmitoyl tripeptide-3), nylon-12, olivem, Renovage (triglyceride, teprenone), olive squalane, ascorbyl tetraisopalmitate, ethoxydiglycol, dimethylisosorbide, meadowfoam seed oil, trans resveratrol, spin trap (phenyl butyl nitrone), vitamin e, c10-c30 alkyl acrylate crosspolymer, leucidal, lipochroman-6, sodium hyaluronate, coenzyme Q10, tetrahydrocurcuminoids, alpha lipoic acid (R-lipoic acid), triethanolamine ? Thank you for your input!

Answer:

in my humble opinion, no. JG 6.24.13

Question:

What`s your take on facial yoga to maintain plump cheeks?

Answer:

Absolute waste of time. JG 6.14.13

Question:

what do you think of a hydrofacial? Is it just a temporary fix and if it is temporary will I see anything that day or the next days or is it a waste of money? thanks.

Answer:

very temporary, less effective than microdermabrasion. Whatever you get will be seen for a few hours to days at most. JG 6.3.13

Question:

Hi, Dr. Garcia. Happy June! I have a silly question for you. I`m 53 and have developed in the past three months four persistent pimples (2 on my forehead, 2 on my cheeks). They are superficial, hard whiteheads. I`ve had my dermatologist perform extractions twice on them, but they keep coming back in exactly the same spots. I`m using salycilic acid, had IPL and a chemical peel, Izolaz (sp?) and now topical antibiotics, but they keep coming back. My question is, why do they keep returning in the same place? If this were generalized acne, I assume it would migrate. What`s the mechanism that`s causing this? Anything else you might suggest? Thank you. I hope you and your family will have a delightful, restful and safe summer, Dr. Garcia.

Answer:

Does not sound like acne, more like a cyst. Can try Retin-A but you might end up needing them cut out. JG 6.2.13

Question:

I am thinking of those laser that target dark spots. To get rid of skin colored seborrheic keratosis, could I apply a black marker on them so a laser can target or zap them? I have so many of them that I just want to target the skin growth instead of also damaging surrounding tissue like liquid nitrogen does. Is there a better to treat this?

Answer:

The lasers that are best for SK`s are ablative laser like CO2 or Erbium so color does not matter. Done properly therw should not be any damage to the surrounding skin if appropriate spot size is used. JG 5.29.13

Question:

What is your opinion of lifecell? Is it worth the money?

Answer:

if you mean the skin care line, I think it is a lot of hype and very overpriced. JG 5.29.13

Question:

I have a 20% glycolic wash and the Dr. Brandt microdermabrasion crystals. I have had in office TCA peels with microdermabrasion in the past and was wondering, do I put the gycolic acic on for a few minutes and then wash it off and then use the microderabrasion crystals or do I use the microdermabrasion crystals first then finish with glycolic wash last? I am a male with decent skin but noticing some small crevice and crepey like surface issues.

Answer:

Microderm first, then the glycolic. JG 5.25.13

Question:

What is your opinion of the Murad Resurgence line of products? It claims to treat the dermatological symptoms of hormonal aging. Is it as effective as, more efective than or less effective than using bio-identical OTC estriol and progesterone creams? It claims to be safe for women who have or who have had cancer, so I`m assuming that its ingredients are significantly milder than OTC hormone replacement creams I`m using. Is that right? Have you had patients who have used these products? Thank you.

Answer:

The bioidentical creams are more effective, l do not think Murad is any better than the others out there, just marketing. JG 5.19.13

Question:

Hey Dr. I just had botox for the first time a month ago and like it. Thinking about getting Juverderm for my nasal folds, I am 48 and want to look younger for my age. Is this something I will have to continue to do and is there side effects to this injectable? Thanks

Answer:

minimal side effects, little things like a temporary bruise, but if you like the look you will need to continue it as it does not stop the aging process. JG 5.16.13

Question:

I `m 55 and recently moved (just two states away on the East coast -- no difference in regional aesthetic sensibility) and have been looking for a new PS. For years I have had 50 units of Botox to my glabella and forehead and 10 units lateral to each eye for a total of 70 units. I`ve consulted three practices and they are all appalled by that amount, saying it`s way too much and that they never use that amount on any patient, that that amount makes people look done and plastic They usually only use 25 to the glabella and forehead and 6-8 lateral to each eye. With 70 units, I still have expressive movement in my face, just no dynamic forehead lines or crow`s feet. I`m writing to ask what you make of this. Is 70 units unusually high? With less, I tend to get terrible wrinkling. Thank you for your valuable time and opinion.

Answer:

the dose needed for a certain effect varies from patient to patient, people with strong muscles need more, so there is no right dose. If you were getting 70 units, that is likely what you need and getting less will leave you with continued animation that will require more Botox at a later date. If they will only do a certain amount I suggest you ask them what they will charge you after a week or two to inject more. wish you the best. JG 5.15.13

Question:

What is your opinion of dermarolling to help with certain scarring? Also, what is unique about your cell matrix cream? Does it help with textural issues? Thank you.

Answer:

waste of time. Our cream does soften skin texture by increasing cell membrane stability, it does not reverse aging effects but slows its progression.It is a mix of ingredients that exist in many other products but to as high of a level that we can dissolve in the base cream. JG 5.15.13

Question:

hello , in your opinion, how important is using the Obagi day exfoliating cream right after the obagi 20 percent serum drops? What does the cream do and or is it something I should forego. ? I am seeing the drops of the serum work much better. Thank you

Answer:

It all works better together for better absorption. JG 5.11.13

Question:

Hello, my skin is extremely dry. I have used your cell matrix cream, and squaline oil and my skin is still extremely dry. Within two hours I have to reapply the squaline oil to hydrate my skin. Is there any other product that I can use to hydrate my skin. I am thinking it might be hormone related but my skin on my body is not dry. I did have a facelift, lower bleph and brow lift a year ago. Your help would be greatly appreciated.

Answer:

I do not think it is hormonal and I think the best thing is to keep reapplying the cream or oil, anything longer lasting will just sit on the surface and not truly hydrate your skin, just merely lay on top of it. JG 5.8.13

Question:

If you have dissolvable stitches that are either infected or your body is reacting to, is it best to have the scar revised again when the area is healed without puss oozing out or is best to have it revised right away to remove all the dissolvable stitches underneath skin although the area has oozing scab on it? The wound seems to be spreading or getting bigger and bigger, but there is red inflammation around the wound, which makes it harder to see the exact outline of scar.

Answer:

Best to allow the infection to resolve first, otherwise the new incision can become infected right away. JG 5.7.13

Question:

Hi again, Thank you for answering my last question about progesterone cream!! So for a 37 year old female that is still menstruating, the cream would be used mid-cycle (day 14) until day 28? Is that correct? Thanks again for your help.

Answer:

Correct, just two weeks. JG 5.4.13

Question:

Hello, I have a problem with acne flare-ups before my periods. I also have some thinning hair and facial hair. My sister suggested progesterone cream used during certain times (which has worked for her); however, someone else told me that progesterone will actually CAUSE acne? I`m confused. I thought it was the testosterone that caused acne/facial hair and that progesterone blocks this? Who`s right? Thank you in advance for your help and knowledge.

Answer:

Progesterone will help as it will slow the conversion of testosterone to DHT, it is the DHT that causes the acne, so progesterone will help the acne and the thinning hair. JG 5.4.13

Question:

I have an embarrassing non-cosmetic simple medical question for you. Out of nowhere, I have developed three painful pimples on my labia. They can`t be an STD because I haven`t been sexually active for over 10 years and even then had just one partner for thirty years. Might tea tree oil help? Any other suggestions?

Answer:

Yes, tea tree is fine and hot sitz baths and they will open up and drain. JG 4.30.13

Question:

Hey Dr. Garcia, what do you think about Radio Frequency Facial and Neck Skin Tightening and contouring. Reduces lines and wrinkles and also gives a lift to the face. Known as the Princess lift. Reactionâ„¢`s breakthrough technology lifts and tightens the skin giving you a youthful apperance. Is this lasting results you think??

Answer:

lots of hype about it, I think it will work in some people, but not in most and there can be loss of fat in unwanted areas too.No one knows how long it will last if it works. Sorry. J 4.26.13

Question:

I started using estriol and progesterone creams 4 weeks ago To improve my skins texture. This week I have started to develop many small superficial pimples. Is this a common reaction? I`m using a salicylic acid face wash and toner to help with this situation. Is there anything else you might recommend?

Answer:

it can happen due to the carrier the hormones are put into for the cream. Try using a little less and it should clear up,or get one with a different carrier cream. I think what you are doing is all I would do for now. JG 4.25.13

Question:

What do you think of Hydroxatone as a temporary , daily cosmetic aid to blur wrinkles? Same ingredients as L`Oreak`s Miracle Blur or as that product from South Asia Nanoblur? Cosmetically effective? It`s pricey, so I don`t want to waste my money if it`s not effective. Thanks!

Answer:

it will blur them as l;on as the cream is on your face, once it rubs off they will come back. Pretty much the same for the other ones you mention. Effective but might last a couple of hours or so.JG 4.25.13

Question:

What product would be the most effective for wrinkles on the neck, Retin A or your peptide cream? Thank you

Answer:

for the neck, likely Retin-A. JG 4.17.13

Question:

Hello, Is Tretinoin Cream 0.05% the same a Retin A ? I am using your Cell Matrix Peptide cream and do not know if I should use the Tretinoin Cream as well. If so how long should I wait before applying it. Which would I apply first? What is the standard wait time for apply different cream or do you have to wait at all. Thank you

Answer:

I do not think you need to add the Retin-A or Tretinoin, they are the same , unless you are trying to remove brown spots. If you do, then wait ten minutes in between application. Apply the Retin-A first. I always suggest at least 10-15 minutes between any creams to allow the skin to absorb the product. JG 4.16.13

Question:

What do you think of the Perricone line of products? Anything special about his Cold Plasma neck cream?

Answer:

over-priced and over-hyped, I think his neck cream is no better than many others out there.JG 4.15.13

Question:

Would a Microneedle Roller help gently stimulate collagen & elastin production to reduce the appearance of scars, wrinkles, & imperfections ??? Not looking for a miracle, just some improvement. Thank you for your insight, I appreciate it much

Answer:

sorry, lots of hype and I do not think it will work. If it did, it would work by creating scar tissue and not soft pliable collagen. Save your money. JG 4.7.13

Question:

hello dr. garcia. can i use bio oil to moisturize the eye area after applying retin-a around it? thanks.

Answer:

Should be fine to do as long as you wait at least 15 minutes for the Retin-A to absorb. JG 4.1.13

Question:

Hi Dr Garcia. I just read your answer to the question about little bumps that form in tear duct area with aging making the texture look bumpy. I have had them for two years and now are getting them down the sides of my nose down to the corners of my mouth. Ugh. I`m having IPL for rosacea - would that help? Or salycylic acid? They are driving me crazy.

Answer:

might have your dermatologist just hyfercate( he fancy way to say burn) them off. They will come back slowly over time though. I do not think IPL will help them. I wish you the ebst. JG 4.1.13

Question:

I heard that using tissues or any paper product to cleanse the facial skin would damage the skin.Do you think this is true? Thanks

Answer:

I think as long as they are soft and smooth that there is no damage. JG 3.30.13

Question:

What are those little bumps that form in tear duct area with aging making the texture look bumpy?

Answer:

usually just plugged oil glands that can be opened by your dermatologist. JG 3.30.13

Question:

If ou had recent scar revision out of state, will the scar stretch if it still has stitches and you go on airplane? I do not know if air pressure makes scars stretch more?

Answer:

Should be safe. JG 3.29.13

Question:

Hi Dr. Garcia. I just had the third IPL in a series for rosacea. My face broke out like crazy and now I have whiteheads and blemishes in addition to the redness. Is this normal? The technician did increase the intensity this time.

Answer:

yes because the IPL is purging deeper pores of the oils, it will all settle down and once the Rosacea is better controlled it will happen less. I wish you the best. JG 3.22.13

Question:

Moisturizer first and then sunblock or sunblock first and then moisturizer? Of course, I wait about 10 minutest between the applications. Thanks!

Answer:

Sunblock first. JG 3.21.13

Question:

What do you think of Strivectin for fine lines on the face? The manufacturers purport it to be a good treatment for stretch marks, which cannot be true, of course; but if they`re making such an ambitious claim for something it cannot do, I`m wondering if it might be effective on a much smaller version of the strectch mark problem ---i.e., fine facial lines/loss of elasticity. Thanks so much for your amazing generosity to all your readers. We all wish we lived in Las Vegas just so we could see you!

Answer:

I think if your skin is recently weathered there would be a change, but I do not think you will see much reversal, possibly a slowing down of some issues from progressing or a better hydration of the skin.I wish you the best and if you are ever visiting here, stop by and just say hello! JG 3.14.13

Question:

Is there any machine that can actually lift the face any without a facelift?

Answer:

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Question:

Is there any machine that can actually lift the face any without a facelift?

Answer:

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Question:

Is there any machine that can actually lift the face any without a facelift?

Answer:

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Question:

Is there any machine that can actually lift the face any without a facelift?

Answer:

sorry, but no, it is all hype. JG 3.13.13

Question:

hi doctor, i dont know why some questions you are not replying ? Is there any reason?

Answer:

Not sure, will ask my webmaster, sorry.

Question:

Hi Dr. Garcia. I asked a question that was eaten by your server too. I am wondering how many IPL treatments I might need for rosacea? I have had three and am told by my derm that I may need six. That`s a lot! Any way to tell when enough is enough? I have troublesome whiteheads in addition to the flushing and broken capillaries. Thank you!

Answer:

The number of sessions varies, depends on how severe the rosacea is and the setting on the ipl and you will need sessions to control it, it will not stop it permanently. JG 3.9.13

Question:

Hi Dr. Garcia,can retin-a help with either removing or at least fading old acne scars? Thanks.

Answer:

Maybe to recent brown spots. JG 3.6.13

Question:

Oops. I meant to type, I try not to PILE products onto my face ! Sorry.

Answer:

I figured.

Question:

Hi, Dr. Garcia. I try not to file products onto my face, but I do like to use several different kinds for different reasons. Will I get the maximum benefit from various products if I leave them on for an hour or two and then rinse my face to apply another product, leaving that product on for an hour or two and so forth? I`m thinking especially about days when I am at home like a Saturday and I might want to give myself several different treatments; or if I get home from work early enough at night, I could apply some products, rinse them off, and then apply products to sleep with overnight. Thanks for your guidance.

Answer:

well, that type of application has not been looked at for effectiveness, because most people do not do that. The time period for which a product needs to be on the skin for the active ingredient to be totally absorbed has also not been studied, but common sense would make us think its a few hours, so if you wanted to follow the regimen you describe, I see no problem in doing it but I cannot say how effective the staged application will be. Likely just as effective to use one product at a time for a week and then switch to the others. I guess that will depend on the individual product ingredients and their intended purpose and effect. I wish you the best. JG 3.5.13

Question:

Hi Dr. Garcia. I have a relatively new surgical scar on my hand. I would like to wear make up on it that also contains mineral sunblock to protect the scar from darkening. Is there a particular type or brand of makeup you recommend for this purpose? I would like something that adheres well, is long wearing, and has mineral sunscreen. Thanks for your help.

Answer:

All of the makeup I have seen has sunscreen and not sun block.I think Dermablend is going to be your best bet but you will likely need to re-apply the makeup as it will get rubbed off your hand I am afraid. JG 3.1.13

Question:

Hi Dr. Garcia! I have read about rebound pigmentation from Hydroquinone. Is this possible to happen if there is no sun exposure or indoor light exposure? Is it a reaction that happens to the skin or does it only occur from UVA/UVB exposure? Thank you!!

Answer:

that should not happen but some people find Hydroquinone very irritating to the skin, and in those cases, continued irritation can lead to the body creating a pigment change in an attempt to protect itself even without UVA/ UVB. So HQ will prevent the sun/ light created spots but can cause pigment changes due to its potentially irritating nature. JG 2.28.13

Question:

Hi Dr. Garcia. My skin does not tolerate daily hydroquinone. I have some very faint hyperpigmentation. Is it possible that a series of PCA chemical peels could lessen the hyperpigmentation even though I am unable to use daily HQ?

Answer:

yes, it is possible, especially if it is a recent development, the longer the period of time the spots have been there, the more difficult it is to get rid of them, and anything you do to rid yourself of them is temporary as the skin has memory and the spots will come back in time. JG 2.27.13

Question:

I meant to write that he uses only 8/side, total of 16 units. Sorry!

Answer:

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Question:

Hi Dr Garcia. Two years ago I had a series of four IPL treatments that greatly helped my rosacea flushing and also acne/clogged pores. Would I now need one annually to maintain? My dermatologist says I need another four and I don;t want to spend the money if it is unnecessary. In your opinion what is a good maintenance plan? Most articles online talk about shrinking pores and building collagen, which is great, but I am really just trying to keep rosacea under control. Thank you!

Answer:

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Question:

Hi doctor, my birthday is approaching and i will be 46. I intend to buy a brand product for my skin, could you advise me which brand should i buy for best results. Thanks again for your valuable advice

Answer:

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Question:

Dr. Garcia, I read everything here on sebaceous hyperplasia. In the past, I think I have had them hyfercated (I called it burning them off). I was satisfied. Now my derm. tells me he doesn`t want to do that but wants to use laser genesis. You didn`t seem to keen on laser removal. From what I have read of this laser it doesn`t do much of anything? Thanks for any information.

Answer:

you can use a laser to hyfercate/ burn them, just costs more for the same effect. Genesis will be no better, sounds like he is trying to pay off the Genesis purchase by using it for other things. JG 2.18.13

Question:

Hi Dr. Garica! I was using a compound RX of HQ 4%, RA .05% and steriod for melasma and PIH from laser. My doctor gave me a new compund of HQ 8%, RA .025% and Vitamin C 10%. I was thinking that since I wasn`t irriated from the .05% RA that I should still use that as I know you said that the Retin A does more for removing pigment that is there already and the HQ supresses it. Do you think I should get another RX for the .05% instead of the .025%? And how do you feel about Vitamin C? Good/Bad? Lastly, is it possible if I get the Rx for .05% RA that I can mix in into the compound I have or do you recommend another compund Rx already mixed with it? THANK YOU!!!! I value your opinion.

Answer:

I think a stronger RA is needed and I think the effects form Vit C are mild at best for spots. It is an acid so it will help some, but much less than the RA.I think you can mix the 0.05 into the already present cream as it will dilute the RA to some degree and should not be a problem.Best of luck. JG 2/15/13

Question:

From reading this blog, I see that you don`t think chemical peels are useful for wrinkles and not as effective as lasers for dyschromia. Do you think they are of any value at all? If so, for what? Thanks so much, Dr. Garcia.

Answer:

yes, for recent superficial spots they work well, but not on long-standing spots. JG 2.13.13

Question:

What do you think of Pelleve?

Answer:

I have to say that it is mild at best. JG 2.12.13

Question:

I started using your peptide cream , pea size amount at night and my skin feels dry. Is it okay to use squaline oil as well. Thank you

Answer:

Yes, OK to use both. JG 2.10.13

Question:

Which regimen is more anti-aging: tretinoin .05% nightly, or tretinoin .1% every other night? Thanks for your advice!

Answer:

I believe the 0.1% every other is likely better but more irritating and harder to toelrate. JG 2.4.13

Question:

Hi. I am wondering how long you would advise a patient to wait before using peptide serum or squalane on the face after having dermabration? Is there anything else that you would recommend for healing? Thank you for all your help!!

Answer:

Ince the top layer is healed it is OK, time depends on how deep the dermabrasion went. JG 2.4.13

Question:

I started using your cell matrix peptide cream and squalane oil for very dry skin. Squalane oil in the morning and the peptide cream at night. What are the ingredients in the peptide cream. I was told that the peptide cream would be good for my dry skin. Thank you

Answer:

There are 5 proprietary peptided meant to stabilize cell membranes, for most people that is enough. JG 2.4.13

Question:

I got a custom made lotion with 7% hydroquinone and 0.05% tretinoin. I was so excited to use it to even out skin tone and fade dark spots but the 0.05 Tretinoin is making it difficult to use frequently. My face is easily reddened if I use it 2-3 days back to back. How can the adverse effects be reduced while optimizing the benefits of the cream including the retinoid? Is there anything I can pair it with or use over? Thanks

Answer:

I believe the problem is not the retinoid but the excessively high concentration of the hydroquinone. You can dilute the cream with a moisturizer before you put it on until your skin gets used to it and then decrease the moisturizer a bit as you adapt to the irritant effects.Best of luck. JG 2.3.13

Question:

I have a lump on my chin that hurts when touch it. I thought it was pimple, but retin-a cream has not helped it go down. If it is a pimple, is there some type of shot that can decrease the bacteria? Or how do I get the trapped bacteria out?

Answer:

might suggest seeing a dermatologist and they might consider injecting it wit a steroid to settle it down. JG 2.1.13

Question:

Hi, Dr. Garcia! Do you have any opinions about Olay`s Pro X Tone Correctiing Protocol, which is a new product in their line? Based on its ingredients, do you think it can deliver what it promises? Thanks, as ever, for helping us all to save our pennies and to spend them wisely. I hope you and your family are in good health, body and soul!

Answer:

Good product for a non-prescription. All the best. JG 1.29.13

Question:

Hi Dr. Garcia, regarding the question below about the tyrosinase inhibitor cream 5%, I`m using it mixed w/ retin-a for the whole face and not for spot treatment. I`m using it to maintain my slightly fair complexion.. Is it ok as a daily regimen? Thanks. :)

Answer:

if you avoid sun and use total sunblock you should stay that way with less product on your skin. There are no long term safety studies for tyrosinase inhibitors as they are meant for use until spots are faded and not as prevention. I do not recommend it for long term daily use. JG 1.23.13

Question:

Hello Dr. Garcia. Is it safe to use tyrosinase inhibitor cream 5% everyday for the facial area? Thank you.

Answer:

if it does not cause irritation, it is likely safe but it is not usually need to be used that often once the brown spots are gone. JG 1.23.13

Question:

What do you think of the skin biology product line? I`m trying to repair damage from a fraxel restore treatment-pin prick scarring etc.. Also do you recommend any particular supplements for damage repair? Thanks

Answer:

they are pretty good products, as to supplements for repair,the B`s and C Vitamins are the best. JG 1.22.13

Question:

if hypopigmentation is just temporary ... does the hypopigmentation become permanent if the hypopigmented area does not become exposed to uv rays for like 1 year after having the hypopigmentation ? does the temporary become permanent after a certain period of non exposure to uv rays ? and if it does become permanent , what is the period of time that we are talking about , 6 months ? .. 1 year of non exposure to uv rays ? , thank you for your time

Answer:

no, it does not become permanent, but the longer you go without sun exposure the longer you will look uneven. JG 1.21.13

Question:

What do the micro current face lift machines do for the face?I mean do they do any lifting or decrease wrinkles at all. If so,would the results be long lasting? Thank You

Answer:

Sorry, waste of money in my humble opinion. JG 1.20.13

Question:

hi , if hypopigmentation following a chemical peel is only temporary and not the permanent kind... is there like a grace period beyond which the temporary hypopigmentation will become permanent already ...i am asking this because i have hypopigmentation and i really really hardly go outside the house or do outdoor activities... i really live a sedentary lifestyle and i only like go outside of the house like once every two months and i only go outside for a brief period .. so the areas on my face that have hypopigmentation rarely gets exposed to uv rays .. will this cause the hypopigmentation ( given that they are the temporary kind and not permanent ) to become permanent if i do not routinely expose them to uv rays say for like a year after having them ? youtube downloader

Answer:

in order to see if the pigment loss is permanent you will need either sun exposure or a tanning bed, just short term to regain some pigment, but not extended periods of teem to avoid the aging effects. JG 1.20.13

Question:

Is there any treatment for melasma for asian skin type? thank you so much for you answer in advance. Kati

Answer:

I would only use Retin-A with either hydroquinone or Kojic acid. JG 1.16.13

Question:

Hi dear, what do you recommend as daily routine for acne prone face. I am 34 and have this bloody problem since my adolescents age. have been using Retino A and benzyole peroxide, but they don`t work recently. please help out. Arzhang

Answer:

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Question:

Hi dear, what do you recommend as daily routine for acne prone face. I am 34 and have this bloody problem since my adolescents age. have been using Retino A and benzyole peroxide, but they don`t work recently. please help out. Arzhang

Answer:

might consider getting some beta-hydroxy acid peels at a spa, I also think fotofacial/ IPL`s help decrease break outs, as well as microdermabrasions. Otherwise it might be Accutane time, but I would like to avoid that if at all possible. JG 1.16.13

Question:

Which copper peptides do you recommend? should they have exp. dates on them? Thank you.

Answer:

Have not seen expiration dates, might suggest the Kinerase copper sold on Amazon. JG 1.16.13

Question:

My daughter who suffers from persistent breakouts of little pimples on her forehead and temple went to the doctor who does my botox injections yesterday for some help. The doctor gave her cleanser and topical treatment to use daily and also recommended that she have a light chemical peel soon, and then come in for additional peels on an occasional basis after the treatment starts working. She told my daughter that the reason products stop working is that dead skin and other gunk build up and need to be removed. She said mechanical exfoliators are probably not good for her skin because it`s on the sensitive side and that a light chemical peel would do the trick. She also said she may introduce a retinol product into my daughter`s treatment depending on how things go. My daughter is 19 --- does this doctor`s advice sound reasonable to you? Thank you.

Answer:

Yes., accuarate and reasonable. JG 1.13.13

Question:

I had hand surgery 6 months ago which has left with me with a large scar. I have been using Scar Away (silicone sheets)for the past 5 months. Is there benefit to continued use at this point? Is there any harm in continuing to use the silicone sheets beyond 5 months?

Answer:

It can help for 12 minths. JG113.13

Question:

Which copper peptide product do you recommend for help with post laser healing? Thank you.

Answer:

Kinerase is good and sold on Amazon. JG 1.13.13

Question:

Hello Dr. Garcia. I just wanna ask a couple of questions. a.) Is it okay to mix a pea size of retin-a and a pea size of tyrosinase inhibitor cream 5% for the face before going to bed? b.) And is it also okay to use this mixture around the eye area or will the tyrosinase inhibitor cream cause more harm than good? Thank you.

Answer:

Good to go on both as long as it does not get it into the eye itself. JG 1.7.13

Question:

Dr. Garcia, do you like Obagi Blue Peel? My plastic surgeon is recommending it for my hands. He regularly has great results. What do you think? Thanks. Happy Holidays!

Answer:

Good for the face, so so for the hands. JG 12.21.12

Question:

Happy Holidays Dr. Garcia ! Question : I have used estradiol cream under my eyes twice this week (Monday and Tuesday). Is it ok to now do a 25 % TCA peel? Thank you so much

Answer:

yes, should be fine. JG 12.20.12

Question:

Thank you for answering my question about Benzyl Peroxide. I am going to advise my son to stop using Benzyl Peroxide and to try something milder. Do you think switching to a milder cleanser (no BP or salicyc acid) and using Clarisonic or other similar exfoliators will help to maintain skin that is under control? (He hasn`t had extensive breakouts at all since using the Benzyl Peroxide)

Answer:

it should, but he might need to use the BP every once in a while, I would not be too concerned about it.JG 12.19.12

Question:

Hi Dr. Garcia. My 26 year old son started using Oxy Wash with 10% Benzyl Peroxide 2 years ago to help clear his skin from persistent breakouts. It did the trick, and he continues to use it every day. I was told by the esthetician doing my facial yesterday that the safety of Benzyl Peroxide is questionable and that it is considered a possible carcinogen. Do you know anything about this and would salycic acide be a better choice? Thank you.

Answer:

any constant irritation can cause problems but I think the risks of cancer with benzoyl peroxide or overblown. Salicylic acid is good too but also would carry the same risks, I suggest using it for as short of a period of time as possible, then stopping as it can always be restarted. I wish him the best. JG 12.19.12

Question:

Thanks once again for educating us so well with your responses! I have always read that Retin A is the gold standard for skincare, but recently had an aesthetician tell me that, in time, it thins the skin and veins will be evident. She also doesn`t care for microderms as much as IPL . I`m trying to do the right thing for my skin but always get conflicting information from various medspas. I am 55, have very minor wrinkles and great skin texture, other than enlarged pores on my nose. I use Retin-A .1% daily, Vitamin C serum 2x`s daily, and sunblock daily. I used to get microderms every other month to help clear my pores and an IPL maybe 3Xs per year. Am I doing the right treatments for my skin which is rather oily? Do IPLs continue to help once your skin texture and tone is good?

Answer:

Retin-A is fine, but take break for three months every year, it might be better in your case for an ipl every 6 weeks. There will be point where all of that will be stabilzation and no reversal . I wish you the best. JG 12.16.12

Question:

I`ve read that copper peptides are good for wound healing and scar tissue remodeling. Will they work on old scars? I had a lower body lift two years ago and the posterior scars are just terrible -- wide and red. After a year, my surgeon revised them but they`re just as bad the first. It`s been almost a year since the revision. Might copper peptides help them look better? And what about on new scars?

Answer:

not very effective for older scars I am afraid. Sorry. Works only on new scars. JG 12.12.12

Question:

Dr. Garcia, have any of your patients used Oxygenetix make-up following laser resurfacing? What do you think of this product line? Can you take a look at their website if you don`t know about their products to let us all know what you think? oxygenetix.com And how soon after ablative resurfacing can their foundation be used? They claim from day one, but I doubt that`s true. Doesn`t it take 10-12 days for the skin to heal before anything at all can be put on it? Thanks, as ever, for sharing your opinion and medical insights. Have a restful weekend!

Answer:

I have not had any patients use that, they usually use Jane Iredale. I do not think you should use it until the epidermis is totally healed, otherwise it will cause cysts. That might be 1-2 weeks depending on the depth of the peel done. I wish you the best. JG 12.8.12

Question:

Have you ever heard of exfolitive cheilitis? I know there is not a lot of literature on it and it is supposedly incurable... I had a 20% TCA peel on my lips a couple months ago for darkened lips and the skin on my bottom lip has basically never been the same since going through an unending process of peeling and repealing with the skin looking slightly yellow before it peels and turning white with contact of water. My dermaoligist is not saying much. I looked it up and the my condition basically looks and sounds exactly like the people who suffer from this disorder. Actually, reading up on it, I think I may have had this condition for the last few years before the peel, without knowing, but a very minor case where I would just wipe away a little dead skin from my lower lip in the morning. Now post peel it is much worse. Is there anything I can do about this?

Answer:

maybe use some copper peptide creams on it to see if it will settle down, otherwise some mild steroid creams intermittently. I wish you the best. JG 12.8.12

Question:

Hi Dr. Garcia. I have hollow skin around my eye area. Will Retin-A help in repairing and thickening the skin around it? Thanks.

Answer:

It will thicken the skin some but your problem is likely fat loss below the skin and that will not be helped by Retin A. JG 12.4.12

Question:

Hi Dr..... I just had Juvederm on nasolabial and under the eyes but i have lined up appointment for my Micro current face lift and upper lip laser hair removal in 2 days .My Q is that would that micro current facial Or laser hair removal would destroy or spread the Juederm gel on my nasolabial and under eyes area??PLEASE respond.THANKS

Answer:

Should not have any negative effects. JG 11.28.12

Question:

Is it ok to use Retin-A 0.05% around the eye area or is it too strong? And will it still be effective even if I use it only once a week and not increase it gradually for the eye area only? Thank you.

Answer:

I would start by using it every third night and then increase the frequency as tolerated. if even that is too strong, you can weaken it by mixing equal amounts of it and a moisturizer in your palm before applying it to that area. For it to give you the maximum effect, you will need to use it daily at the strongest concentration tolerable.Best of luck. JG 11/27/12

Question:

I have read that Viniferine is 62 times more effective than vitamin C: 4 times more effective than kojic acid :13 times more effective than arbutin in boosting skin radiance and fighting dark spots, is this true? Have you even heard of this product?? Thank you for your time

Answer:

`Yes, but I do not believe the hype. JG 11.17.24

Question:

Hello Dr. Garcia. What`s the less expensive alternative for Obagi Nu-Derm for wrinkles, large pores and uneven skin tone? Thank you.

Answer:

plain Retin-A and a good facial cleanser along with sunblock. JG 11.16.12

Question:

Just a ff-up question about Madonna eye lift. Is is suitable for hollow eyelids? And if I`ll have 4 to 5 sessions, are the results more permanent? Thanks.

Answer:

it will do absolutely noting for the hollowness of the upper eyelid.The only thing 4-5 sessions will do is make sad after you realize all the money you have wasted and leave your eyes the same after the swelling goes down. JG 11.14.12

Question:

Hello Dr. Garcia. Is Madonna eye lift effective? How long is the recovery period? Thanks.

Answer:

Recovery about one week, effects might last 3-6 months at best. JG 11.13.12

Question:

You say that Isotretinoin prematurely ages the skin? Is it just for the duration or course of the drug or is it a permanent premature aging of the skin?Thank You for your time:-)

Answer:

if you use it the effects will be there unless you do lasers or things such as that to help, but the prematurity of the aging will always be there, having said that, since most people use it for acne and most of those patients have oily skin with their acne, and since oily skinned patients age slower than dry skinned people, the effects might not be visible compared to someone else, just within your own person and photos, hope that makes sense.JG 11.12.12

Question:

Thanks for answering my question below. Still wondering what lampprobe is good for in general. any insight? I will check into IPL as well.

Answer:

if it was good for anything I would have one, but I don`t. JG 11.7.12

Question:

I have very good skin but want to even out some toning issues red veins around the nose and get more smoothness. I just had a microplane which I liked. Next month I want either another microplane,microdermabrasion or lampprobe. Any suggestions? Also what is your opinion about lamprobe in general? The woman suggested fraxel laser but I know you are not a fan and I think it is expensive for what you get. I have a limited budget. Thanks Dr. G

Answer:

the microdermabrasion might make the vessels more easily seen, I might suggest some IPL session for the red blood vessels and evening out of the tone. The Fraxel might be overkill for what you desire. I wish you the best. JG 11.7.12

Question:

Hi Dr. Garcia, I appreciate all your help, you are so timely and helpful with your responses, in addition, in this day and age, unbelievable such a service is offered. With a facelift that includes fat injections, is it safe to go later have laser resurfacing to the area that has fat injections in it? I am not sure how deep the fat is injected. The best to you.

Answer:

It would be safe but I would wait a while, ideally 6 months, but at least 6-8 weeks after the fat injections before a laser is done over the same areas. JG 11.6.12

Question:

I had a 20% tca peel... after 5 days I kind of got fed up and assisted the skin peeling which I shouldn`t have done and the area is now red around my nose. I`ve had many peels and I remember doing this once before and I got some pih in the same area after doing the same thing (stupid me) but it resolved pretty fast on its own. Is there anything I can put on it to avoid the pih now? I tried hydroquinone but it burned when applied so I took it off. I think it`s still too fresh. Perhaps coconut oil now (or something else?) and in a couple days hydroquinone? Thanks

Answer:

Nothing for now, once healed the hydroquinine and Retin-A. JG 11.6.12

Question:

Hello Dr. Garcia. What can you say about ZO Skin Health line by Dr. Obagi? Is it as effective as its Nu-Derm Products? Thanks.

Answer:

I think they are better. JG 11.6.12

Question:

Hi. Dr. Garcia. Sorry this is off-topic..Do you happen to know this site - http://www.dorsetstreetdermatology.com/ by MITCHELL SCHWARTZ, MD. Are they selling genuine Obagi Nu-Derm products online? Thanks.

Answer:

It appears so but legally they cannot sell you Latisse or the Obagi Retin-A product and Hydroquinone online or just by coming in to the front office. They cannot be sold without a prescription being written and that means they need to see you in person, at least once r year. But they might be skirting the law too. JG 11.1.12

Question:

Hi. Dr. Garcia. Sorry this is off-topic..Do you happen to know this site - http://www.dorsetstreetdermatology.com/ by MITCHELL SCHWARTZ, MD. Are they selling genuine Obagi Nu-Derm products online? Thanks.

Answer:

' '

Question:

Dr. Garcia, Would using the erbium laser on some deeper milia be appropriate? I think manual extraction would not be effective and could damage skin more because of force needed. Retina has not worked. Thanks for your help.

Answer:

No, I would have your doctor open them with a small needle. JG 19.27.12

Question:

Is Fraxel woth the money

Answer:

if you expect only a little improvement, yes, if you are looking for something more dramatic, no. JG 10.24.12

Question:

Dr. Garcia, Do you think it is safe to have several lesions (seb hyperplasia)in the NL lines and marionette folds lasered off with the ebium laser, 2 1/2 months before a facelift and fat injections to those areas? Thank you very much.

Answer:

absolutely OK. JG 10.23.12

Question:

Hello Dr. Garcia. Which is better between obagi elastiderm eye treatment cream and replenix eye repair cream in minimizing fine lines around the eye area? Thanks.

Answer:

not much difference. JG 10.22.12

Question:

Is Physicians Complex 6% Bleaching Cream any good? The manufacturer doesn`t specify 6% of which ingredient. It contains hydroquinone, but does this mean it`s 6% hydroquinone? I thought that could only be made by a compounding pharmacy. I`m looking for something a little stronger than the standard 4% hydroquinone. Thank you.

Answer:

well, you are correct, there is no way to tell i fit is 6%, but I have to say that anything higher than 4% is likely not going to give you any better result, it might irritate your skin more but is about all. I might suggest mixing the 4% with Retin-A 0.1% and using them in combination, that should improve the result. If that still does not help then you likely need peels or a laser.JG 10.20.12

Question:

Hi Dr. Garcia. Is it true that once you used the Obagi Nu-Derm line, you will have to depend on it forever? Bec. I`ve read from some users in forums that once you stopped using it, even for just a few weeks, your face will get back again to the exact same problems before you started using it. Thanks.

Answer:

no, but some type of skin care should be continued.The fading creams are to be used only intermittently and the Retin-A can be used as long as you take 3-4 months off every year, it does not stop the aging process though, so with time and unprotected sun exposure,your skin will get older. JG 10.19.12

Question:

Hi Dr. Garcia. Are Obagi Nu-derm products also suitable for men`s skin? Thanks.

Answer:

yes, they are suitable for men also. JG 10.17.12

Question:

Hello Dr. Garcia. Will Obagi NU-DERM Eye Cream help in minimizing wrinkles and plumping the skin around the eye area? Thanks.

Answer:

to a small degree, yes. JG 10.15.12

Question:

Hello Dr. Garcia. Do you still believe that dermarollers are ineffective? Thanks.

Answer:

always have and likely always will. JG 10.15.12

Question:

I had hand surgery 13 weeks ago. The site has healed nicely but I am left with a large nasty scar. I have been using Scar Away silicone sheets with some improvement. I am curious about retin-a. What exactly does retin-a do for scars, and could it help a 13 week old scar?

Answer:

I think it will do little, to be honest. JG 10.15.12

Question:

Hi Dr. Garcia, I have a toner that has a small amount of hyaluronic acid, it is listed as #7 on the ingredient list. If I use this toner after washing my face at night, will it impede the absorption of my retin-a?

Answer:

do not think it will impair the absorption of the Retin-A and it will be washed off when you rinse your face. JG 10.13.12

Question:

Hi Dr. Garcia, I am wondering what you think about a product like Tanda Luxe,(a hand-held device, at home version, with a light emitting head-which uses light (red light therapy specific wave length 660nm) which is supposed to increase overall cellular activity, boosting the body`s production of collagen, elastin and increasing microcirculation. There is also a blue light version for acne. I am concerned that these types of treatments may be found to actually accelerate skin aging and cancer risk. While they do not use UV light, dermatologists once thought UV treatments were safe to treat acne. I value your opinion and look forward to your response. Thanks so much~

Answer:

No one knows if they will cause long term effects, but they will not help, so save your money. JG 10.13.12

Question:

Hi Dr. Garcia! What is your opinion for saline injections for fat atrophy on the face due to kenalog injection for a cyst? I have heard they have to be done weekly but- Do they help the healing process faster or hurt it at all or is it mostly cosmetic?

Answer:

they will not help at all as once there is fat atrophy,the steroid injection that caused the problem is already gone. Sorry. JG 10.12.12

Question:

Good day to you Dr. Garcia. Will these ingredients help in reducing fine lines around the eye area? -- Water, Butylene Glycol, Soluble collagen, Sodium Hyaluronate, Carbomer, PEG-40 Hydrogenated Castor Oil, Hydroxyethylcellulose, Sodium Benzoate, Triethanolamine, Panthenol, Disodium EDTA, Potassium Sorbate, Glycerin, Fragrance, Acetyl Tetrapeptide-5, Acetyl Tetrapeptide-9, Tripeptide-3....Thank you.

Answer:

Hard to say without knowing what the tetra-peptides are. JG 10.12.12

Question:

Hello, Dr. Garcia. Would you please tell me what exactly happens during IPL to help with acne? Does the heat kill the bacteria? Or does the light do something to it? Thank you.

Answer:

the heat generated kills some of the propionobacter bacteria in the pores that causes the acne. JG 10.8.12

Question:

Hi- what is the best tx for blackheads? I use retin a and have tried all the recommendations but nothing helps! Remedies that work for others do not do anything for my blackheads. Would ipl or microdermabrasion help. I am willing to keep up with the treatments if they help (as I am guessing results would be temporary). Thank you

Answer:

`Yes, temporary, I would do both ipl and microderm, along with a good facial wash. JG 10.5.12

Question:

Good Day Dr. Garcia. Are these ingrdients good in minimizing fine lines and wrinkles around the eye area --- Water, Glycerin, Methyl gluceth-20, PEG-40 Hydrogenated Castor Oil, Carbomer, Phenoxyethanol, Sodium PCA, Hamamelis virginiana (Witch hazel) water, Sodium hydroxide, Hydrolyzed collagen, Butylene glycol, Denatured alcohol, Hamamelis virginiana (Witch hazel) extract, Benzotriazolyl dodecyl p-cresol, Dichlorobenzyl alcohol, o-Cymen-5-ol, Ethylhexylglycerin, Fragrance, Glycine soja (Soybean) protein, Ethylparaben, Methylparaben, Propylparaben, CI 14700 (Red 4), CI 17200 (Red 33)? Thanks.

Answer:

for short term improvement only,hours. JG 10.4.12

Question:

I have a limited amount of money to spend on my appearance. As a maintenance program, which do you think gives more benefit: regular IPL`s or regular chemical peels? Thank you.

Answer:

between those two, likely the chemical peel as it will exfoliate your skin much better. JG 10.3.12

Question:

Is retin-a good for preventing the signs of aging? In other words, if I do not currently have wrinkles or discolorations, can I maintain this w/ retin-a, or am I better off using a peptide cream or something like that?

Answer:

it does help the skin to some degree yes, maximum benefit is achieved in one year and then its a maintenance at best. I think a peptide cream is fine too, either one will help slow but not prevent what will come eventually. JG 10.3.12

Question:

Hi Dr. Garica, Sorry to bother you again about the laser spot question. I do understand the need to keep it moist for 3-7 days, but can a scab still form up to 7 days? Thanks much.

Answer:

yes, but only if the wound is not healing, a scab usually forms quicker than 7 days if there is no infection and the wound is not too large. JG 9.30.12

Question:

Hi Garcia, I wrote about having lesions on my face lasered. What do you believe is the optimum time to keep covered and moist to avoid a scab? I have heard 5 days or 7 days. Or is it another amount of time? What is your opinion? Don`t know what I would do without . Thank you.

Answer:

it can be 3-7 days, everyone heals at a different speed and the deeper the laser went, the longer it takes to heal.Hope that helps. Thank you also for the kind words. JG 9.30.12

Question:

What do you think of the StriVectin line of products. As usual, the before and after photos in their promotional materials are fairly impressive. Anything special to recommend them? They`re pricey. I wouldn`t mind investing the money if they are good products. Thank you.

Answer:

I think they are no better than the others out there, but they are more expensive than the others, save your money and use something else, Oil of Olay Pro line is good and less expensive. JG 9.28.12

Question:

hi dr garcia, i have a small spot on my lower back that is a mildly ulcerated due to packing and covering up for a week from the surgeon. what should i do to speed up the healing process? also i have terrible hyperpigmentation with white stretch marks on my hips buttocks area its patchy rough and uneven in tone..do u recommend retina n hydroquinone or some type of chemical peel or lasers to treat this

Answer:

I am not sure the Retin-A, hydroquinone or the chemical peels will help white stretch marks at all. As to the ulceration,hard to say without seeing you, but I might suggest neosporin and then keep it covered with a large bandage to it does not rub on your clothing. JG 9.25.12

Question:

Dr. Garcia I do not wear face make up with the exception of some light blush. Once is a rare while I will put on some powder. I use the clarisonic cleanser brush so clean my face. I have noticed that after using this I can take a cotton ball and swab alcohol/ or toner and the cotton ball is dirty. I think that our faces do not get as clean as we think they do. If one does this on the neck it is amazing to see the dirt that come off. Is this dirt or just dead skin? I am so shocked to think my face is not really clean and I don`t even wear to much face make-up. Do you recommend any cleansers? I use various ones and all have produced the same results. Thanks.

Answer:

it is a little of both. I think the Clairsonic is fine, but after you have already washed you face with a product that has alpha hydroxy acids to loosen the dead skin, the brand is really of little importance. JG 9.24.12

Question:

When considering non irritating topical cosmetic products such as peptide creams, antioxidant serums, niacinamide lotion, etc, is the benefit increased by applying the product twice per day or does the effectiveness of the product cap out with a once daily application. Thanks for your advise!

Answer:

twice per day will yield more benefit, the skin will need more and it can only absorb so much in one sitting before it gets wiped off. JG 9.23.12

Question:

Hi doctor, i intend to have an IPL treatment, could you tell me its benefits and is there any side effect. I am an asian people, i want to know if after my IPL treatment, is there any risk to have pigmentation because actually i have a normal skin.

Answer:

done properly at low levels, it is safe, but if you do not have brown spots now, I see no reason to use IPL on Asian skin, it is best at reducing brown spots, that is about all it is good at, and maybe small red spots too. JG 9.21.12

Question:

The skin on my upper lip is so different from the rest of my face, it is crepey, dry, scaly, even bumpy looking sometimes I have tried all the expensive moisture products What can I do for this ? any product? or procedure? Thanks

Answer:

try some prescription Retin-A cream next. JG 9.16.12

Question:

Hello doctor, summer is approaching and i really want to have gorgeous skin. According to many doctors, skin should be treated from inside which means lot of vitamins.Could you suggest to me which vitamins should i take daily and the dosage. thanks

Answer:

Vit C, 1,000mg per day, Vit E 400iu per day and Omega 3 Fish oils, 1,000mg per day. All the best.

Question:

OK. I`ll try the antihistamine for the swelling post IPL. Do you think icing is worth it? I`d be willing to spend the next two days with the 20 minutes on/20 minutes off thing if it`s valuable, but I don`t want to do it if it`s mostly a waste of time. Thank you for your advice!

Answer:

after the first 24 hours the effects are not dramatic and likely of little benefit. JG 9.7.12.

Question:

Thank you for your reply to my questions about pigment, Dr. Garcia. May I 2 further questions? 1) Based on your answer, I am deducing that there is a finite limit to this pigment problem -- that after a few IPLs, we will have treated all the pigment that rises to the surface of the skin and that it will be gone for good. Is that right or is this sort of an endless process? (I use a broad spectrum physical sunblock, applied throughout the day, all year long. I think this is old sun damage I`m seeing now.) 2) Thank you for guarding my wallet re the chemical peels! Very helpful information! But ifI did want to do one peel just to freshen my skin and even out the tone, how long after IPL do I have to wait to do it? Cheerio from London!

Answer:

well, your assumption is true, partially. That is because the accumulation of sun and fluorecsent light damage that produces spots will continue to aggregate. Also, the removal of the pigment is temporray as the melanin cells that are treated to fade have memory and with proper stimulus, will repigment. The sunblock you use will certainly slow it down considerably.As to the peel, wait about 7-10 days at least. All the best and congrats on a great Olympics production! JG 9.7.12

Question:

I had IPL yesterday and am really, really swollen. I have a busy day today and all through this weekend. I will cancel some things to take the time to ice and the time to be a bit groggy from taking an antihistamine if you think it`s worth the time; but if you think it`s just a waste of time, that it won`t effect much improvement for the investment of the downtime, then I`ll skip it. What say you? Enjoy your coming weekend, Dr. Garcia! Thanks for the help.

Answer:

I think the antihistamine is OK and should help some. I do not think it will have a negative effect on the end result. All the best. JG 9.7.12

Question:

Dr. Garcia, Have you seen fat injected into the orbital rim cause lumps in any cases? Do you inject fat there, or because of potential lumps, prefer Restylane? Answers much appreciated.

Answer:

I have seen that frequently actually.I never inject fat into the orbital rim for that reason, for the reason that if the fat survives the fat will grow if you gain weight, for that fact that removing it can be difficult and because it causes more swelling and bruising with longer recovery than Restylane. All the best. JG 9.7.12

Question:

Good evening, Dr. Garcia. I have two pigment questions for you. I`m undergoing IPL to reduce the visible pigment in my skin. (I`m English and very, very fair!) 1) Am I understanding this correctly? The pigment I can see has risen up from a deeper layer of the skin. The light breaks that up, making it less visible. If the pigment is rising from the deeper layers of the skin, then I assume that at some point, when it has all surfaced and we`ve broken it up, then it should be taken care of. Is that right? 2) The aesthetician is recommending chemical peels to do the clean up work of peeling off the pigment after the IPL. How many days after IPL is it safe to do a chemical peel? Thank you.

Answer:

1 is correct and as to the chemical peel, I see no reason to do that except to make more money. JG 9.6.12

Question:

Hello Dr. Garcia. I`ve had rosacea forever and just read the new research finding pointing to demodex as the culprit. Does this affect treatment in your opinion? I now take 100 mg of doxycycline daily, metrogel topical at night and an antibacterial topical in the morning, I think it is clinicin. The article I read implied that diet and reducing sebum were important. So is there anything I should stop or start? I`ve always had enlarged pores and excess sebum production on my nose. Thank you!

Answer:

I think IPL sessions at the medspa help dectease oil producton and shrink pores, it can also decrease bacteria count. All the best. JG 9.1.12

Question:

Hi doctor, what is cetaphil and what are its benefits. thanks

Answer:

good hypoallergenic facial cleanser. Easy on your skin but keeps it clean. They also make a good mousturizer. JG 8.22.12

Question:

Hello Dr Garcia, I have red stretchmarks and they are fairly new. About a 2 months old. I wanna treat it with creams cuz laser is too costly for me for now. Which stretch cream do u recommend? Strivectin, revitol, or trilastin?

Answer:

I think the difference between them is quite small, none work very well, it is more a matter of time. When a patient of mine wants to treat them I suggest Mederma or ScarGuard, both OTC. JG 8.22.12

Question:

Is there any filler for smaller wrinkles that will last more than a couple of weeks?Thanks

Answer:

the thicker stuff that lasts longer can look lumpy, might need a light laser to help them look better for a while, but there is more downtime. JG 8.21.12

Question:

Dr. G, does your cream help improve skin elasticity or fines lines around mouth? There are so many products out there I`m overwhelmed. Right now I use revalie night cream and tns recovery serum. Thank you.y

Answer:

general skin elasticity yes, but the effect on the fine lines around the mouth, to be honest, will be quite small. Those lines are very recalcitrant to creams due to the amount of motion in that area and collagen loss in the skin. Old fashioned Retin-A would work better. JG 8.20.12

Question:

I`m in my mid 50`s and am developing crepey skin on my forearms. Any treatments that might help? Thanks.

Answer:

all I can suggest are sunblocck and good moisturizers. Sorry. JG 8.19.12

Question:

Hello Dr. Garcia. Is coconut milk put in the freezer to solidify before slathering it on face to apply as facial cleanser effective? Thanks.

Answer:

Nope. JG 8.16.12

Question:

Thanks for answering so quickly. You say Genesis might help prevent folliculitis in the future. I never had it before the electrolysis. Do you mean that now that I have this condition following one treatment of electrolysis, I`ll have it forever and will need to do Genesis to manage it into the future? (Anything else you might recommend by the way? Light chemical peels perhaps?) I`m hoping that this is an acute, short-term condition and not a chronic one! Your response makes me wonder if folliculitis is a known, permanent side-effect of electrolysis. If it is, I didn`t know it and would never have elected to do this. I`m a mess! Thanks so much, Dr. Garcia.

Answer:

no, it should not recur, but if you see it does, the Genesis might help prevent it or decrease the frequency and severity of it. You can also use FotoFacials which is a treatment using an IPL, it is weaker than a laser but still effective for what you need.The risk of follicuilitis is there with electrolysis but small and it likely will not be a problem in the future. I wish you the best. JG 8.15.12

Question:

I had a bad case of folliculitis following electrolysis and am taking mupirocin. It`s clearing up. Might Genesis help tamp down the inflammation and perhaps assist in killing the bacteria? Thank you.

Answer:

might help some, nothing dramatic though, might be effective in keeping the folliculitis down as prevention. JG 8.14.12

Question:

If I pre-treat with an HQ free skin lightening product, will that be enough to prevent hyperpigmentation for a PCA chemical peel?

Answer:

nothing will take the risk away 100% but it will certainly help to lessen the risk, but without knowing what the ingredient is,and with no hydroquinone, I cannot say how effective it will be. JG 8.13.12

Question:

what do you think of clinic line products. Can i buy the whole set, i mean the moisturiser, the wrinkle one etc or is there any brand which is better than this, thanks.

Answer:

I have not heard of clinic products, sorry. JG 8.13.12

Question:

I keep reading about the benefits of pure argan oil as a moisturizer, anti-inflammatory, and antibacterial. Do you recommend it for aging skin? Thanks. Have a great week.

Answer:

no personal experience with it, but I have not seen any published information in the medical literature, to substantiate their claims. JG 8.13.12

Question:

What do you think of the ProActive line of products for acne? Thanks

Answer:

`a little pricey but they are good products. JG 8.11.12

Question:

What do you think of the eye cream Lumatone? The ads are, of course, quite impressive, which makes me dubious. Have any of your own patients tried this product?

Answer:

I have had no patients use it but their website uses different directional lighting on the befores and afters. I do agree that light reflection will make people look older or younger, there is a news piece about Meredith Viera at the Olympics and how they had to use different lighting to hide her wrinkles. I would not believe the hype though JG 8.10.12

Question:

Hi doctor, thank you again for all your valuable advice. I am looking a cream which has collagen which i can use day and night. could you suggest me one. i am 45 and notice that my skin look dull. please advise. thanks

Answer:

applying a cream with collagen will only mask things for a short time as the collagren is not absorbed. Retin-A is better at exfoliating your skin to help it look fresher while at the same time causing your body to create new collagen. JG 8.9.12

Question:

I do use a 20% glycolic wash but can`t do that everyday as it is very drying on my skin.I haven`t used any retin a in 3 years. My dermatologist is perplexed as to my issue. We have tried 2 TCA peels full strength and looks fine for a couple of days but then the problem persists after 3 days. I have gotten very discouraged about trying to do anything and just let it go. I did have psoriasis in my teens and some dandruff even now but my facial skin just sloughs off way to much.

Answer:

it is you skin that is producing the layer, I think the 20% glycolic wash is too strong, look for something lighter about 10%, and I would also restart the Retin-A slowly, it should help. JG 8.8.12

Question:

Dr. Garcia. I have had high energy PSR portrait 5 years ago and used retin A some since. I develop this thin clear layer of skin on my face now. I have to get it wet and soap clean it and then slough it off about every 3 days. It looks great after that but then 3 days later it comes right back. I have tried TCA peels and medical grade microdermabrasion but it still comes back in about 3 days. It makes me look 10 years older until I slough it off. I have tried bio complex Neo cutis and various IS clinical products but still comes back. What product would you recommend to stop this from forming?

Answer:

If you are not suing the Retin-A daaly, I think that is the first step, maybe also using a Clairsonic facial cleanser machine and using a facial wash that has glycolic acid in it should help. You might also need to look at the creams you are applying on your skin and eliminate any of them that contain petroleum based ingredients. JG 8.8.12

Question:

Hi doctor, i want to use a skin toner. Which one can i use for best results. i have a normal skin

Answer:

to be honest, because of what toners are, there are very little differences between the ones on the market, so just using one made by the company that makes the other skin care products you use is likely fine. No need in paying for a fancy one that does not do anything more than the normal priced ones. JG 8.8.12

Question:

Hi Dr.Garcia I am a 33 year old and i am a Indian my skin colour is brown recently i have notice a few brown spot which they refer to as age spot on my face is there any cream i could use to help with fading? Do you recommend any of your product for this, also do you ship to Toronto? Does the spot came from genes or i was using conceptive for like 10 years? Thanks You..

Answer:

The spots come from genes, hormones and sun. i think your best option is to use prescription Retin-A and hydroquinone . My creams will not help, but a dermatologist can write it for uou. JG 8.5.12

Question:

Hi Dr. Garcia, I would like to use a toner that has some antioxidants, essential fats, no alcohol or witch hazel. It is slightly thicker than water with a milky consistency. The thickening is due to some silicone in the product. My question is: will this small amount of silicone be enough to decrease the absorption of my Retin-a at night and my antioxidant serum in the morning?

Answer:

it likely will slow or prevent the absorption of the Retin-A, so you might need to use Retin-A first if you are set on using it. JG 7.30.12

Question:

hello like to know what would u recommended for age spot.

Answer:

start with Retin-A and hydroquinone, progress to light chemical peels or IPL, then move on to Nd:YAG lasers. JG 7.25.12

Question:

Hey Dr. Garcia, can you tell me if your peptide cream would lose it`s effect from it getting to hot? The reason for my concern is when I order it from your office it takes a whole week to get to me and when I receive it the little jar is very hot. Thanks

Answer:

the cream may separate, so just mix it up with a Q-tip is all. It will not degrade the efficacy JG 7.24.12

Question:

Hello Dr Garcia. Are there any new treatments for new stretchmarks that are still red? I have deep, large ones on my armpit area and I was wondering what I could use for it to at least reduce them.

Answer:

The best for recent red ones is a YAG laser. JG 7.22.12

Question:

When ScarGuard is used on a new surgical scar, does it make the total healing better or does it just speed up the healing that would have eventually happened anyway? In other words, 2 years from now, would my scar be less because I used ScarGuard?

Answer:

I feel it speeds the normal process that was going to happen anyway. JG 7.20.12

Question:

Dr. Garcia, what do you think of the latest procedure called Venus Freeze? Very expensive, is it worth it? Thank you!

Answer:

not a fan, would not advise to spend your hard earned money. JG 7.18.12

Question:

I have had reconstructive hand surgery, I am getting the stitches out this week. Is Mederma worth my time?

Answer:

Yes, I think it will be worth it for you. JG 7.16.12

Question:

I am so careful about any laser or IPL due to my Asian skin type 3-4.PLEASE tell me the best option to treat my face Pigment without any risk besides Retin-a and Hydroquinion?

Answer:

I am afraid light IPL is about all I would add, or some very light TCA peels, 20% at most. JG 7.13.12

Question:

what`s your opinion of ActiveFX and deepFX?

Answer:

results don`t last last long as they claim, pretty safe when done in experienced hands, just seems pricey for a relatively short term result. JG 7.11.12

Question:

Regarding your Cell Matrix product building collagen as does Retin-A: suppirting studies/literature you can cite? Thanks.

Answer:

I base my statement of collagen production based upon personal observation of visible skin changes in my patients comparing them to Retin-A patients. I have not performed any double blind studies or biopsies on my patients using it. It is a combination of multiple ingredients that myself and a pharmacist came up with. JG 7.10.12

Question:

How do you achieve natural skin tone quickly? After you go outside very much, you are bound to get tanned. I was wondering how you regain your natural(lighter) tone faster? Any sort of creams or something I can use that will help?

Answer:

the quickest is with a series of microdermabrasions if all of the issues are recent. JG 7.9.12

Question:

Hi Dr. Garcia! I`m sure you get asked the same questions over and over and I apologize as I am probably going to ask at least one of them again, lol. But I am noticing that my facial skin (for as much as I try to take care of it) is looking a bit dull, the pores look larger, a little bit of discoloration. What procedure would you recommend? I`ve heard that some lasers (if that is your recommendation) can cause hyperpigmentation. Obviously I don`t want that. Just want to know something that truly *works* in brightening, tightening, refreshing the skin. THANK YOU!

Answer:

I would suggest a series of IPL sessions at a medispa, low risk of hyperpigmentation as it is fairly weak, and also some Retin-A. Best of luck. JG 7.6.12

Question:

What benefits do toner impart to skin -- what exactly does it do for skin?I know that the really effective components of the Obagi line are just hydroquinone and retin A, but it also includes a toner, which I notice is an element in most complete skin care lines (including even Pro-Active). Just wondering if it`s worth the investment. Thank you.

Answer:

In cosmetics, skin toner or simply toner refers to a lotion or wash designed to cleanse the skin and shrink the appearance of pores, usually used on the face.There are different types of toners. Skin bracers or fresheners,These are the mildest form of toners; they contain virtually no alcohol (0-10%), water, and a humectant such as glycerine. Humectants help to keep the moisture in the upper layers of the epidermis by preventing it from evaporating. A popular example of this is rosewater.These toners are the gentlest to the skin, and are most suitable for use on dry, dehydrated, sensitive and normal skins. It may give a burning sensation to sensitive skin. Skin tonicsThese are slightly stronger and contain a small quantity of alcohol (up to 20%), water and a humectant ingredient. Orange flower water is an example of a skin tonic. Skin tonics are suitable for use on normal, combination, and oily skin. Astringents,these are the strongest form of toner and contain a high proportion of alcohol (20-60%), antiseptic ingredients, water, and a humectant ingredient. These are commonly recommended for oily skins as they are drying, but note that the removal of oil from the skin can lead to excess oil production as the skin tries to compensate for this and prevent moisture loss.[citation needed] Witch hazel is an example of an astringent. To prevent dehydration, astringent is best applied only to problem areas of skin, such as spots. If you fall into the need for the astringents,. then the toner is likely helpful. If not, it feels good, makes money for the company, but likely will not see as much from it.JG 7.6.12

Question:

I`ve had 3 chemical peels since January, with nice results. Each time, the aesthetician has also applied the peel to my hands and arms, but they`ve never peeled. Why is that? Does she need to use a stronger mixture? Am I getting any benefit anyway? Thanks.

Answer:

the arms and arms have much thicker skin than your face does so they are more resistant to the same strength peel. I will also say that deeper or stronger peels on the arms and hands can lead to burns as those areas, although thicker, have less capacity to heal from what is essentially a controlled burn. For that reason, peels on off face areas have to be done very carefully and in light applications, but the positive effects on those body parts is quite small I am afraid. JG 7.3.12

Question:

Dr. Garcia, I`d like to know if broken blood vessels on one`s nose are a recurring thing? I had two spots below the bridge of my nose treated with a V6 laser, and after the purpura disappeared, the broken blood vessles were unnoticeable. About one month later the broken blood vessles returned in the same spot. Would a strong dose of vitamin K be better than a laser? I`m around the public a lot because of my profession, and I`m very self-conscious about this.

Answer:

yes, after being treated and looking better,they will come back in time. I do not think the Vitamin K will help I am afraid. I think after you have a series of the lasers done, they might slow down in terms of their recurrence. JG 7.2.12

Question:

Thank you for your answer earlier today about the series of chemical peels I`m undergoing. I think you`re right that because I use Retin A, the amount of improvement I will see with the peels will be minimal, so I`ll likely need the resurfacing. In the meantime, my doctor says that the peels are very good for my skin, even if the visible improvements are small. In what ways are peels generally good for the skin beyond visible improvements? I ask because this is a pricey way to improve my skin`s health if the visible effects are so minimal. Thank you again for your incredible generosity to all of us who badger you with questions. What a great person you are!

Answer:

well, any new damage you get from the sun, the peels will lessen that, but that is about it. In cases where the patient continues with the sun damage or gets plugged pores or the pores get more visible, the peels will help that, but if you are taking proper care of the skin, they are not as essential. I appreciate the kind words. JG 7.2.12

Question:

I`m 50, blonde hair, blue eyes, Swedish descent. I`m undergoing a series of Skin Medica Rejuvenize peels (the highest strength in their line) and am not peeling at all -- just flaking a tiny bit on my chin. My dermatologist thinks this is because I used Retin-A and am pretty well exfoliated already. Despite this, he claims that the peels are still beneficial to the skin. Is that correct? If so, how exactly are they helping? I was hoping they`d diminish the fine lines on my cheeks, but those lines appear to be here to stay. I`m considering a CO2 resurfacing to address them. With respect to that, I have another question for you. I know that if I have a resurfacing, I`ll have to keep up the Retin A and hydroquinone to help prevent hyperpigmentation. How long should I wait after this series of 6 peels to undertake the resurfacing? And how long before the resurfacing should I stop the Retin A and hydroquinone? Thank you very much.

Answer:

yes, but the amount of difference you will see is less than in someone who had not used Retin-A. You degree of fine line improvement compared to what you had with the Retin-A alone will be relatively small if you are not peeling. If you were to undergo a CO2 laser, I would wait 2-3 months in between. I have my patients stop the hydroquinone and Retin-A the day of the laser. I wish you the best. Jg 7.2.12

Question:

Hi, I have been using Retin A for two years with overall good results. My skin continues to be dry however, no matter what moisturizer I use. My dermatologist told me to apply the Retin A nightly, wait one hour, then apply a thin layer of vaseline???? What is your opinion of this? Will it decrease the effectiveness of the Retin A? Thank you.

Answer:

Never vaseline, it cliogs your pores, use a good moisturizer or squalene oil. JG 6.39.12

Question:

What do you think of Glocolic Acid??

Answer:

if you mean glycolic acid, it is a good exfoliant and helps keep skin looking fresh. JG 6.30.12

Question:

I believe I`ve read in this blog that you don`t think home needling is effective for collagen stimulation. My own plastic surgeon is a big proponent of it. Three years ago, I got a full thickness burn on my neck from an overly-hot IPL bulb. It left me with a thick, raised scar, which we`ve treated with Mederma, F5U and Cutera`s Genesis. Since it`s still raised, my surgeon is now recommending daily needling to help flatten it. This seems counterintuitive to me. If needling s is supposed to stimulate collagen and if scar tissue is essentially an over-production of collagen, why would he think that needling will help to flatten it? I suspect you`ll say it won`t do anything at all to the scar, since you don`t think needling is a good idea. Any other suggestions?

Answer:

I do not think needling will help the scar. I do think continuing the 5FU shots is likely the best option, the lasers I would use only to reduce redness of the scar. I wish you the best. JG 6.29.12

Question:

Dr. Garcia. What is the best treatment for eczema/dermatits of the neck? Would there be something to clear it, and then what is the best mositurizer for it? Thanks much. kp

Answer:

two topical (cream) medications have been approved by the FDA for the treatment of eczema: tacrolimus (Protopic) and pimecrolimus (Elidel). These drugs belong to a class of immune-suppressant drugs known as calcineurin inhibitors and are indicated only in patients over 2 years of age. You will need a prescription form your dermatologist for it. As to the moisturizer, it will be atrial and error thing I am afraid. JG 6.27.12

Question:

Regarding rhe label on your Cell Matrix product: Fair Packaging and Labeling Act - To ensure that packages and their labels provide consumers with accurate information about the quantity of contents and facilitate value comparisons. Does this law not apply to your products?

Answer:

The active ingredients are Argireline,Hyaluronic acid, Phytessense wakame algae, Phytotal FM, Calmosensins, Phytessense Stevia, Phosphatidyl choline, Arlasolve DMI. JG 6.26.12

Question:

What do you think about the No7 skin care products that Target store sell. Are they comparable to Oil of Olay products? Do you think that Emu oil is good for the skin. Thank you so much.

Answer:

Emu oil is a good moisturizer but I cannot comment on the No 7 as I have never seen anyone that used it. JG 6.26.12

Question:

I received your Cell Matrix product, but am disappointed to find essentially no literature included. It would be helpful to know the ingredients and specifics of use (besides applying pea-size amount in the evening). For instance, may I apply Squalane oil, too and if so, before or after the Cell Matrix? How about applying other antiaging products (Retin A) with Cell Matrix? Thanks.

Answer:

The ingredients are proprietary. I would stop the squalene, and if you desire to use Retin-A, apply it first, wait ten minutes and then apply the Cell Matrix, although most patients stop their Retina-A. JG 6.26.12

Question:

Dr.Garcia, What is better and give less damage to the skin on the face and neck : use of self tanning products or use a poweder and fondation to give the face and neck tanned look? Thank you for your time.

Answer:

powder and foundation, no question. JG 6.25.12

Question:

Is Olay Wrinkle Regenerist (http://www.olay.com/skin-care-products/anti-aging-products/wrinkle-treat...) just a good moisturizer or does it also contain the ingredient that -- in an extremely mild and temporary fashion -- mimics the effects of Botox? What is the name of that ingredient? If Olay Wrinkle Regenerist doesn`t contain it, what topical product in the Olay line or in another line does? Thank you.

Answer:

it is a good product but does not mimic Botox in any way because it does not affect the muscles under the skin which is the only thing Botox does. There is no skin care cream sold at the present time that can affect the underlying muscles as that would make it a drug and require a prescription, so the present claims are hype and marketing. JG 6.15.12

Question:

Is electrolysis effective for the white peach fuzz on the face of post-menopausal women? Does it need to be repeated or is each follicle permanently damaged after one treatment? It`s hard to find electrologists in these days of laser hair removal -- which only treat dark hair. Thanks for your expertise.

Answer:

It is effective, each follicle that is treated usually dies and does not re-grow, but not all follicles are in the growth phase at the same time, so you might have a treatment and then find small hairs growing next to the ones that got treated a few weeks later. Worth searching for one if your hair is pale or white. JG 6.13.12

Question:

On one of my eyes when I keep it closed for sleeping and what not there are no little crows feet that appear, on my other eye when I keep it closed (not when I blink only when the eye is held shut) there are small crows feet that appear next to the eye and it`s causing early wrinkles in the area. Would botox help these lines that appear from closing my eye from getting worse? Thanks you.

Answer:

it might slow the progression of the lines, but not the lines seen in the resting position.JG 6.13.12

Question:

One of your Q/A: I have rosacea and am having trouble balancing those treatments with anti-aging. I`m 54 with fair skin. If I use retin A under my eyes and near my nose for clogged pores and wrinkles it seems to make broken capillaries worse. What would you advise?  Answer:  I would stop the Retin-A and use a different cream, I have one on my shopping cart, otherwise you need to avoid products with Retin-A or retinols with your Rosacea. Might suggest using IPL treatments to help control the Rosacea and reduce the broken blood vessels. I wish you the best. JG 6.5.12 Dr. Brandyth Irwin & other MDs are now saying that for many years dermatologists recommended against using Retin A with rosacea because they were afraid it would cause more irritation.  But, a few years ago, several studies were done which showed that Retin A/Renova/tretinoin, etc. in fact do NOT irritate rosacea and, in many cases, improve it.  It`s fine to stay on it! Please comment. Thank-you.

Answer:

well, in my humble opinion, I disagree, but it is easy to test it out Apply it on your Rosacea and see what happens, if it gets worse, then stop. JG 6.11.12

Question:

Dr. Garcia,what do you think about self tanning lotion, will it give any harmfull effect for the skin and body if use it regularly for a long time, to keep the skin taned? Thank you.

Answer:

it is just a temporary dye, not harmful effects have been reported in the medical literature, but the prevention against a sunburn that naturally tanned skin has is not present in a self tanner scenario, so you can still get a sunburn. JG 6.8.12

Question:

Sorry, it`s me, hysterectomy Lady. I forgot to mention that the cystic acne is only in my lower T zone and I`ve been treating it (unsucessfuly) with Proactive. Would Ziana, or Benzaclin, or Benzamycin be better?? HELP! Thank You Much

Answer:

Benzaclin would`ve be Goo. JG 6.6.12

Question:

I had a hysterectomy 4 years ago and about 6 months ago my ovaries went menopausal and are now defunct. So now I need to take bio identical hormones.My GYN has prescribed 15GmCMP BI-EST 10MG/GM 50/50 cream and 15 Gm CMP progesterone 20% cream. But now my hormonal cystic acne has returned with a vengeance!!! She said I should do some blue light thing. I was wondering how you would treat this??? Thank you for your time

Answer:

Would check you blood levels, you likely need more progesterone. Could`ve also start some Retina-A. JG 6.6.12

Question:

Would you please recommend a moisturizer for very dry flaky skin. I am using Tretinoin Cream 0.05% only 2x a week due to the dryness but would love to use it more often. My skin was dry and flaky before I used the tretinoin cream. When I wake up in the morning my skin is not dry but once I cleanse my face the dryness appears. Thank you

Answer:

Might want to try squalene oil, sold at good health food stores. JG 6.7.12

Question:

Hi Dr. Garcia, Thank you for your quick response. Two more questions. I saw one derm a while back and she suggested Retin A micro for one not as close to eyelid at all. I used it very sporadically. This is the same one that a different derm (I just relocated) used some kind of a electric current, it has already come back after about three weeks. Does the needle method you suggested leave a scar? Thanks again, kp

Answer:

the needle should not leave a scar, it can be burned or cauterized with electricity or heat, but it is usually not needed. JG 6.6.12

Question:

Hi Dr. Garcia, What is the best treatment for milia right around the eyes? In fact have one right on the lower eye lid. Any help is always much appreciated. kp

Answer:

Would see a dermatologist so it can be marsupialized, a fancy word for opening it with a needle and pushing the material out, but do not try it yourself. JG 6.6.12

Question:

Hello Dr Garcia, I sent a msg here a week ago. I`m still trying to get to the bottom of what happened to my eyelid. I am the 33 year old with mild seasonal allergies and a mild case of chronic blepharitis. Previously no wrinkles. It has been a week now since I spontaneously developed a thick puffy and slightly red and irritated crows feet wrinkle that radiates out about a cm from my eye and it has not budged at all still looking exactly the same as the morning I got it. I went from not even having a visible fine line in the area, to waking up with a this puffy wrinkle. My actual eye and eyelid seem to have no effect at all but the crows feet area is swollen and wrinkly. Like two puffy folds of skin forming a rather thick, albeit short wrinkle next to my eye and a couple fine lines in the area as well that were not there before. It makes no sense to me how one can spontaneously develop a thick wrinkle like this, or that it`s red, or that it looks and feels somewhat swollen and even burns a little. I tried some cortisone cream with no positive effect and was also given an antibiotic cream by my family doctor fucidin incase it was infected and that has done nothing either. It is causing me distress because I am mostly not sure if this is simply age related or a physical problem? Based on my description what are your thoughts? Should I treat with Botox?

Answer:

I do not think Botox should be sued until the inciting cause is eliminated. I really don`t have much to offer, it would seem that an insect bite would be a possibility, or a topical allergy to some substance but there is no history of that. JG 6.5.12

Question:

Hello Dr! I have been using retin a for many years now trying to have the recommended breaks of a couple of months. In the earlier days I had the usual reaction of dryness, flakiness etc with that lovely glow that resulted days later. Nowadays, even if I mix it with Obagi Blender to intensify the retin a, I get no reactions whatsoever. Does this mean that its results are now final and there is not point using it anymore or does it continue to work at a deeper level? Thank you

Answer:

Likely you have maxed out the improvements, now it will only maintain and not reverse anything. JG 6.5.12

Question:

Hello, what layer of the skin are freckles and sun spots located?, and can that layer of skin be removed safely to bring back an even complexion. Thanks.

Answer:

they extend to the middle part of the skin, they can be removed temporarily, but the deeper skin cells will regenerate the freckles in time and they cannot be removed without permanent scars. JG 6.4.12

Question:

hello I have seemed to have gotten a very dark red facial chemical burn from shaving upper lip area with razor and using nair product later afterwards. ( i know not smart) i am using cortisone creme, and olive oil serum. and the concealer which is creamy base im using seems to keep moist also. again very bad red burn about half inch to quarter inch near upper lip area. any more i can do? and i also have mederma. thank you so much.

Answer:

I would suggest using the Mederma and stopping the cortisone ans the cortisone will not help the redness. Avoid sun exposure and you no products with retinols or glycolic acids. Time is the best friend. I wish you the best. JG 6.4.12

Question:

Hi Dr. Garcia, I just wanted to ask you what your opinion is of copper peptides in general as a collagen builder, and also it`s effectiveness in treating scar tissue. Thank you! Lisa from Myrtle Beach, SC

Answer:

I think after an injury like a peel ir laser they help, not I see no need on a daily basis. JG 6.2.12

Question:

I have persistent erythema on my lower eyelids. I need to have regular IPL treatments (for years) and VBeam treatments to keep it at bay, but I need to do something more between these appointments to tamp it down. I`ve found a product o line put out by SkinMedica called Redness Relief Complex. It`s pretty pricey, so I don`t want to waste my money if it`s not effective. Have any of your patients used it? Does it work? Thank you so much for this generous service you provide. You are amazing!

Answer:

I am sorry but I have not had any patients use it.In general, SkinMedica is a good line so it might be worth using it. I wish you the best and thank you for the kind words. JG 6.1.12

Question:

Hello I`m 33 years old... have tanned and smoked. I have mild allergies this time of year and my eyes were very slightly red in the crows feet area. When I wake up the redness is a bit more pronounced I think because tears collect in that area. Well, I seemed to develop 1 deep crows foot, which I never had before. It seemed to spontaneously erupt with the redness in the corner of one of the eyes. It`s still a bit red and puffy. The wrinkle is right at the corner of my eye and does not radiate outwards far just maybe a cm. Like the wrinkle that would appear if I close my eyes like I am going to sleep. Only now it is visible at all times even when my eyes are open. Does this sound permanent? If it is would botox help this close to the eye? Thank you

Answer:

I might get better during the day and over the next few days but it appears that you likely will develop a line there in time. Botox might help slow the progression but will not avoid it entirely. All the best. JG 6.1.12

Question:

Have you found that bruising really is helped by ice in the first 48 hours? It`s been my experience that once a bruise appears, it`s there to stay for at least 9-10 days, usually more. I ask because I was bruised again this morning in a procedure and am wondering if icing it is just a waste of time. Thank you.

Answer:

ice will work in prevention, but not in the resolution, although it will help further swelling from occurring if there is continued damage, like after surgery. JG 5.30.12

Question:

Hi - what is the best treatment for red, slightly raised scar on face? IPL? Microdermabrasion? Thanks.

Answer:

between those two, I would choose the IPL. JG 5.28.12

Question:

Hi, Dr. Garcia. Is Skin Ceutical;s Pigment Regulator any good? If so, is it better than, the same as, or less effective than Neocutis`s Pearl? And are these two products better than the less pricey widely available dark spot correctors like Neutrogena and Estee Lauder? Also, my derm has me on CE Ferulic Acid morning and night. How will this product improve the appearance of my skin? He just says that the antioxidants will assist with protection from free radicals, which I believe may help prevent skin cancer -- always a good thing!! But can I expect any visible improvements too? Thank you!

Answer:

I think it is a good product, similar to the NeoCutis one. I think they are pretty similar ot the less expensive ones though as they are all less than prescription strength. I know that the Ferrulic acid is very popular, but I have not been impressed by what it does. I wish you the best. JG 5.28.12

Question:

Hi Dr. Garcia, My 3 year old daughter has deep scar from leishmaniasis on one of her checks , is it fine if I have her done a small plastic surgery (in India) or I should wait untill she is grown up. I want her face to be cleaned from this scar before she starts noticing it. Thanks in advance for your advice on this. Arzhang from Afghanistan

Answer:

If you revise the scar now it will likely need to be done again as she grows, but there is nothing wrong with that. If it will make her look better for a few years I would do it. I wish her the best. JG 55.29.12

Question:

my husband suffers from sebboreic dermatitis. He has large dark patches on his neck with light ones above. How can he even these out?

Answer:

best to treat the areas with topical creams and then the dark spots could be treated with an Nd:YAG laser to lighten them. Could also use an IPL laser, but it is not as strong. Best of luck. JG 5.28.12

Question:

Hi Dr Garcia, I use sunblock religiously but remain prone to melasma and HP. During the summer months, is it best to use HQ as prevention or is it best to wait till the fall and do a round of triluma and chemical peels at that time to address the problem when the sun is not so strong?

Answer:

Use the sunblock and hydroquinone in the summer and then add the Triluma the other 9 months. JG 5.26.12

Question:

Hello doctor, i am 45 with fair and dry skin and with age i am noticing that the glow fade with time. could you tell me which brand can i use for better skin and which vitamins taken. I have heard of cellex c brand.what do you think about it. Thank you again for your valuable advice

Answer:

I think Cellx C is fine, or Oil of Olay Pro-X, otherwise, you can use some prescription Retin-A. Best of luck. JG 5.25.12

Question:

Hi,Dr. Garcia. I had Fraxel Repair in March and am not impressed with the results. When would it be safe to try the traditional CO2 resurfacing? Could I do it in June? Also, I know you like Olay products. What do you think of Garnier`s line of cosmeceuticals? Thank you. Have a great holiday weekend! Hope you can get some fishing in!

Answer:

I would wait 6 months after the Fraxel before the CO2 laser. As to Garnier, I do not like it as much as Oil of Play. Not going fishing but will relax with my wife and curly dogs. JG 5.23.12

Question:

If I am eating fish 2-3 times per week,is there an additional benefit to taking a fish oil supplement?

Answer:

as long as it is an oily fish, like Salmon or Cod, that should be enough. JG 5.23.12

Question:

You recommend using a Total Sunblock and not sunscreen. What brands do you recommend and what SPF? Some of the sunblocks are inexpensive and I dont know if they are effective. I have checked Ulta stores and other beauty supply stores and they do not carry sunblock. Do I have to order these online. A lot of the spas do not carry sunblocks just sunscreens. Thank you for your help

Answer:

my preference are the products by Fallene. Online will be the cheapest and the widest selection. JG 5.23.12

Question:

I had a facelift, brow and lower bleph 6 weeks ago. I started using tretinoin cream 0.05% this week. Do I use this every night or less? Can I use it on my neck as well and if so how often? How close to the eye area should it be applied? I see from the Q&A that you recommend using Hydroquinone with the tretinoin cream. What is that used for? Sorry for so many questions. About sunscreen, I use MDsolar Sciences spf 40. Titanium dioxide 7.7% Zinc Oxide 3.8%. Is this enough or would you recommend something else. Thank you so much for all your help.

Answer:

I would start every other night until well tolerated then increase the use. It can be used on the neck with the same frequency. It can be applied to the eyelids as long as you do not get close to the eye itself as it will irritate the eye. I use the hydroquinone with the Retin-A when trying to fade brown spots are for pretreatment before resurfacing. The hydroquinone is used to slow the conversion of dormant pigment to visible pigment. I think I would look for a sunblock, rather than a sunscreen for mroe complete coverage. All the best. JG 5.23.12

Question:

What can be done for the discoloration left by cystic acne? I have about 6 of these scattered about due to getting deep cystic acne in my late 40`s...fabulous. They look like age/brown spots. I have tried everything like microderms and acid peels...nothing works. Any help?

Answer:

would suggest some Nd: YAG laser sessions. Best of luck. JG 5.22.12

Question:

Morning. I posted about 5 postings below re blocked pores. Thank u for your response however, in Canada IPL`s run about $300-$400 dollars each and micros are about $100 each..could you please advise me as to some products or solutions I may do myself to keep the cost down. I really do appreciate your advice. Thank you.

Answer:

Try some Retina A and the microdermabrasion then. JG 5.22.12

Question:

Hello. Could you please tell me what I should use or do to avoid or minimize blocked pores. my skin type tends to be a bit on the oily side/sensitive I use a Clairsonic device, 0.1% tretoinin, 15% Cellex C and a moisturizer. I am 55, fair skinned..no real wrinkles...do IPL twice a year for mild Roseasa

Answer:

I think increasing the IPL to once every 4-6 weeks and also add microdermabrasions at 4-6 weeks too, separate them by a couple of weeks. That should help. JG5.21.12

Question:

Dr. Garcia, Sorry to bother you about the Retina Micro spot application for milia. It is on the very top of the upper outer eyelid. At the juncture of the top of eyelid and subbrow area. Is is safe there? Thanks again.

Answer:

yes, safe to use. JG 5.21.12

Question:

Hi Dr., I had dysport injections in the glabella for the first time last week. I am happy with the results, but when I lift up my eyebrows high, like when I`m surprised, my lateral brows (outer portion) lifts up much higher then the inner half of my brows and it looks weird! I have a follow up with the Dr. who gave me the injections next week. Just wondering if you think this means I need to get an injection just beyond the glabella, so that the brow doesn`t left so high.

Answer:

If that bothers you, then yes, you need to tame the brow a bit. JG 5.20.12

Question:

Hi Dr Garcia, How close below the brow can I put a dot of Retina Micro. It would be just above the eyelid skin. Have a milia I want to get off. Thanks and I hope you are having a good weekend. kp

Answer:

You can out it onto the brow and the upper half of the eyebrow. All the best. JG 5.20.12

Question:

Dr. Garcia, do certain steroids cause bleaching of the skin? I have had a pimple the size of a pinhead on the dead center of my nose, and I applied a pinhead amount of mometasone furoate cream to it. Now this area on my nose is noticeably white. Is this a permanent side effect of the mometasone, or will it get better with time? Why does this steroid bleach the skin? Thanks, Bill

Answer:

if applied on the skin for longer periods of time or too strong of a steroid in short time they can, but not if taken orally. It usually will get better with time and a little sun exposure. The steroid does it by affecting the melanocytes in the skin, but they usually will regenrate. All the best. JG 5.16.12

Question:

In regard to the Q&A below: I should of mentioned that I do not sunbathe anymore because the white spots on my face do not tan. I can get very dark but then the white areas are very noticable. I wear sunscreen everyday and am very fair. So in this situation, can anything be done to restore the white patches? Thanks. Hi, I have hypopigmentation on certain areas of my face as a result of Profractional laser. Is there anything that can be done to restore color? Answer: if it is true loss of pigment, then sun exposure might help, if it looks lighter because the surrounding skin is still darker form prior sun damage, then the darker under treated skin needs to be treated to remove its sun damage. JG 5.15.12

Answer:

The only solution might be to lessen the pigment in the darker skin, but that can be unreliable.JG 5.15.12

Question:

I`m considering Smooth Shapes or VelaShape for improvement in the appearance of mild cellulite in my thighs and arms. If I understand cellulite correctly, it`s caused by a breakdown of the connective tissue which allows the fat to protrude between it, like fat in a weak fishnet.. And these technologies to improve the appearance of cellulite work by traumatizing that connective tissue enough to temporarily cause swelling, so the tiny pockets of herniated fat aren`t as noticeable. Here`s my question: do these treatments induce enough injury to the connective tissue to cause not just temporary swelling and so viusal improvement but also permanent damage to hte connective tissue that will in the long run make the probrlem worse? I have only a mild cellulite problem now, so I don`t want to make a mild problem into a big and permanent one. What do you think about this? Thank you!!

Answer:

it is actually not a break down but a tighter firmer attachment compared to normal. These technologies tear those dense attachments but the body tends to heal them and they return. I do not think it will make it any worse with repeated treatments though. Best of luck. JG 5.15.12

Question:

For brown spots on the hands (very fair skin), do you prefer 1) IPL 2) NdYAG 3) Fraxel Duo 4) microdermabrasion 5) hydroquinone and retin-A or 6) some combination of these? Thank you, Dr. Garcia!

Answer:

NdYAG with Retina-A and hydroquinone. JG 5.13.12

Question:

What are your thoughts about the new product Nanoblur (a light deflecting product to make lines and pores less visible)? Obviously, it`s just a cosmetic, not a cosemceutical, but does it contain any ingredients that might be bad for the skin? Have any of your patients used it, and if so, what do they/you think? Thanks!

Answer:

Nothing bad from what I can see. JG 5.13.12

Question:

Hi, Dr. Garcia. Several of my friends have had some nice results with regular HydraFacials (which combine water-based exfoliation and microdermabrasion with 30% glycolic peel and peptides). I`ve tried it three times and have liked it except my chin and jaw break out in pimples each time the following day. The equipment sterilized between each use, so I don`t think it`s a mater of bacteria being introduced into my skin (and if it were, it would affect my whole face, I think). This hasn`t happened to my friends (who go to the same plastic surgeon as I). What do you think is causing this? Is it stimulating the sebaceous glands? I`d like to keep doing it because the rest of my face is looking better, but I`d obviously like to avoid these breakouts. Thanks for your help.

Answer:

Could be the treatment is purging oil that was deep in your pores, or the microdermabrasion is too irritating and causing some pores to swell and plug up. Also can be due to what you apply after the treatment. I would start by changing the aftercare first. Best of luck. JG 5.12.12

Question:

How long can one continue tretinoin and hydroquinone until the benefits max out?

Answer:

12 months. JG 5.9.12

Question:

Thank you for your advice last week about getting less expensive Vitamin C +E serum. I`m still curious though: are its effects supposed to be invisible? I`ve seen no difference in my skin despite several years of daily use. Perhaps its benefits are powerful but unseen? Thank you for your time, Dr. Garcia.

Answer:

No, it just did not give you any benefit. If you don`t see a benefit, stop it. You paid to look better. JG 5.8.12

Question:

My dermatologist has all his patients on C+E serum for antioxidant protection. As you know, this stuff isn`t cheap. I`ve been using it daily for over a year and don`t see any visible difference in my skin. Are the benefits supposed to be invisible? I`ll do it if it really is contributing to the health of my skin, but it`s a bit depressing to shell out major bucks for no improvements in appearance! Thank you for your expertise and time, Dr. Garcia.

Answer:

No better than other less expensive creams sold OTC like Oil of Olay. JG 5.4.12

Question:

Is Tazorac stronger than Retin-A .1%? I`ve been using the latter for years and am wondering if I need something stronger. Thank you

Answer:

About the same, not worth changing. JG 5.3.12

Question:

What are your thoughts on LED therapy (Red for texture)? Are the in-office machines that much more powerful than the OTC ones for sale? Thank you.

Answer:

I am not a believer, office or home. JG 5.1.12

Question:

Hi Dr! I am 44 with fair and very dry skin even on my body. With age I am noticing it is getting worse and I am losing elasticity. Although I use body oil before going to bed, my skin is still dry in the morning. Are there any supplements I could take to combat this or any rich cream that would work? Thank you

Answer:

CoQ 10, Vit E and C, fish oils might help. JG 4.30.12

Question:

Should anti-oxident serum (CE Ferulic) be used in the morning under sunblock, at night before bed, or both? Also, how long after CO2 resurfacing before new collagen starts to be made? And how long does it continue to be made after that? Thanks very much for your help.

Answer:

it can be used at both times if desired. The new collagen starts to be made the day of the procedure, at first it is very disorganized and over the following months the collagen gets organized and then tightens, the tightening does not start for 4-6 weeks and can continue for another 8-10 months for the final result. Best of luck. JG 4.29.12

Question:

I am 64 years old and have been using copper peptides on face for about 10 years. I now get an inflamed red patch under eye whenever i use the product. Could this be from the copper peptide? Is it possible that the skin is becoming too thin and the copper is to strong. What do you suggest that i use for my eye treatment? thank you Josie

Answer:

I do not think the copper peptide has caused the problem. I do not have patients use copper peptides long term, just after acute injuries like a laser peel. I would stop it, try using some OTC topical steroid cream for 5 days and see what happens. If not better in 5 days, I think you should see a dermatologist to be sure. All the best. JG 4.29.12

Question:

I was in LV, in one of the mall they sell Orogold cosmetics. They have a stretching mask str.. serum and str.. cream. Also, they sell a lifting mask, serum and cream. Do you think will any of them stretch or lift the skin on a face and neck? Thanks.

Answer:

no, they will not do any lifting or decrease stretch. JG 4.27.12

Question:

Hello, Dr. Garcia.1 Do you recommend to use Mederma or different brand of scar gel on a scar under a chin, 2 If so, when to start to use it after the surgery to make this scar less visible. 3 Keep it moist or dry to make it heal better? Thank you, very much for your time.

Answer:

we suggest either Mederma or ScarGuard for the scars. We start one day after the sutures are removed and continue for three months. I prefer to keep the incision dry. JG 4.27.12

Question:

I`m 47, Fitzpatrick 1-2 female with well maintained skin (Ogagi Nu Derm, Retin A, religious sunscreen) that has no uneven pigmentation or textural issues. I, like everyone, would like to perk up my skin. Downtime is not an issue. Options include WHisper, IPL, VI Peel, TCA peel. What do you suggest based on this very minimal description and why? Along other lines, what`s your opinion of Exilis for melting fat? Tightening skin? Thanks. EJM

Answer:

Either the TCA peel or series of IPL, as the Exilis, skip it. JG 4.25.12

Question:

Hello Dr. Garcia ... My 54 year old friend had a combined non-ablative and ablative laser treatment almost 8 weeks ago. She thinks she sees a little tightening of the skin and an improvement in the tone of her skin (more uniform, less spotty), but she sees virtually no improvement in her lines, which was her main concern. Is this typical? She paid $4K and is thus far disappointed.

Answer:

I would say what she is seeing is typical, the fine lines might get a little better over the next 1-2 months, but nothing dramatic I am afraid. Sorry. JG 4.24.12

Question:

hello dr garcia what do you recommend for a good face cream against sagging i need something like a good tightening cream As we age we all loose some elasticity in our skin any suggestion? Thanks dr

Answer:

all creams might help fine lines, but although they are frequently marketed as fixing sagging skin, they do not, it is all hype, sorry. JG 4.23.12

Question:

how do you feel about Kinerase extreme lift for just a slight sagging of the brow upper eye lid only?

Answer:

It is good for little fine lines but it will not lift anything that is sagging. JG 4.22.12

Question:

Hi Dr. Garcia, my face was cut when someone accidentally knocked and broke the glass I was drinking out of into my face. The main cut was in my lip that stretched out to a more superficial cut across my cheek. Is there anything I can do to minimise scarring? I have kelo-cote (silicon gel), would you recommend that and can I start applying that immediately, or must I wait for the wound to heal a bit? Sorry for all the questions but I`m a bit traumatised. Any advice would be greatly appreciated. Thanks.

Answer:

I think Mederma or ScarGuard are easier to use on the face and as effective. Also use sunblock when outside. I would not use the products until the superficial surface has healed, maybe a week to 10 days. All the best. JG 4.20.12

Question:

Hi Dr Garcia, What do you recommend for milia very close to eyes? I used RetinA Micro for other areas on face, but it tends to migrate,so afraid to use it there. Thanks much.

Answer:

It is OK to use it there, otherwise you need to see an aesthetician for extractions. JG 4.18.12

Question:

Dr. Garcia, after a neck lift surgery, which cream to use : light, concentrated-rich,regular face cream or neck, lift neck cream? to keep skin on a neck in a good condition. Thank you.

Answer:

honestly, there is no neck cream that will keep things any tighter than regular creams. If your skin is very weathered, use the concentrated richer ones, if there is not a lot of sun damage, then the regular face cream would be enough. I wish you the best. JG 4.9.12

Question:

Dr. Garcia, Hope you are well and had a good holiday. My question is, can a person have too many treatment of the vbeam laser to an area. I have broken blood vessels on my chin, and have them treated over the times many times. It seems they are still there, or there again. I thought I read the treatment could cause permanet ones. If so, any other treatments to take them away. Thanks much as always.

Answer:

I have not seen the VBeam cause permanent broken vessels, but all patients that have broken blood vessels will get more with time, so it is likely just that you need continued sessions. I see no harm with repeat VBeam sessions if done correctly. They can also be hyfercated but that can leave pale scars and you will still get more right next to the ones you treat. JG 4.9.12

Question:

Hi Dr. Garcia - My 18 year old daughter just returned from a trip to Punta Cana. She used 30 sun block most of the time (she usually re-applied throughout the day) . She developed what I think may be melasma in some areas of her face, as well on her back and upper hip. The back and upper hip spots are very oddly shaped. On her face, it presents as one dime-shaped circle on her lower left cheek and a slight uneven-ness of tone in other areas, almost like parts of her face is a little dirty. She has never had anything like this before. Don`t know if this matters but she went to a tanning salon prior to the trip to get a little pre-tan and she used a mineral powder during the evenings on her trip (I read that some make up can cause a chemical reaction with sun block and result in sun spots, or melasma). What are your thoughts about the possible cause and would hydroquinine help to get rid of it if it doesn`t go away soon? Thanks so much!

Answer:

for it to be melasma, it would likely take a much longer time. I think hydroquinone is better at prevention than treatment if used alone. You would need to use Retin-A with it to help now. Might suggest some microdermabrasions or IPL sessions to clear it up. She will lose the tan along with the fading of the spots. All the best. JG 4.9.12

Question:

Hi, I had CO2 laser around my eyes and mouth 7 weeks ago. I am thinking of doing Thermage to get a little collagen stimulation of the upper lids. I have just a little pink on my lower lids right now. Healing really well. Do you think Thermage will inflame the tissue again, as it does heats up the skin?

Answer:

It will inflame the tissues again, yes, and I do not think you will get much for it. JG 4.7.12

Question:

Hi Dr. Garcia: I had a v-beam laser treatment to treat some broken capillaries on my nose about 10 days ago. Now, there is one purpura that is red (not purple), and a band of redness that looks like a visible sunburn. I`ve tried to heal the area by applying mometasone furoate to the area, but no results so far. I know I`m only 10 days out, but is there a prescription I could obtain from a physician that would expedite the healing process and get rid of the redness for good? Thank you.

Answer:

using topical steroid swill not help, but will slow the healing and potentially increase the redness. I would suggest just using some OTCsqualene oil or a copper peptide cream and leaving it heal on its own. There are no prescriptions that will speed its disappearance. JG 4.6.12

Question:

Hi Dr. Garcia, I have a 3 inch wide keloid in the middle of my chest. It was the size of a green pea, then grew. I had is excised along with radiation and steroid injections. Now the scar is MUCH bigger and wider than the original scar. I am researchin other methods to flatten it. I will NOT have surgery again. What is your opinion about cryotherpy, bleomycin tattooing, and 5 FU injections? I am looking for a plastics specialist with lots of experience with keloids...specifically on the chest. This keloid is big, painful, itchy, and unsightly. I often wear turtle neck shirts so people won`t stare. Can you or one of your colleagues help me? Thank you!

Answer:

I do nto think the cryo will help, there are reports of the bleomycin working, I use the 5FU injections on scars and although it takes time and numerous injections, I have been very happy with the degree of improvements. You will need to call around and ask plastic surgery offices and dermatology offices if they do it though, I do not have a list of them. I do the injections every two weeks in my office on patients. JG 4.6.1.2

Question:

Thanks for your answer about using alcohol prior to a peel. You also suggest acetone. Like nail polish remover?!! That seems incredibly harsh. (I shouldn`t use that, right?) Where would I purchase acetone that would be appropriate for the face? Thanks so much, Dr. Garcia.

Answer:

we use it for our deeper peels, it is harsh, but that is part of what is needed, the chemical you are going to peel with is likely more harsh than the acetone, or nail polish remover. You can get acetone from medical supply companies. JG 4.5.12

Question:

I`m doing a very mild, OTC home peel. Even though it`s not professional-grade, I`d like to degrease my skin properly. Will 70% alcohol be good for that? I was going to put it in a spray/mist bottle and blot my skin with gauze. If this isn`t the best way to degrease skin, what is? Thank you so much for your help!

Answer:

that is fine, or you can use acetone also. JG 4.5.12

Question:

Thank you in advance for this wonderful site - you have provided us so much valuable education & information. I am 54 YOA with moderately oily skin, enlarged pores at t-zone. My morning regimen is salycylic acid wash, vitamin c serum and NIA 24 sunscreen. In evening, same cleanser and then a pea size amount of Retin-A .1& and 4% hydroquinone mixed together. At times, I have a lot of exfoliation around the mouth and below. I am very compliant with skincare and would like to have your opinion if you think this is a good routine or if I should change/add anything?

Answer:

might want to add some microdermabrasions to keep the pores clean so they can close, otherwise sounds OK. If your pigmentation is under control I would stop the hydroquinone as it will irritate the skin and if you do not need it at the present time, there is no need for that. It can always be started again alter. Also make sure the sunblock is complete sunblock, SPF 50 or higher. JG 4.3.12

Question:

Just saw a question here about HydraFacial. Now that the company has introduced a newer improved version of this technology, all the derms and plastic surgeons in my area of the country are offering this -- for about $150/session. What is your opinion of this facial? Worth it or another way to part with hard-earned money? Thanks as ever for telling us all the truth!

Answer:

Mild, will need to be repeated, no better than others out there. JG 4.3.12

Question:

What are the most important ingredients I should look for in a moisturizer? Thanks

Answer:

avoid petroleum and as much fragrance as possibly. Otherwise, ti all depends on what of the claimed newest and greatest you want, I like retinols or lactic/glycolic acids in there, along with CoQ 10, Vitamin E. JG 3.30.12

Question:

Hi doctor, in that case which cream should i use for better result apart from surgery, thank.

Answer:

I must apologize, when a person asks a question, I cannot see your name so if you could repeat your question and reference your issue so I know what we had previously discussed, I can then answer your question, sorry. JG 3.30.12

Question:

Q: So which IPL machine is best for redness? Answer: The difference between brands is minimal, none are great for red, effects are short lived. JG 3.29.12 So if IPL is not the best treatment for redness from rosacea, what is the best treatment for redness?

Answer:

IPL helps but needs frequent sessions. Otherwise a VBeam laser is more effective. You also should use topical creams to help control the Rosacea. JG 3.29.12

Question:

Hi Dr Garcia, My dermatologist told me to apply Benzaclin and other acne medication to damp skin . Do you know what good that would do? thank you

Answer:

no need for damp as long as you just cleaned it, you can dry it and then apply. JG 3.29.12

Question:

hi doctor, could you suggest a cream which contain hyaluronic acid. i want to have a firm skin. thanks

Answer:

Topical hyaluronic acid creams do not work. JG 3.29.12

Question:

Is it normal for hyperpigmentation to be a bit darker the first week or two following a chemical peel? Answer: yes, very normal Regarding this question and your answer: Does the darkening mean that the peel is working? Is this a good sign? How long until this extra darkening fades out?

Answer:

it is the epidermis and the upper dermis that have been inured, similar to a sunburn, it will flake off and look refreshed.The extra brown spots will take 2-4 weeks to fall off. JG 3.28.12

Question:

Is it normal for hyperpigmentation to be a bit darker the first week or two following a chemical peel?

Answer:

yes, very normal. JG 3.27.12

Question:

Hi Dr Garcia, I have a lot of blackheads/whiteheads on my cheeks and my dermatologists have always prescribed retinoids. I`ve tried all 3 types, adapalene, tretinoin, and currently tazorac. All make my already oily skin unbelievable oily during the day. I can wash my face with a bar of dial soap, and within 15 minutes, my cheeks are getting oily again. I`m thinking of just going back to using acanya or benzaclin. I was wondering if you knew why a retinoid would cause skin to become even more oily, and if a product like acanya or benzaclin could also help with blackheads and whiteheads? Thanks so much.

Answer:

if the retinoid is to strong, it can cause that, might want to decrease the strength and see how it goes. Can also use microdermabrasion to control the blackheads and whiteheads. All the best. JG 3.27.12

Question:

Hi Dr Garcia, Last year I was diagnosed with Poikiloderma of Civatte on the neck and tretinoin 05% was prescribed – the derm suggested that I also use this cream on my face, and I ended up with erythema and broken capillaries about 3 months later. I then had three sessions of PDL (Candela V beam) following which the dermatologist suggested a course of IPL to “feather out” my skin tone. My last IPL was January, and a few weeks later a dent appeared on my cheek, and several pinprick indentations, more broken capillaries and a large rectangular mark - all on the same side, none were present before the IPL. These marks are obvious and I wondered if you’ve heard of this before and why would it happen? Also, do you have any tips/suggestions on what I should do to help/rectify my skin and this damage. Incidentally, the machine used was an Ellipse Flex PPT. Thanks again - I very much appreciate your advice.

Answer:

sounds like the last IPL caused some deeper injury than intended, can be caused by too much pressure on the head or not enough gel or too high of a setting. That should gt better on its own. Might suggest some light YAG lasers to settle it down. I wish you the best. JG 3.27.12

Question:

I am 38, can you recommend a skin care line that is best for anti-aging, and fine lines around the eyes. Thank you.

Answer:

I think Oil of Olay Pro series is a 3.26.12

Question:

Hi Dr. Garcia, I have a small round rosacea cyst on my cheekbone that refuses to go away after many years. Tried all topical & pill medications available. Is there any laser that might shrink the cyst or is the only option a small incison to remove it? Would hate to have the surgery and find out there was a laser to shrink it. Thank you for your time.

Answer:

IPL or VBeam laser are the next option. All the best JG 3.26.12

Question:

I have been pre-treating with hydroquinone 4% for one month now. Which will be more effecting for removing hyperpigmentation/melasma: a series of 6 PCA peels or a series of 6 IPL treatments? (I am not concerned about the price difference). Thanks for your help!

Answer:

likely the PCA peels. JG 3.26.12

Question:

Hi - Can you please separate fact from fiction - what actually is effective for getting rid of cellulite? I exercise regularly and am a fit size 2-3 but still have cellulite on the back of my thighs...Thanks.

Answer:

There is nothing that permamently eliminates it, diet and exercise will not help, treatments like endermologue help for a few weeks. JG 3.19.12

Question:

Thanks for your response, may be the last question. My daughter is 2-year old. will her face scar from leishmaniasis will look better as she grows older. I mean in terms of its appearance, depth and roughness. or it will continue to look the same. and lastly what about a plastic surgery in her older age like above 10? many thank once again. Arzhang from Afghanistan

Answer:

It will likely look somewhat abetter with the passing years. I think if there is a plastic surgeon there that can do some laser or scar revisions, I think it is OK to proceed if it is bothering her emotionally. I wish you both the best. JG 3.19.12

Question:

Hi Dr. Garcia, I have several small spider veins on the side of my nose. What is the best laser to get rid of them? After the laser, are there any creams that will help prevent them from coming back? Thank you.

Answer:

I suggest a YAG laser or VBeam laser, and there is nothing that will prevent them from coming back in time, sorry. JG 3.19.12

Question:

Hi Dr Garcia, I am a 20 year old female with about 10 hypertrophic linear scars (about 1 cm each) on my shoulders. I have got kenalog injections in the past that have only left them more red and noticeable. I am extremely self conscience of them and have recently began seeing a new dermatologist who I really trust and have been getting combined vbeam and kenalog treatments. The first treatment I did not bruise from the vbeam, the scars definitely flattened but the redness was unchanged. I just had the second treatment 2 weeks ago and this time all of the scars bruised. Its been about 10 days and the bruising has heeled, scars are now a reddish color similiar to what they were to begin with. Do you think they will continue to fade? Any info would be greatly appreciated.

Answer:

with more treatments, the will continue to fade in terms of the red color. Best of luck. JG 3.16.12

Question:

Thanks for the answer about the coconut oil. He meant that it should be applied topically; he didn`t say anything about ingesting it. But do you mean it has some health benefits if consumed? What do you think about its topical effects on the skin? Sorry for asking two questions in one day. And thank you for your very valuable time and advice, Dr. Garcia.

Answer:

similar but no better than squalene,oil, emu oil, or even extra virgin olive oil. They are all good because they are close to the fat base in our human skin. JG 3.16.12

Question:

My dermatologist tells me that coconut oil (particularly the solid rather than liquid kind), purchased in the baking aisle at the grocery store, is great at promoting wound healing. Is this true? I`ve never heard of it before. Any risks of infection? Thank you!

Answer:

it does have some health benefits as it is a medium chain triglyceride but the effects on wound healing are not anything to get excited about. JG 3.15.12

Question:

Hi dr Garcia, what is in your cell matrix creme that can give you similar benefits as retin a?I can`t tolerate retin a even a few times a week,too sensitive. Is your cell matrix the same as your peptide creme?how long before you see results? And finally , why don`t you put it in a pump bottle instead of a jar?

Answer:

the cell matrix has improved penetration agents it it, but is pretty close to the peptide, cream, a little more effective I feel. The ingredients are proprietary but there are no retinols or acids in it. Some people will see results in 2-6 weeks, it will vary. We have found the pumps to push out a larger amount that is required so we use the jar. JG 3.8.12

Question:

Hi Dr. Garcia: I don`t know what possessed me to do so, but I had some corticosteroid cream left over from a rash on my arm, and I thought that putting some on a pimple on my nose would get rid of the pimple faster. Now the pimple is gone, but there is a noticeable white spot where the pimple was, and I guess this is from the steroid. I also was out in the sun, and the white mark is even more noticeable with a sun tan now. Will this white mark from the steroid fade eventually, or is it irreversible? Thank you.

Answer:

it should, if it does not, it might be a small fungal infection that is preventing the skin from repigmenting and a dermatologist can give some antifungal cream to fix it if that is the case. All the best. JG 3.7.12

Question:

hello dr garcia! i have a question regarding my skin. i started obagi 3 yrs ago and my skin was flawless porless etc. i always had oily skin and open pores before i discovered obagi which cleared the problem, however things have really turned for the worst now, since i had a copper iud contraceptive inserted 1 and a half years back my skin started to deteriorate, even obagi has become non effective, i have dilated large pores that look like oranege peel texture all on my cheeks and forehead and nothing works to get rid of it i had the copper coil out 2 months ago but my skin has not improved, i heard of so many women having copper intoxication and skin problems, acne & cysts etc from the effect of too much copper released into the body, but iam worried iam scarred for life with this, tretinoin used to work wounders on my skin and i was always poreless now i look worse than what i did before i started obagi. can you suggest anything? i have been thinking of doing active fx laser or an ablative co2 as i have tried even the blue peel and that did nothing its like i have permanent tiny holes in my skin that wont close in, iam oily too which makes it worse. any suggestions? what about accutane or isotret? thanks!

Answer:

I think some IPL and microdermabrasioms, would not do Accutane and the partiallly or totally ablative laser would make it worse. Might want to get your hormones checked to to make sure your proegesterone levels are OK. JG 3.6.12

Question:

Dr. Garcia, just to clarify, my periods have ceased close to two years and hormone levels reveal that I am menopausal not perimenopausal. Do you recommend menopausal women to take progesterone replacement from day 1 or from day 12. What are the advantages and disadvantages of both? O.K. I promise this will be my last question, but I am just a little confused why my friends doctor only recommends progesterone from day 12 for perimenopausal women. God bless your cotton socks, I still don`t know where you find the time for all that you do. Cheers

Answer:

I usually have my patients take the progesterone and estrogen along with testosterone every day of the month, I have the woman stop the creams entirely three times per day for 5 days to allow the uterus to avoid too much thickening.That will avoid menstrual flow and avoid issues with the uterus. Taking it for three weeks and stopping for one week is similar to the cycles you had when younger, but it can lead to menstrual flow and PMS. JG 3.5.12

Question:

Dr. Garcia, I am menopausal and have been taking bio hrt for a few years now. The last six months I have been on a protocol of applying a cream made up of 3mg biest, 1mg testosterone and 20mg dhea which I apply twice a day from day 1 to day 26 with five days break. I apply the progesterone cream 50mg from day 12 till day 26 then a break for five days. My friend who is on a similar protocol as me except that she has the progesterone from day 1. When she asked her doctor why she can`t commence progesterone cream from day 12 onwards her doctor informed her that commencing progesterone from day 12 on is only for perimenopausal women. As she is menopausal (same as me) she needs the progesterone from day 1. Is that correct? I hope you don`t mind answering questions regarding bio hrt as your information has been invaluable in the past and I am guided by your expertise, have a lovely day Thanks in advance

Answer:

well, if you take the progesterone every day, it will likely stop your periods. In theory, if you are still having periods, your ovaries might be making some progesterone, but I have found that if your ovaries are not making as much estrogen as they used to, then the ovaries are likely not making as much progesterone as they were either. Dosages might need to be higher once your cycles stop, but if you are taking HRT during the menopause, you have no accurate measure of ovary function as you are overiding it. Blood levels need to be checked to make sure the dosing is correct, both peri and post menopausal.JG 3.4.12

Question:

I know Endermologie produces only temporary improvements in cellulite, but I wonder if you think it is potentially harmful to the long-term appearance of cellulite; that is, since cellulite is the result of weakened connective tissue allowing the fat to herniate a bit, does the vigorous manipulation exerted on that connective tissue by the device further its deterioration even as it temporarily contracts it? I don`t want to make my situation worse for a short-term (and expensive) improvement in appearance. Thank you for your guidance, Dr. Garcia.

Answer:

I have never seen ti have an adverse effect where it makes the cellulite worse. JG 3.4.12

Question:

I have sensitive skin and even have had v-beam and IPL for redness in my skin and old acne scars. However, I would like to start a mild regimen of retin-A to improve the texture of my skin. Is there a gentle way to do so? maybe use it every other day to get the benefits but keep the irritation low and redness at bay?

Answer:

keep it low and it might avoid the irritation but it will also not be as effective. JG 3.4.12

Question:

Hi Dr. Garcia, I am an african american woman suffering from melasma, nevus ota. About 2 years ago, I had 4 fraxel treatments that made the Nevus darker and the melasma spread. Since then, I have had several peels, including melange with little improvement. My self esteem has suffered and i am now looking at trying the Q-switch YAG laser. Do you think I should try laser treatment again? I have read it is safe for african americans but I am very nervous. I need to do something but I do not want to make it worse. ---S

Answer:

I think the Q switched YAG laser is where I would have suggested you start, the Fraxel will do nothing for the Nevus of Ota and has the chance of developing new pigment problems. All the best. JG 2.29.12

Question:

I had my first injections of Sculptra 6 weeks ago and am thrilled with the results. The only problem is that the ps who injected me massage it WAY too vigorously, and left a huge abrasion on my cheek which bled for an entire week. I kept it moist so it wouldn`t scab and scar; but I have been left with a big, bright red mark on the cheek, and it`s not fading. Will a VBeam treatment help? Thank you, Dr. Garcia!

Answer:

VBeam or YAG laser would help. JG 2.28.12

Question:

Oh, the blanching happened right away; it just hasn`t resolved yet. Should I still massage it and use moist packs? Thank you.

Answer:

I see, sounds like a spasm or the muscles squeezing the blood vessel. I would use the moist heat to relax the tissues, massage to break muscle spasm, can also take some oral magnesium as that helps relax muscles too. The skin of the face is quite resilient to such issues. JG 2.27.12

Question:

Hi, Dr. Garcia. I just moved and went to a new provider for Botox -- an experienced nurse practitioner in a plastic surgery practice. 10 hours later, and I have a blanched mark at the injection site lateral to my left eye; in fact, it looks exactly like epinephrine. In nearly 20 years of being injected with Botox, this has never happened to me. Anything to worry about? Thank you!

Answer:

If the Botox was going to cause a blood flow issue,it should have happened right away. Not sure what it could be at this time, but since it has been 10 hours, some massage and moist warm packs might be a good idea. JG 2.27.12

Question:

Hello doctor, pls kindly tell me how i can heal a thick burn scar of six mnths from the inside out. Which supplements are best to get my skin to near its former state? Thanks so much

Answer:

I am sorry, but no such thing exists. JG 2.25.12

Question:

How many units of Botox are typically needed for the glabella? Thank you.

Answer:

The FDA trials used 20 units to see a clinical response, but some people with stronger muscles require more. JG 2.23.12

Question:

So is it feasible to do a PCA peel series (excluding the rosacea areas from the peel) at the same time as a series of IPL, alternating the treatments, each 2 weeks apart?

Answer:

correct, 2-3 weeks apart, as tolerated. JG 2.21.12

Question:

So in my case where I struggle with both rosacea and melasma, is IPL my best option as it can address both? Also, can I have two passes with the IPL? - one pass at settings to address melasma and one pass at settings to address rosacea? Thanks for your help in this.

Answer:

it is part of the regimen, you will need to use more than one thing though, ie retinoids and hydroquinones only on melasma areas, topical antibiotics for the Rosacea, along with sunblock. Double pass at different settings is possible, yes. JG 2.21.12

Question:

Hi Dr. Garcia, Thank you for your advise. So if I understand correctly, IPL may worsen my melasma initially but will help to lessen it in the long term?

Answer:

correct, although Melasma is deep, so it is better treated with a YAG laser, which is a true laser where an IPL is an intense light, not a laser.JG 2.21.12

Question:

Hi Dr Garcia, Me again, the melasma and rosacea gal. In regards to my questions, I should let you know that I am a Fitzpatrick III, and I use zinc/titanium sublock spf 30 daily rain or shine. Thanks again for your help!

Answer:

keep the sunblock too. JG 2.20.12

Question:

Hi Dr Garcia, I am lucky enough to have melasma and rosacea (subtype I) at the same time :-) I am currently treating the melasma with tretinoin and 4% HQ and will start a series of PCA peels this week. The results have been wonderful so far. Problem is, this treatment has exacerbated my rosacea to the point that I can`t even exercise without burning and flushing. I would like to finish out the melasma treatment as the results have been great. Is there something I can add to the mix to address the rosacea (while continuing the tret/HQ)? Would switching to Triluma be better on the Rosacea (as compared to just tretinoin and HQ)? Also, I understand that IPL can exacerbate melasma. Is this true if the IPL machine is set at settings for rosacea? Perhaps I should proceed with IPL while I`ve got the HQ on board? I guess this is what I get for wanting it all :-) Thanks for your help!

Answer:

Avoid the creams on the Rosacea and try getting some IPL or Fotofacials on the Rosacea to control it. I do not think Triluma or Retin-A will help Rosacea and will likely aggravate it. IPL can short term aggravate the melasma, but will help long term. The settings for red and brown on the IPL need to be different.JG 2.20.12

Question:

Had Erbium resurfacing 2 mos ago, raised vertical scars under both my eyes. Doc wants to see me in 6 mos. I don`t think this will heal in 6 mos. I am so scared that my face is ruined. Is this going to heal in 4 more mos? If not is there any treatment for this?

Answer:

If the scars are raised and vertical you should have at least so me kenalog or 5FU shots to decrease the scarring . JG 2.19.12

Question:

Hi Dr Garcia, Am I to use hydroquinone up to the day of my PCA peel? How many days after the peel do I resume the hydroquinone? I have the same questions regarding the tretenoin.

Answer:

We use both until the day of the peel and start between 5-7 days afyer. JG 2.19.12

Question:

Hello, I currently use retin a at night and a sulfur cream in the morning. I have been using 20% vitamin c serum under my eye area only in the mornings but would like to begin using it over my entire face. Is it ok to layer this under the sulfer cream? Thank you.

Answer:

should be safe, yes. JG 2.16.12

Question:

I have a few spots of black melasma above my eyebrows, and brown across my upper lips. What kind of treatment would you recommend? Thanks

Answer:

I would suggest a YAG laser for that. JG 2.13.12

Question:

Hello Dr. Garcia. I have a 30 spf moisturizer I use daily. Will I still get 30 spf protection if I put a 15 spf foundation over the day moisturizer? Thank you.

Answer:

No, they do not add up, they dilute one another. JG 2.12.12

Question:

Which is more effective for treating melasma: IPL or chemical peels?

Answer:

chemical peels. JG 2.9.12

Question:

If I use 4% hydroquinone only once daily for 3 week prior to getting my chemical peel, will that be enough to prevent PIH?

Answer:

it should, along with use after the peel too. JG 2.8.12

Question:

How many units of Botox do you typically inject into your own patients` crow`s feet (per side and total)? Thank you!

Answer:

10-20 units per side, depending on the patient. The degree of wrinkle reduction is not remarkable, I use it for brow elevation rather than wrinkles. JG 2.7.12

Question:

oops....see previous question. I meant to ask if a series of 10% TCA peels (PCA Ultra Peel I) would do much for my mild hyperpigmentation/sundamage.

Answer:

Should help if done in a series. JG 2.7.12

Question:

Hi Dr. Garcia, is a series of 10 TCA peels (PCA Ultra Peel I) from my local medispa likely to do much for reducing some mild sun damage/hyperpigmentation?

Answer:

Should help, yes. JG 2.7.12

Question:

Following the chemical peel I will continue the 4% hydroquinone for 4-6 weeks to prevent PIH. Can I use it once daily or is it necessary to use it twice daily in order to prevent PIH? Thanks for your advice!

Answer:

Once, at night and sunblock. JG 2.4.12

Question:

How long after a chemical peel do I need to continue Hydroquinone in order to prevent PIH?

Answer:

4-6 weeks, and don`t the sunblock. JG 2.4.12

Question:

Hi Dr. Garcia, what is your opinion of the PCA oxygenating trio? Worth the time?

Answer:

Sorry, but no. JG 2.4.12

Question:

Hi Doctor.I hope you and yours are well and many thanks for your site and your advice.What are your thoughts on the use of skinoren(azelaic acid) for the reduction of thread veins on the face? Can it help?

Answer:

Likely will not help and could make them worse, sorry. Thank you for the kind words too. JG 2.2.12

Question:

Hi Dr. Garcia, I had two diluted kenalog injections into an acne cyst on my cheek last year. I now have a obvious 3 inch hypopigmented mark in the injection site area. Is there any treatment available to restore some of the melanin back in that area? Thanks,Al

Answer:

Supposedly excimer lasers help but I have never personally seen it, sorry, but not much else I can offer besidea trying to go out in the sun. JG 2.1.11,

Question:

My ps used radiesse in my face and stored some to use later. Will it still be as potent next time it is injected? Thank you

Answer:

Should have the same potency, yes. JG 1.31.12

Question:

Is it OK to use Retin-A on lips to promote exfoliation? Thank you!

Answer:

I have had patients use it, just don`t swallow it. JG 1.31.12

Question:

For how long do I need to use hydroquinone prior to a chemical peel or IPL in order to prevent PIH?

Answer:

2-4 weeks. JG 1.31.12

Question:

Good morning Dr Garcia. Does using hydrquinone twice per day (instead of only once) produce results that are twice as fast?

Answer:

cannot say twice as fast, but it is more effective. JG 1.30.12

Question:

Hallo Dr. Garcia ! I have developed rocasea and now I had my first IPL done. How long should I expect swelling.. I did it yesterday and I still have swelling. Many thanks;)

Answer:

Depends on how strong a setting was used, can last 2-4 days in some patients. A liile ice will help. JG 1.29.12

Question:

I would apprecaite your thoughts on ultherapy. Is it a waste of time and money?

Answer:

Painful to have done and results do not last as long as advertised. JG 1.28.11o

Question:

hi doctor, i am 45 and i wanted to use hyaluron fillers from eucerin. is it a good product. please advise, thanks.

Answer:

not much better than all the other moisturizers out there, they are trying to capitalize on the popularity of hyaluronic acid fillers, while they are not a filler and the ability of topical hyaluron to push fluid into the cell is minimal to none. JG 1.27.12

Question:

I have sensitive skin and melasma. Is 2% hydroquinone worth the time?

Answer:

since your skin is sensitive, I think it is a good concentration to start with and see how you tolerate it. If you tolerate it well, then you can move up to a stronger dose. JG 1.26.12

Question:

What would be the best or longest lasting filler for marionette lines? I have tried radiess and restylane, but they go away shortly. I have been considering artefill, but I am a little wary because of the potential for infection or nodules or long term consequences. Could you address my concerns about artefill? Also, what is your opinion of the ebrium laser? Would it help get rid of small wrinkles and lessen the appearance of deep wrinkles? Also how long would the effects last?

Answer:

well, I do think Artefill should last longer, but the marionette line will recur as the problem causing it, which is the downward descent of the cheek skin is not helped by a filler into the fold. I think erbium lasers are good, but expect no more than 12-18 months of improvement on the fine lines and less on the bigger wrinkles. JG 1.25.12

Question:

One more question Dr. Garcia ... is there anything you`ve seen work on old scars or stretch marks? I (foolishly) did a body lift many years ago. Over the years I`ve tried different things in the hopes of lessening the scar. I used Mederma and I`ve used Hydroquinone (Porcelana and the like) but to no avail. The scar in the crevice of my thighs is the worse (more brownish than pink). Anything that you know that will help? Thank you!

Answer:

might try some Q-switched lasers to fade the brown is about all I can suggest, sorry. JG 1.22.12

Question:

Hi Dr. Garcia, I may have asked this question before but can`t remember (although I`m sure many others have asked it) *but* is there ANY treatment that is good for cellulite? While I exercise 5 days a week, I have a LOT of cellulite on my thighs (which I believe lipo made worse - though no one told me that when I originally got it 20 years ago - or again 10 years ago). I`ve tried creams. Zero. I even did endermologie for a while. Didn`t notice much, if anything. I`ve heard (on the Housewives of Atlanta, LOL) about thermage. Is there any hope? Any thing at ALL that you`ve seen work? THANK YOU!!!!!

Answer:

I think the only thing, and it does not work for all, is endermolgie, Thermage is no better than endermologie. sorry. JG 1.22.12

Question:

Hello Dr. Garcia. Which is the best and lasts the longest dermal filler that you can recommend for hollow lower eyelids? Thank you.

Answer:

I only use Restylane for that problem. Best of luck. JG 1.20.12

Question:

I have a raynaud`s type of problem with my hands, where they lose circulation and turn pink and purple..my hands are very leathery looking..would having a fraxel treatment to the back of my hands to improve the texture cause complications with the circulation in my hands and aggravate this condition?

Answer:

I do not think a fraxel will compromise your circulation but I am not sure how much improvement you will get that will be long lasting. JG 1.20.12

Question:

I have a few questions for you tonight, Dr. Garcia: 1) Can you recommend a good moisturizer with salycic acid for keratosis pilaris on the butt? Any other treatment recommendations? 2) I`ve been reading some of the recent exchanges here on Zeltiq. I see that you think conservative liposuction on the arms would give better results, but I have just a small amount of fat there and am wondering if the results with Zeltiq will be so limited that it will prevent me from having the dreaded sagging skin problem; that is, is Zeltiq so limited in its efficacy that it may actually be better for someone like me? It sounds like while it reduces some fat, it could never get rid of enough of it to produce loose skin. Is that a reasonable conclusion? I don`t want to do this and find that it reduces so much fat that it leaves loose skin, but from your reviews of this technology, that scenario seems highly unlikely. Am I thinking correctly about this? Thank you! Good night.

Answer:

I do not think there is any one skin cream with salicylic acid that is better than another, I am afraid. As to the Zeltiq CoolSculpting, I do not think their smaller pads for areas like the arm is available yet, but you can try it, the less loose skin will happen if you remove less fat, whether its liposuction or Zeltiq though. The typical reduction with the Zeltiq is 20-24% on the abdomen, I have not seen percentages from an arm treatment as of yet. JG 1.19.12.

Question:

Hi, Dr. Garcia. I had an aggressive IPL treatment and a mild Titan treatment two days ago, which I`ve had often, but the procedures left me INCREDIBLY swollen, unlike other times. I`ve taken diphenhydramine, used ice packs, slept with my head elevated and not had any sodium, all with no results. Could something have gone wrong? If so, what? Anything else you would recommend that I could do to reduce the swelling? It actually looks like I`ve been stung by a swarm of bees!

Answer:

I think what you are doing is all good, might want to contact the doctor where you had the treatment and see if they can call you in some oral steroids, something called a Medrol Pack is used at times for circumstances such as yours and it helps. I do not think anything went wrong, can be a normal response to the treatment but eliminating all creams or ointments that might be causing an allergy are also important. I wish you the best. JG 1.18.12

Question:

Hi Dr, What treatment do you recommend for the crepey but not loose skin only in the central panel of the neck. I have tried Dermaroller and Retin A but they havent really helped. I understand RF cannot be used in this central area because of the thyroid? Thank you

Answer:

I feel that there is really not much out there that works well. Chemical peels might give a few months of improvement, some of the folks doing fractional lasers claim to have great results but I have not sen pictures of any patients past the 6 month point to say whether it is worth it or not. JG 1.18.12

Question:

Hello Dr. Garcia. Which is the best treatment for hollow lower eyelids - dermal fillers, fat transplant, midfacelift, or lower blepharoplasty? And also, which of these give longer lasting results? Thank you.

Answer:

if it is the orbital rim, the fillers is the safest and easiest with the least risk. I do not think a midfacelift will help a hollow eye. If the eye is already hollow I do not think a blepharoplasty will help.I think fat grafting is unreliable and can lead to lumps due to the larger needles or cannulas used for infiltration. If the holowness is of the eyelid itself from excessive surgical fat removal, there might not be much that can be done. JG 1.17.12

Question:

Hi, Dr. Garcia. I think you`ve answered this question for another reader in the past year, but I can`t find it in the archives. Sorry for a repeat question! You advise a two month annual break from Retin A, but if one is using an OTC retinol, is the same break necessary? (I use Environ`s Retinol with colostrum.) Thank you! Also, to the person who wrote below that s/he had had Radiesse under the eyes, let me echo your caution: No one should EVER allow that material to be injected under their eyes. Six years ago, a plastic surgeon did that to me, and I developed huge granulomas that had to be removed surgically, along with a big portion of my mid-face tissue and eye muscles, bilaterally. I was permanently --and seriously -- disfigured by this injury. Seven reconstructive surgeries (and 75K+) later and while I can now close my eyes, I look like I was in a horrendous car accident. In fact, that is what I now tell people when they ask what happened to my face, which they do multiple times every week of my life. I wear thick glasses I don`t need to hide some of the scars. All of this from one stupid injection. I used to be a relatively attractive woman, but no longer. Thank you for all you do to help other people avoid my fate, Dr. Garcia.

Answer:

the retinol is not as irritating so you could potentially use it 12 months a year, although I think it is wise to give the skin a little break, it seems that even with the lighter forms, a short break with a different product and then resuming the old products gives the skin a bit of a jump start. Thank you so much for your personal anecdote, it means a lot hearing from an actual patient. Many thanks and all the best. JG 1.16.12

Question:

Hello, Dr. Garcia. What is your opinion of Vivite`s Vibrance Therapy? What does it help/what is it especially good for? My dermatologist is claiming it`s terrific, but of course, he`s selling it!! Thanks, as always, for your honesty and help.

Answer:

no better than all of the others out there. JG 1.15.12

Question:

I had flat moles removed. They were removed deep enough to leave very slight (but not very noticable) indented scars. They were scratched and a chemical was put on them to burn them off. They appear completely gone right now. What are the chances they would come back with sun exposure?

Answer:

now way to tell on the time, but they will come back as some of the pigment creating cells still exist in the skin. JG 1.15.12

Question:

Hi Dr, Agian ,do you want to say that led therapy is not working and its only waste of time and money? what about softlaser? is it same useless? thnaks

Answer:

I think they are both a waste of money, sorry. JG 1.13.12

Question:

Hi Dr Garcia, i am 40+ and due to crash diet i got sage skin and pigment /wrinkles and so many problems ,,i need to know about led light therapy if it is good for my problems please sugest me one of them which is you think is the best check it http://www.ebay.com/itm/LED-LIGHT-THERAPY-PHOTOREJUVENATION-IPL-ANTIAGIN... http://www.ebay.com/itm/Anti-Aging-LED-Photorejuvenation-Light-Therapy-R... also please let me know can i use this light therapy for my 15 years old daughter to get fariar complection thanks and waiting your feedback

Answer:

I would not spend any money on that product, sorry. JG 1.12.12

Question:

Have you done any Y lifts? Supposedly some kind of filler is injected at the top of the cheekbones and at the jawbone to fill in lost fullness of the face. Is it okay? and how long would something like that last?

Answer:

depending on the kind of filler, anywhere from 2-10 months, would make someone look better if they have lost facial fat, but in full faced people, it will make you look fuller or heavier. JG 1.12.12

Question:

Dr. G: What have you heard about Allumera, the new photo dynamic cosmetic treatment that is suppose to get help with sun damage and discoloration as well as diminish pore size, lines and wrinkles? Does it work?

Answer:

a new player in the PDT arena, I will say that any effect on the pores will be short lived as it does not affect the cause, just the symptoms. Also, it has to be done carefully and after care in terms of exposure to light is imperative, otherwise the risks of burning the skin increase with scarring and the safety margin is gone. It is a cosmetic use for something that was originally developed for the treatment of precancerous lesions and controlling acne break outs. Might get 3-5 months on the pores and maybe 6-8 months on the texture and small lines. JG 1.12.12

Question:

Hi doctor. I am 45 and i noticed that my face is becoming dull.Please could you suggest to me what should i do to have a youthful appearance. Is there a cream that contain hyaluroni acid that i can use. please advise, thanks.

Answer:

I would suggest starting wit Retin-A, you could also do some IPL sessions in a MediSpa and some microdermabrasions too. Best of luck. JG 1.12.12

Question:

Hi Dr, i start using 40% glycolic acid before one month at home ,,,now i got softlaser machine at home so the question is can i use both glycolic and soft laser at a time if yes what is the time period between these both treatments? thanks waiting your feedback

Answer:

well, you must have gotten the glycolic acid at that stength through an illegitimate seller as glycolic acids past 15% are not to be sold to the lay public.The potential for scarring using a glycolic acid of that strength is high as it is intended to be used at lower concentrations in order for it to be safe, once you go that high, the risks are also high As to a softlaser at home,it is not a true laser in the generally understood sense and I think you will get little to nothing from it.Sorry. JG 1.9.12

Question:

Hi Dr Garcia, I have very small pores and oily skin, and have a lot of non-inflammatory acne (blackheads and bumps under skin on forehead and cheeks). I have had poor success with tretinoin (atralin and epiduo) and since my insurance stopped covering my meds, thought to go for over the counter solutions. Do you think a glycolic acid wash twice a day and nightly use of something like salicylic acid oxy-pads, and going without anything during the day may do something for this kind of acne? Thank you.

Answer:

I think it wil help, can add a toptical retinol cream, which is a lighter Retin-A analog. Could also consider IPL sessions or microdermabrasions to keep the pores as clean as possible. All the best. JG 1.6.12

Question:

How long does it take for most topical products to absorb fully into the skin? I apply them at night about 20 minutes apart and then leave them on until morning, but there are a few I would like to use under sunblock every morning too (like antioxidant serum). I find that if I apply sunblock over them after 20 minutes, I`m shiny all day. I wonder if I can apply those (costly) serums to my face, wait twenty minutes, blot off any excess with blotting paper, and then apply sunblock. Will the serum mostly have absorbed by then so that I will benefit from it during the day? Obviously, I don`t want to 1) undo any good I may be obtaining from the serums and 2) waste any expensive products by essentially wiping them off. Thanks so much! A happy and healthy New Year to you and your family, Dr. Garcia!

Answer:

in most cases the active ingredient has absorbed in 10-20 minutes and what is left is the carrier. All the best and Happy New Year. JG 12.27.11

Question:

Hi, Dr. Garcia. Quick question about pigmentation: I see that you always advise here that no matter what one does to remove pigmented marks, they will always return due to repeat sun exposure. You`ve also said here that deeper pigmented spots can`t rise to the top layer of the skin. But what if a full spectrum physical sunblock is used 365 days/year all over the body? How could the spots that have been removed return? Newly visible spots shouldn`t be caused then by external factors, right? And since the deeper pigmented spots that haven`t been removed by laser and hydroquinone can`t rise to the top, newly visible spots can`t come from within, right? Thanks for clarifying this puzzle for me.

Answer:

That would help make it tale longer but the sunblock wears off or smears off so unless you live inside with incandesent lights only, they will come back. The more diligent you are with avoiding the light, the longer they will take. JG 12. 26.11

Question:

Hi Dr Garcia, For post op bruising, do you recommend Arnica Montana, or SinEccH? What is the difference between the two? The best of holidays to you. Thank you for all your valuable support and guidance throughout the year. You are truly the best. kp

Answer:

I prefer the Arnica Montana, higher does and less expensive.Merry Christmas and a Happy New Year to you. JG 12.22.11

Question:

I had a fraxel treatment done 2 years ago. The skin that was treated takes a very long time to heal. No improvement noted and some horrible pits on my nose! is there anything I can do now? I used 3 years of savings for this treatment.

Answer:

might need a CO2 laser to attempt to smooth out the depressions on the nose is about all I can suggest. Sorry to hear about your issues. JG 12.21.11

Question:

Hello Dr. Garcia. Is the aloe vera gel straight from the plant a good facial moisturizer? Thanks.

Answer:

usually pretty good but can irritate a small number of people. JG 12.16.11

Question:

What do you think of SkinCeuticals Pigment Regulator? I know it`s less powerful than hydroquinone but is it effective (and less irritating/safer)? As good as or equal to the other competing products now widely available (like Clinique`s Even Better)? Thank you. Happy holidays, Dr. Garcia!

Answer:

likely less irritating but every patient is different, safe to use though. I think it is fairly similar to the Clinique one. All the best for the holidays to you too! JG 12.13.11

Question:

I know you regularly instruct those who write to you to ensure that their physicians are adhering to the single-use rule for each vial of Botox. Whenever a shipment of Botox arrives at my own PS`s office, he and his nurse draw up individual syringes from the bottles, refrigerate the syringes and then discard the bottles. I`ve seen them doing this many times. I assume that this is safe, since they`re not drawing up the syringes from the bottles between patients, but could you confirm that? Thank you! By the way, your colleaguesacross the country should be paying for you all the on-call work you do to handle their patients` concerns when they themselves are unresponsive. You are an amazing physician and human being. God bless you.

Answer:

seems to me that it is a conscious decision to circumvent the labeling that they are aware of, so still wrong. Also, you need to know it was mixed and used within 4 hours. Safe, likely, ethical, not likely. I will not do it that way. JG 12.13.11

Question:

I have faint melasma scattered all over my face, so it really isn`t possible to apply the HQ only to the darkened areas. How long can I apply a HQ/tretinoin combination to my face without the HQ lightening the color of the unaffected skin? I only want to achieve lightening of the darkened areas.

Answer:

Since all the skin has some sun damage, just worse in certain spots, the entire surface willl fade some with the HQ and Retin-A JG 12.10.11

Question:

Hi Dr Garcia, I don`t tolerate the steroid in Triluma. I have been layering tretinoin 1% cream followed by HQ 4% cream each night with good results. I am tired of layering and am wondering if there is a prescription cream that combines 4% HQ with tretinoin. If not, would a compounding pharmacy be able to compound that for me?

Answer:

Go with the compounding pharmacy, best price and quality. JG 12.10.11

Question:

Thanks, Dr. Garcia, for your web site and resources. :) My question: I have older but quality powder makeup (bronzer, blush, face-base powder, etc) that I would hate to toss. However, the products are open and range 1-4 years old. Some of them were my mom`s hand me downs. I don`t want to introduce bacteria to my skin as I am acne-prone. However, I am budgeted and, froma frugal perspective, I want to know if wiping off the surface layer then spraying (or dousing) these powders with alcohol or vinegar, THEN placing them in direct sun to dry is an idea worth trying vs throwing out all the makeup and having to purchase new. Thoughts or other ideas? My main goal is to make the makeup powders I already have safe to use on my acnegenic skin. Thanks!.....

Answer:

I think bacteria growth in the powder is a low risk, so likely safe to use. Best of luck. JG 12.7.11

Question:

Hello Dr. Garcia, I have two questions. 1). I have a mild form of rosacea. My derm has recommended IPL treatments monthly x 4 months then maintenance at once every 3 months. Do you think that would be effective? and 2). Can you please explain how topical progesterone cream helps prevent hormonal acne? I thought progesterone is what caused the breakouts before a period? Does it help by delivering a steady dose thereby counteracting the monthy surge? What is the proper concentration to apply

Answer:

I do think that IPL is helpful in controlling mild Rosacea, yes. As to the progesterone and hormonal acne, the issue is one of the progesterone competing for the break down enzyme that functions on testosterone. If the progesterone uses up the break down enzyme, then the testosterone cannot turn into DHT which is the culprit of the hormonal acne. The break outs before your periods are actually due to the precipitous fall in the progesterone level which allows the menstrual flow to start.What concentration is needed varies from patient to patient, and needs to be tried and individualized. JG 12.6.11

Question:

Hi, Dr. Garcia. Two things for you today: 1) What id your estimate of the new line of OTC products competing with hydroquinone? I`m referring to Clinique`s Even Better, Garnier`s Dark Spot Corrector, etc. I`m using NeoCutis`s version, called Pearl. I remember reading in your blog that long-term use of hydroquinone isn`t a good idea due to the irritation. Are these other products really effective? And are they less irritating than hydroquinone? 2) I want to wish you and your family a beautiful holiday season and a healthy, fulfilling new year. You do so much for all of us. May you receive in the coming year even some of the immense kindness and generosity you always offer to others.

Answer:

the concentration of the hydroquinone-like ingredient in OTC products is low enough that the irritation factor is diminished, but I still would take a break during the time when it is easiest to avoid sun exposure. All of those products are pretty similar and they are fairly effective, especially in more recent areas of hyperpigmentation. Thank you for the best wishes and I wish the same for you and yours. JG 12.6.11

Question:

Hallo Dr Garcia. First a early merry christmas and a happy new year. Now to my question. What experince do you have with keloids (scartissue) and if what treatment besides cortison injection could be done? Thank you

Answer:

Thank you for the kind wishes. As to keloids, I do think kenalog or cortisone injections do help but can cause surrounding tissue atrophy. I use either 5FU injections and at times combine the 5FU with very low doses of kenalog to help flatten the scars. In many, but not all cases, the injections can help, but it is always a series of injections. Merry Christmas to yours and yours too. JG 12.5.11

Question:

Hello Dr. Garcia..Is it advisable to have a Blepharoplasty procedure for hollow eyes, wherein they stretches the skin below the eyes to make it firmer? Is it long lasting? Thanks..

Answer:

I thin the degree of improvement of the hollows by merely tightening the skin of the lower lids will be very short lived and the hollows will be visible again in a few months, once the swelling is gone. Sorry. JG 12.5.11

Question:

Hello Dr. Garcia. Is it safe to put pure aloe vera gel extract around the eye area to moisturize it? Thanks a lot.

Answer:

yes, OK to do that. JG 12.5.11

Question:

One month ago, I went to my dermatologist for an unrelated issue, and pointed out an almost invisible vein on my face about an inch below my right eye. He said it was a spider angioma, and that he could cauterize it right then, or I could leave it alone. To my deep regret, I chose to let him zap it. The nurse injected it with xylocaine, and he remarked that since it was numb he could really get it good. Now I`m left with an indented red mark that resembles a chicken pox scar. I use Retin A gel, prior to this and now. Could thinner skin from the Retin A be a factor, or over aggressive treatment with the hyfrecator? What do you think might help resolve this mark? Many thanks, Amy

Answer:

more likely due to the depth of injury from the cauterization, the Retin-A will not cause the problem, and using it after the area has healed might help it look a little better as it will aid in the creation of more collagen. I think at this point in time, it is more a matter of time rather than anything else. Best of luck. JG 12.4.11

Question:

I use SkinCeuticals Floretin CF. (I think you generally advise the use of such topical antioxidants. Is that right?) Should I use it in the evening, morning or both? The company recommends both, but I always suspect such instructions are designed to get the customer to use, and so to buy, more of the product. Since it`s a very expensive item, I`d like to use it twice each day only if it`s truly helpful to do so. Thank you very much.

Answer:

I do like topical anti-oxidants.I think those types of products can be used twice daily if desired. The older one is, the greater the benefit from the twice per day. JG 12.4.11

Question:

Would you please clarify something for me, Dr. Garcia? I see that you always advise people who write to you about pigmentation that no matter what one does to fade, peel or ablate pigmented spots, they will always come back -- even with vigilant use of sunblock every day, multiple times each day. Why is this so? Once they`re gone, that should be it, right? But you seem to imply that all these treatments are pretty useless or, if effective, so temporary as to be not worth pursuing. It makes me wonder if I should continue to try to redress this problem. Thanks for filling me in on this mystery!

Answer:

Not useless but temporary, the time to come back varies, the dermal melanocytes have memory and will repigment with time and light exposure. JG 12.4.11

Question:

Hi Dr Garcia! I have a question about Retin A. I`ve read an article by one US based dermatologist , he had mentioned that we should apply any type of retin A or retinol for 6 months, and give our skin a break of the following 6 months later with other night creams like antioxidant to promote new cells turnover.We shouldn`t add the retin A routine during these 6 months gap.Is there any benefits on our skin by performing this act?

Answer:

I also like to give the skin a break from the Retin-A or retinols, I use three months, but certainly 6 months is OK also. I think the constant low grade irritation to the skin with retinols is not good and using alternative creams will allow you to maintain the benefits achieved from the retinols though. JG 12.1.11

Question:

Hi dr garcia. Just one question, I have melasma on both sides of my cheeks. A plastic surgeon recommended Obaji newderm and thereafter Pixel laser treatments. The before/after pictures of the Obaji seem very impressive but I am in two minds. Will the pigmentation return once a complete a course of Obaji? I feel extremely self conscious and am willing to try anything. The Obaji also contains hydroquinone and i fear that my melasma (it is not too dark at the moment) will return if i discontinue use. Any product that you can recommend? I am based in the UK. Thanks in advance

Answer:

in time, with sun exposure or exposure to fluorescent lights, the pigment will return, no matter what technique is used to remove it. I would go with the Obagi, and repeat it in the future as needed. All the best. JG 11.29.11

Question:

Good day Dr. Garcia. Is it safe for a woman who has a history of rosacea do have a face and neck lift? Rosacea under good control, but have think skin. How likely is it to exacerbate the sympmtoms? Bless you for all your help. kp

Answer:

The Rosacea should not affect the facelift, but I will say that anything stressful, and surgery of any kind will increase stress, can trigger an exacerbation of your Rosacea, but that can be controlled with your prior medications.Best of luck. JG 11.18.11

Question:

Dr. Garcia, you don`t recommend MDB at all for skin axfolliation? Thank you.

Answer:

Yes, just not on recently irritated skin, if the patient is on Retin A, we have them stop it for 3 days before and after. JG 11.17.11

Question:

Dr. Garcia, what will you recommend, to do MDB with crystals ones in a month or use scrab cream ones a week (or often) to get rid of dead skin on a face and neck? Thanks.

Answer:

Cream would be less abrasive. JG 11.16.11

Question:

Whats the best skincare for wrinkles, and dark circles around the eyes? Thank you

Answer:

For otc products, look for products with retinol and hydroquinone or kojic acid. JG 11.16.11

Question:

If a person had a facelift, and further down the road, they needed a skin graft from in front of the ear for a cancer on the nose, would the skin in front of the year still be a donor site? How long would it take for it to be be lose enough, and would there be adequate skin and tissue? Thank you.

Answer:

yes, still a viable place to harvest a skin graft.If you can pinch the skin between your two fingers in front of the ear enough to cover the cancer spot, it is OK to proceed. All the best. JG 11.16.11

Question:

Dr. Garcia, Hope you are well. Do those silicone based strips and gels work for raised scars? Are you able to recommend the most effective one? As always, much appreciated. kp

Answer:

they are all about the same, and I feel the effect is minimal unless you apply constant pressure over them. JG 11.16.11

Question:

I wanted to have a medium tca peel, but the dermatologist said that because of the shade of my complexion that my skin would have an uneven color if he did the peel. My skin is not really light or dark. It is more of a medium or maybe slightly olive tone. Do think it would be o.k. for me to have a peel? Thank you

Answer:

I think a light peel is likely O, but nothing stronger than that with your skin tone. JG 11.14.11

Question:

Hello Dr. Garcia.. Have you heard of SHIKAI Borage Dry Skin Therapy Eye Cream? Is it good for wrinkles and skin tightening around the eye area? Thanks.

Answer:

just a good moisturizer. JG 11.14.11

Question:

Hi, Dr. Garcia. I hope you`re having a great weekend! You counsel a two month annual break from Retin-A. Should we do that with OTC Retinols too (as in those marketed by Roc and Olay)? Thank you!

Answer:

They are not as irtitating so no need to do so with the OTC ones. JG 11.13.11

Question:

I tried using itworkspaste on a small flat mole on my face as an experiment (I have many so I wanted to see the result) and it got rid of the mole but left what looks to be a small pitted scar. So I will not proceed with the rest of the moles. It`s reddish and not that deep and it`s only a week out since the scab came off... is there anything I should put on it to assist in it`s healing?

Answer:

Just neosporin and time. JG 11.12.11

Question:

Hi Dr Garcia, I purchased the Pep-tide cream from you for under my eyes and I received it yesterday in the mail. I applied it last night and I woke up this morning and applied my makeup and for the first time in a year, I have no creasing under my eyes!!!!!!!!!!! I am shocked because I didn`t know I would see a difference this fast!! I am the lady that kept asking about eye creams to use, because of my terrible sleeping pattern and you recommended your night cream and Alvita Valerian Root Tea. I started using the tea and I sleep better now!! I still have little bags under my eyes and dark circles. Will the peptide cream take care of that too or its just for wrinkles? Thanks so much!! You are just so awesome!!!!! God bless you!!!!!!

Answer:

the cream might help some with the dark circles but if they and the bags persist, a little injectable filler can certainly hide those too. Glad all is getting better. JG 11.9.11

Question:

I hope that this question isn`t below your dignity as a surgeon to answer, Dr. Garcia, but you are knowledgeable about dermatology, so here goes. My nails break and seem not to respond to any nutritional supplements. My sister has had the same problem, so she now gets gel manicures regularly and no longer has the problem. I am 53 and have never had a manicure because I`ve thought them 1) unnecessarily indulgent and 2) potentially dangerous for fungal infections. Of course, a properly licensed shop that sterilizes its equipment shouldn`t routinely present an infection risk. That said, I`ve read somewhere that gel manicures can damage the nails and potentially the nail beds. Do you know if this is accurate? If not, I guess I`ll be adding that regular ritual to my Botox and filler schedules. Gosh, getting old is expensive, time-consuming and tedious, isn`t it? Thanks for cheering us up along the way and steering us straight! You are lovely and generous.

Answer:

properly applied gel manicure should be safe for you and protect your nails. Best of luck. JG 11.9.11

Question:

Hi Dr. Garica, Is it safe to have a one time vbeam laser treatment done for red blood vessels on an area on the nose that has been diagnosed with dermal elastosis? As always, your help is greatly appreciated.

Answer:

Yes, safe to proceed. JG 11.8.11

Question:

Hi Doc.I had juvederm dermal filler for nasa fold and lip corners but I bruised very bad.It took 10-12 days to subside the bruising.I have to go for it another time.Doc told me to take ``Arnica``tablets for 3 days prior the treatment.I am takin 5 small tab 3times a day.Would you advice on that?

Answer:

Well, it will help a bruise to resolve faster but anytime you use a needle, there is a possibility of bleeding. I suggest also avoiding things that can thin your blood for 10 days before, things like aspirin and ibuprofen. Best of luck. JG 11.5.11

Question:

Hi Dr Garcia, How soon after the sutures are out of a wound is it okay to have a vbeam laser done to remove the red? You are such a lifesaver for me when I have these questions. I appreicate you being there. kp

Answer:

I would wait 4-6 weeks to allow swelling to go down. Best of luck. JG 10.28.11

Question:

Hi Garcia, Back to my question regarding Fraxel Laser for new indented scar. I believe you thought it might help some, but totally. Do you have any suggestions would might be a beter fix? Thanks much

Answer:

a totally ablative CO2 laser, and it might take more than one session. All the best. JG 10.26.11

Question:

My doctor is suggesting using the Fraxel Restore after my piopsy reveals a dent. He says it would build up collagen and then I won`t need fillers forever. What is your thought on the Fraxel Retore for any kind of indnents ont the face? As always,thanks you are the best,

Answer:

I believe it will help some, but likely not a complete fix. JG 10.25.11

Question:

Hi doc, my dermatologist once injected a little Botox at the top of my naso-labial lines to reduce an extra cheek bulge caused by smiling. It worked well, didn`t affect my smile or mouth movement. However I`m scared to do it again in case I was just lucky last time! Is this a normal off-label use of Botox, do you think it would be wiser not to repeat the experiment? how great is the risk of abnormal smile/mouth movement?

Answer:

It is an off label effect. You have the possibilty it will work well, not work at all, or make you look like you had a stroke. I woild avoid it. JG 10.22.11

Question:

Hi Dr Garcia.....I hope you are having a great day. I had an ipl treatment 5 days ago and had the area around my nose done for spider veins. The one side of my nose kept scabbing over about 5 -6 times. Now it is really red with almost a white spot in the center. What is this and will it heal on its` own? How should I be treating it? Thank you

Answer:

All normal, it will heal well, can use a little neosporin for a few days. JG 10.16.11

Question:

Hi Dr garcia, thank you for all your help over the years. I asked about eye creams and I have decided that maybe I should get it from you since you are a plastic surgeon and I trust your judgement more. Insomnia is taking a toll on my lower eyelids. I now have under eye bags, slight wrinkles and dark cicles and its making me look older than my age. Which one of your eye creams can take care of that and how long will it take to see some improvements? Thanks.

Answer:

the cell matrix would be the best., but you need to use something to help you sleep, some GABA or Valerian root tea, or melatonin. JG 10.16.11

Question:

Hi Dr. Garcia I hope you are having a great day! I wanted to ask you after a photo rejuvenation procedure, what is the best thing to put on your skin to help it heal. I was told to put on lavender oil but someone else told me that aloe Vera gel is the best to put on to help it heal. What do you recommend? Thank you so much!

Answer:

I think they both would work as well as the other. All the best.JG 10.13.11

Question:

Hi Dr Garcia again, I forgot to ask you with this new steri strip placed yesterday, should I change it for wait for it just to fall off? As I said sutures were removed on Monday, steri strip placed then, and then a new on Wed. I obviously am anxious about this, don`t need anymore scars. I just know of the old school of thinking keeping wounds mositurizer. Looked like there was already a sm scab there yesterday. (Wed.) You are a blessing, I really appreciate you. kp

Answer:

I always let them fall off on their own. JG 10.13.11

Question:

I had a punch biopsy on my nose 8 days ago. Sutures were removed on day 5. Now I am to wear a steri strip for a week after sutures were removed to prevent widening of site. I am confused in that I have always heard to keep site moistened to prevent scab from forming as a scab can cause a scar. What do you think I should do. I have a steri strip on now. When you take a steri strip off isn`t there some risk of pulling of the scab? Please help. Thanks

Answer:

That is fine to do, in time when the steristrips come off, the scab should have already seperated from the incision. JG 10.13.11

Question:

Hey Dr. Garcia, can you clear something up so i can feel better about my prescription. Why would my dermatologist tell me Adapalene 0.1% is the same as Retin A cream is for wrinkles. My insurance want pay for my Retin A anymore so they give me a prescription for Adapalene which is generic for Diffrin. I would like to have something as effective as the Retin A. If you think it will work for treating fine lines and wrinkles i really value your opinion. Thanks so much...

Answer:

not sure why the insurance company will not pay for the Retin-A anymore as it is generic. The Differin came out and many dermatologists switched to it as it was the new kid on the block, but I have not seen any medical literature that says it is any better than Retin-A. The Differin works the same way and if you can get it covered on your insurance, then go with it, you will get similar benefits from it compared to the Retin-A. JG 10.12.11

Question:

I have been using generic retin A for years and my doctor just sent a perscription for generic differin. Will this help with my fine lines and wrinkles like the retin A. both are the same in strenth. 0.1%. Thanks

Answer:

they are about the same, the Retin-A is likely cheaper though and as effective. JG 10.12.11

Question:

Hello Dr. Garcia. Is pure aloe vera gel extracted from the plant good to apply in facial skin for exfoliation and protection against skin aging. Thanks.

Answer:

I do not think it is a very good skin exfoliator and it does help with skin irritations, but not for slowing the aging process.JG 10.10.11

Question:

Forgot Dr. Garcia, I wanted to ask if there was anything for scars or stretch marks that *truly* worked. While my stretch marks (from childbearing) aren`t terrible (mostly white) I wish I could diminish them a bit. *Also,* about 15 years ago I had a thigh lift. While one side (crease of my upper right thigh in my groin area) healed well, the left side did not. The scar is still a pinkish brown. Not very sexy, if you get my drift. Would anything help? And would it be TWO different things - one for the stretch marks and one for the scar? Or could/would the same thing be used for both? Thank you :)

Answer:

I am sorry, but I do not think there are any products or treatments that will help the stretch marks past the time of irritation that they induce. A YAG laser might help fade the pink and brown on the thigh lift scars, otherwise it would need to be cut out and moved up. I wish you the best. JG 10.8.11

Question:

My wife has multiple facial syringomas. She has tried a number of things for removal but none have worked and some have made it worse ie chemical peels. I saw that you recommend hyfercation. What would the cost of the procedure be? And what would the cost of the initial consult be. She has also tried laser but that didnt seem to work either. Thanks

Answer:

The consult is $50 and the $50 per lesion. JG 10.4.11

Question:

In one of your recent posts, you mentioned that you use a facial cleanser twice each day. Would you please tell us which one you use? And what do you think of Obagi`s foaming gel cleanser? Good for dry/aging skin? Thank you, Dr. Garcia.

Answer:

I think Obagi`s is a good one,as is Oil of Olay. I use Neutragena for Men, but I do not have dry skin.JG 10.3.11

Question:

Hi, Dr. Garcia. Would you please look at this list of ingredients in L`Oreal`s new youth code serum and tell us if you think it`s likely to be a good product? The cosmeceuticals are so expensive that many of us can only afford the drugstore snake oils! Thanks very much for your kind help, as ever! Ingredients L`Oreal Youth Code Serum: Aqua/Water, Bifida Ferment Lysate, Glycerin, Alcohol Denat., Dimenthicone, Hydroxyethylpiperazine Ethane Sulfonic Acid, Peg-20 Methyl Glucose Sesquisterate, Sodium Hyaluronate, Salicyloyl Phytosphingosine, Palmitoyl Oligopeptide, Palmitoyl Tetrapeptide-7, Adenosine, Ammonium Polyacryldimethyltauramide, Disodium Edta, Caprylyl Glycol, Citric Acid, Xanthan Gum, N-Hydroxysuccinimide, Chrysin, Octyldodecanol, Sodium Benzoate, Phenoxyethanol, Limonene, and Parfum.

Answer:

there is some good stuff in there, but not knowing how much of the good stuff is in there, it is hard to say, but L`Oreal is a good company. JG 10.3.11

Question:

Hi Dr. Garcia, I just want to ask what you think of Titan? I had the Titan procedure on my neck area a few yrs. ago, and i feel it did help a bit, but because i relocated i didn`t have any subsequent treatments, and now i read that you are meant to have about 3-4 treatments a month apart. Do you think that something like Titan can at least give a bit of improvement?

Answer:

sorry, but I do not think it is a worthwhile investment. JG 10.3.11

Question:

Hi Dr. Garcia, I just want to ask what you think of Titan? I had the Titan procedure on my neck area a few yrs. ago, and i feel it did help a bit, but because i relocated i didn`t have any subsequent treatments, and now i read that you are meant to have about 3-4 treatments a month apart. Do you think that something like Titan can at least give a bit of improvement?

Answer:

I personally do not think it is a worthwhile investment, sorry. JG 10.3.11

Question:

Hi again Dr. Garcia, Thank you for your earlier response on Duac cream. Regarding irritation of the skin by any source, does that mean that if used to excess, even topicals such as retin-A could potentially have some similar effects? Thank you.

Answer:

that is correct, everything is short doses is better. JG 10.3.11

Question:

Hi Dr. Garcia, I have been using a small amount of Duac cream (containing 5% benzoyl peroxide) each night for a couple of years to control the acne on my oily nose and cheeks. I have recently read that it may have potential for increased generation of free radicals and hence skin aging, but have not found any research to confirm this. Are you aware of any please? - as from your previous responses on the topic, you appear fairly sceptical about any really significant effects as compared to sun exposure, etc. Thank you.

Answer:

I think anything that irritates the skin can cause free radicals, and acne causes free radicals. I think taking a break form the Duac is a good idea and maybe you can decrease its use if you have gotten over the acne outbreaks now. All the best. JG 10.3.11

Question:

Dr. Garcia, Thankyou for your very informative site. I am 59yrs. old, and i am wondering what is the best way to improve a little bit of turkey neck , to lift that area? I would prefer non surgical treatment, but i don`t know if there is anything that would improve that area non surgically? Thankyou in advance for your response.

Answer:

I am afraid that the non-surgical options that are promoted out there are not safe, reliable or worth it, it sounds like you will need a neck lift which is the bottom half of a facelift in order to redrape your skin and tissues in a natural way. Sorry, and thanks for visiting. JG 10.1.11

Question:

Hi Dr. Garcia, Could you please give your opinion on Ulthera. I have read some really good reviews on Ultherapy, and was wondering if you perform this particular treatment. Thankyou for your response.

Answer:

painful, relatively expensive for the short period that it lasts, and no plans on buying the machine. JG 10.1.11

Question:

Dr. Garcia, I`ve never done laser or a peel on my face. The main reason is because I`ve heard negative things about pigmentation problems, red spots, unevenness. Its one thing to have a scar you can hide but I don`t want one on my face. BUT I`m noticing large pores, blotchiness, some acne marks and generally dull skin (I`m 45). I`ve done many skincare regiments, including the expensive Obagi, and I want something more substantial. WHICH procedure - laser or chemical - is safer AND more effective? Thank you!

Answer:

I think you will be better off with lasers as they are more precise, start with something light and as you get older a more intense treatment might be required. Best of luck. JG 9.28.11

Question:

To the reader below: the website you`re seeking is www.lumenis.com. Dr. Garcia, I`m trying to decide between a Skin Medica Rejuvenize chemical Peel (or perhaps the new V.I. Peel) and Fraxel Restore to freshen up my skin. Which will give me the most bang for the buck in your opinion? I know both a temporary, at best. Thank you!

Answer:

between those I have seen the most from the new V.I. peel, all the best. JG 9.26.11

Question:

Hey, thanks so much for telling us what you and your wife do for your skin care routine. I LOVE that you have a less-is-more approach. All the products that are pushed at us are so costly and mostly unnecessary, I think. Just a few follow-up questions for you: 1) You don`t mention that you or your wife use Retin-A. I thought that was a must-have. Why don`t you use it? 2) You also don`t mention that use a vitamin C+E serum, which I also thought was non-negotiable for basic skin care. Why don`t you use it? 3) You mention that you use Dysport or Botox about once per year, but it only lasts 3 months. Why do you both use it so infrequently? Thanks as ever for your candor, Dr. Garcia. You help so many people through your generosity and honesty.

Answer:

Retin-A causes chronic irritation and I feel irritation, if it can be avoided, is better, our cell matrix does not cause irritation and I think works as well as the effects of Retin-A. The same goes for he Vitamin C+E, I am not saying that Retin-A and the C+E are not good, they are, but I prefer to make the program easy if I can get the same results with less. In my case the neurtoxin is used more for prevention than correction, and in my particular case I get 3-6 months of effect. If I am not seeing hyperactivity of the muscle that would create long standing wrinkles, I hold off on the injectables. JG 9.18.11

Question:

I know you have answered many things about acne scarring, but here goes one more. Years ago, my daughter was on accutane and although her skin cleared up nicely she has been left with scarring especially along the cheeks. They are not deep and I would not refer to them as ice pick . Being of Italian descent her skin is also quite thick and a bit porous. To add to the drama, she took birth control pills and almost instantly she developed the hyper-pigmented skin along the cheeks and above the lip. What would you recommend (if even temporary improvement) to clear up the issues she is having? She has a very important job interview next month and doesn`t want to have lots of makeup to cover the imperfections.

Answer:

Tough in one month, but some light chemical feels once per week should help some, but not all the spots will be gone. JG 9.17.11

Question:

PS on the permanent make-up question: Is it true that the eyebrows initially appear about 50% darker than they will one week after the procedure? Both my plastic surgeon and his aesthetician say that this is the case and that while they`ll look a bit unnatural at first, they`ll quickly fade to a softer shade. Is that true or do you find that it`s just that the patient gets used to it after a week and just thinks it looks more natural? Thanks again!

Answer:

yes, they do, because of the small amount of blood mixed with the pigement, and that absorbs over a few days and looks lighter.JG 9.16.11

Question:

How long after a 20% TCA peel to the face should one wait before having flat moles removed on the face via electrocautery? Thank you

Answer:

2-4 weeks. JG 9.15.11

Question:

My eyebrows have become very thin with age, medially and laterally. Latisse isn`t helping. My plastic surgeon is recommending tattooing them on. Even with the improvements in the technique (hair-stroke as opposed to stencil), I confess that I`m afraid of this because, well, it`s a tattoo in the most visible possible place and it will permanently define my face. Of course, the lack of eyebrows is defining my face and make-up always looks inadequate and fake. So I`d like to know, since you always tell us the truth, if you think moderately and carefully done pigment deposits for eyebrows scream artificial or if they truly look natural. Thank you for sharing your honest opinion.

Answer:

It al depends on the skill of the skills of the person doing it, so you need to see before afters. Can also do single hair transplants. JG 9.15.11

Question:

Hi Dr Garcia, if chemical and physical sunscreens work in different ways, is there any added advantage to applying a broad spectrum chemical sunscreen, waiting for it to soak in, and then applying a physical sunscreen over it?

Answer:

Not really, the physical block will do it alone with less chance of the ingredients affecting one another. JG 9.14.11

Question:

Hello Dr. Garcia. This tonr claims to minimize pores..Pls. chck the ingedients - denatured alcohol, panthenol, glycerine, peg-40 hydrogenated castor oil,butylene glycol, fomes officinalis (mushroom) extract, salycylic acid, hamamelis virginiana (with hazel) distillate, fragrance, menthol, tocopheryl acetate, niacinamide, sodium lactate, benzalkomium chloride, benzophenone - 3, peg-4, agar, alginic acid, CI 77891, CI 42090, CI17200...Is this a good toner and pore minimizer? Thanks.

Answer:

For a few hours, yes. JG 9.14.11

Question:

Is there any filler for small wrinkles? Also, is juvederm or juvederm plus the best and longest filler for marionette lines? Thank you

Answer:

the smaller the wrinkle,s the less thick the filler can be, therefore the less tem it lasts, there is nothing good that will last along time for tiny wrinkles. If one wants, I will do Prevelle into those tiny ones. JG 9.14.11

Question:

What are your thoughts on electocautery for the removal of numerous small flat moles on the face?

Answer:

It`s very effective, but if deep, they can grow back. JG 9.11.11

Question:

Hello, Do I need to stop using Retin A before an IPL session? I have read different things. If so, how long to stop before the treatment? Thank you.

Answer:

we advise them to stop 2-3 days before and after the IPL. JG 9.10.11

Question:

My derm is recommending he Opal product infuser, which is made by Clarisonic to complement their cleansing brush. He doesn`t sell it in his office, so he doesn`t stand to profit from its sale, but his aestheticians use it on patients. Do you think it`s a good investment? Thank you.

Answer:

Small to no effect. Sorry. JG 9.10.11

Question:

Hi Dr, Garcia, I had a persistent acne cyst injected with a mild cortasteriod injection in June. At the end of July, it was back again and my doctor injected a styringe of saline and a small amount of cortasteriod into the cyst again. Now in September,I have an obvious 1x2 inch oval depression surrounding the injection site.My thoughts: Could the saline allow the small amout of cortasteriod to travel causing this? My follow up visit diagnosis was wait and see a month what happens that it should level inself in time. Any encouraging remarks would be appreciated.

Answer:

The problem is due to the total amount of steroids, but not the saline. Taking a wait and see approach is good for 4-6 months, after that, if it persists, fillets will be needed. All the best. JG 9.10.11

Question:

Is a Vitamin C Serum used morning and night too harsh for older (over 60) skin? How often should a vitamin C serum be applied to older skin?

Answer:

Every patient is different, some people tolerate it once, some others twice per day. JG 9.8.11

Question:

hi doctor, I have recently just had a really big spot on my face just on the skin above my lip, it was like a boil or an absess but it has cleared leaving a red purplish color patch on my skin this is the 10th day of healing will it go? iam worried its going to be a permanent thing, when i cover it with concealer it goes darker and looks worse. is there a special laser or anything that can clear this? please advice iam so worried.

Answer:

Should get better with time,once the skin is intacy you can use cover up make up is OK, can use Mederma to help fade it, down the road cam consider a YAG laser, but not for a couple of mo the. JG 9.8.11

Question:

Hello Dr Garcia, Is silicone gel sheeting effective in minimizing atrophic scars? I got the scars from using a steroid cream for too long. The skin there is thinned out too. It`s about 6 months old and it still itches. Thanks for your help.

Answer:

I have not seen it work for atrophic scars. Can try some topical, non-retinol, and oral Vitamin A, mild effect, maybe. JG 9.7.11

Question:

Yor are so helpful doc.Would you plz tell me your thoughts on PIXEL?Does it really works for hyper pigments and tightens the skin?What is the down time?PLZ respond.THANKS

Answer:

minimal improvement to those issues with a Pixel laser, sorry. JG 9.7.11

Question:

Good Morning !! Hope you are off to having a great day!. Here I am again, with another question. Is there anything yet to get rid of flat warts? ( other than staying out of the sun?). I am eat up with them! They are mainly on my legs. As always, thanks for your excellant advice.

Answer:

they can be hyfercated off or frozen by your dermatologist. All the best. JG 9.6.11

Question:

Hello, Is is safe for women to use the 5% rogaine that is marketed for men? Thank you.

Answer:

Just wash your hands. JG 9.5.11

Question:

Hi, Dr. Garcia. Have you had any patients use Skin Medica`s new product CalmPlex for persistent erythema? If so, what do you think? Any good? While it claims to be good for garden-variety redness (like rosacea), I wonder if it might help post laser tx. I am 5 weeks post fractional CO2 and am still quite blotchy, streaked and red. Do you think it`s safe to try this product? Thanks, as ever, for your incredibly generous help. You are the best!

Answer:

sorry, have not had any patients use it so far. It is a good company though, I see no reason why not to try it. JG 9.4.11

Question:

Hi Dr Garcia and I hope you had a lovely summer. I have very puffy bags under my eyes but on a short term basis they do improve with an undereye OTC cream with caffeine. I also use an eye cream at night with vitamin C and peptides. But I`m 53 and wondering if they are related to aging, and what else I might do short of surgery. Is it a good sign that the swelling goes down with caffeine and ice? I would like a more permanent solution but am not sure if it is roasacea, age, water retention or what. Thank you for any advice.

Answer:

it is good that they get better with the creams, I think if you rule out surgery, that maybe injecting fillers below the bags can help improve the appearance, should last 8-10 months. All the best. JG 9.4.11

Question:

Here is the list of ingredients in the Vitamin E brand I take ( Nature Made ). It looks like it contains tocotrienes, but I`m not sure if it`s enough. If not, is there another brand you recommend? Thank you. http://www.elements4health.com/nature-made-vitamin-e.html

Answer:

looks good. JG 9.1.11

Question:

I use Omega 3 supplements, which I know are good for cardiac health as well as beneficial to the skin. Do you also recommend Vitamin E supplements? Thank you, Dr. Carcia.

Answer:

Yes I do, look for the vitamin E blend that includes tocotrienes. JG 9.1.11

Question:

Which do you recommend: hydroquinone (4% or 6%), NeoCutis`s Perle, or Clinique`s Even Better for decreasing hyperpigmentation? I`ve been using hydroquinone for years, but my aesthetician now tells me it shouldn`t be used for more than 90 consecutive days. Is this true? Why? If so, do you have a preference between the two OTC products I list above, or any other products you favor? Thank you! Happy September.

Answer:

the hydroquinone can be irritating and one should take a break, once the hyperpigmentation is decreased, stopping the hydroquinone is fine, as long as someone avoids the sun and uses sunblock and not sunscreen. The constant use of hydroquinone offers little benefit over the long term. 6% would be faster acting than the 4% but also more irritating. The NeoCutis and Clinique would not be as effective as they are much weaker. I like the NeoCutis quite a bit. All the best. JG 8.31.11

Question:

I am Asian 54 lady.Aain asking for my lower face wrinkles and droopy lips corners.I am scared of the lasers. Do you think Juvederm/Restylane will work to eliminate these small tiney lines as well as droopy lips corners?

Answer:

I think they will help, yes, in some cases filling the upper cheek will also help, and in a small number of cases a little Botox to weaken the depressor muscles of the lower lip can be used. JG 8.29.11

Question:

I am 54 Asian lady.I have my lower face(from lips corners to the chin)seeing wrnkiles and lines as well as droopy my lips corners.Whe i see my face in mirror i see ugly lines on there.What would u recommened me to treat effectively?How about the PIXEL?my doc recommended me.OR the fillers are better?thanks for a honest advice.

Answer:

I think lasers would have to be done very lightly due to your Asian background and higher risk of post-inflammatory hyperpigmentation, so it might not be worth the investment and risk, otherwise about all I can suggest is Retin-A, wish I had more.JG 8.29.11

Question:

What is the ``BEST``fillers for nasolabial fold and droopy lip corners?As well as for fill up the under eyes hollows?which one last longer and safer?. PLEASE advice.THANKS.

Answer:

I prefer Restylane for those areas, might get 8-10 months around the eyes, 3-4 months on the nasolabial folds and 2-4 months around the corner of the mouth. JG 8.29.11

Question:

I came across this article, see below. In your opinion is it safe for me to use a product w/ferulic acid in it? It`s listed as an ingredient on my vitamin C serum. Thanks for your reply. “Healthful` Plant-Based Antioxidant May Aggravate Kidney Cancer A study in the Journal of Agricultural and Food Chemistry points to a possible link between supposedly healthful plant-based antioxidants and cancer. These antioxidants, including those renowned for their apparent ability to prevent cancer -- may actually aggravate or even cause cancer in some individuals. Their recommendation follows a study in which two such antioxidants -- quercetin and ferulic acid -- appeared to aggravate kidney cancer in severely diabetic laboratory rats. Some researchers believe that quercetin should not be used by healthy people for prevention until it can be shown that quercetin does not itself cause cancer, the report states. In this study we report that quercetin aggravated, at least, if not directly caused, kidney cancer in rats, it adds, suggesting that health agencies like the U. S. Food and Drug Administration should reevaluate the safety of plant-based antioxidants. 9/10/10 Dr. Simon E. Prince, FACP, FASN

Answer:

I think it is safe as the amount is quite small in skin products. JG 8.26.11

Question:

Dr. Garcia, Hope you are doing well and not burning up in this heat. I had erbium laser (I think) 10 years ago on my upper lip so my lipstick would not bleed. It worked great and I still don`t have the wrinkles back. My upper lip in the last year or so is lighter than the rest of my face. I started the Obagi system a month ago and hope this will help. Other than a complete laser of my face what else can I do? It is only about 2 shades lighter and I cover it up with a little bronzer powder and it is just okay. I am 62 with very fare skin (Irish). BTW, after a month my skin is still not peeling with the Obagi...is that good or bad? Thanks for your kind help.

Answer:

I think the best long term solution is to do a full face laser to match the color. I think the Obagi will help,but likely not enough to get a color match. All the best. JG 8.25.11

Question:

Hi Dr, I am a flight attendant and due to 20 years of flying I have spider veins all down the backs of my legs. Which is the most effective and safest method of removing them between laser or injections? Also how long is it before I can fly after a treatment. Thanks

Answer:

I think injections are the most effective, might need a series of sessions, and you can return to work the next day. All the best. JG 8.24.11

Question:

Hello handsome - I know I`m probably crazy for doing this, but, I have been using some premerin estrogen cream under my eyes and then adding your eye ceam over that. Is seems to make sense to me if the estrogen plumps up internal tissues then why not on the outside??? No - I am not the lady that was using preperation H under her eyes ; - )

Answer:

well, although I do think topical estrogens do help skin, I prefer to use bio-identical hormones, and Premarin has mostly horse estrogens that have some less desirable effects, although mild when taken as a cream instead of a pill. If you can switch to the bio-identical creams, your skin will respond better, they are prescription only though. All the best.JG 8.22.11

Question:

Hello Dr Garcia, I sent some pictures of my baggy eyes. I was wondering if you got them?

Answer:

just emailed you back. JG 8.22.11

Question:

Hi Doctor, can you recommend me a good eye cream. Have you heard of replenix eye repair with retinol. And the Oil of Olay ProX line. What do you think?? I value your advise.... Thanks, Oh and i am just turning 47 this month if that matters.

Answer:

I think the Oil of Olay line is good and also a good price. JG 8.22.11

Question:

Hello Dr, it`s me again, I asked about the under eye bags and slight wrinkles. Can I send you pictures of myself to see if I can find a more subtle treatment for it pls? Thanks a lot!

Answer:

Certainly, send them to drgarcia@lvcosmeticsurgery.com JG 8.21.11

Question:

Hello Dr Garcia, Thank you for your reply to my recent question re: potential negative effects of 1% Hydrocortisone cream on the face over 1-2 months use. You said there was likely only to be a small negative effect for that period of time. Could you please just clarify - did you mean temporarily during the period of treatment or overall thereafter as a result? Only I have read that the skin can perhaps recover to normal following cessation of treatment. Thank you again.

Answer:

overall thereafter, once there are steroid induced changes, they will stay there. The thicker the skin and the less strength and time with the steroid the greater the chance for it to get better, but thin skin areas like eyelids are sometimes difficult to normalize. JG 8.19.11

Question:

Ff-up question Dr. Garcia. Are the results gained from microdermabrasion long lasting? Thanks.

Answer:

a few weeks is all. JG 8.19.11

Question:

Hi Dr. Garcia, what brand of Retin a do you recommend to be the most effective? Thanks

Answer:

I think the generic is fine, no need to buy the more expensive kind. JG 8.19.11

Question:

Hi Dr Garcia, I trust you are well! Just wondering as I trust your advice and expertise, what would you recommend for a 35 year old with relatively good skin who would just like to freshen up and tighten her skin without resorting to surgery but would prefer not to use fillers. Also, in having cheek implants removed my right side implant (gore-tex)was trickier to remove and caused my muscle in my cheek/face to be tight maybe it got damaged, pulled or stretched in the process which impedes movement in my right face e.g when I talk etc so it is slightly lopsided and causes the left side to overcompensate, it has however, been slowly getting better with time. It has been 6-7 weeks. Will this just need patience while the muscle heals. Thanking you kindly, I appreciate and value your wisdom and kindness in taking the time to respond.

Answer:

Maybe some microdermabrasions or IPL sessions. I think the muscles will continue to improve slowly for quite a period of time, got to hang in there, but the fact they are getting better is a good sign. JG 8.19.11

Question:

Hello Dr. Garcia. How many sessions of microdermabrasion are needed before I can see improvement on my skin? Thanks.

Answer:

the more damaged the skin is, the more sessions it will take, no way to tell the number though, all patients will respond differently. JG 8.19.11

Question:

Hi Dr. Garcia, i use retin a (tretinoin)at it`s highest strenth but what are all the other brands out there like Atralin, Renova, Avage, Retin a micro are they not all the same? Thanks

Answer:

different carriers so they are not all as effective, but would be easier to tolerate for some people. JG 8.18.11

Question:

Hello, I have a question about retin a - I was using .05% for about 6 months and recently switched to .1%. My face has been breaking out and is a little red and very dry. Is the breakout part of the purging process caused by the increased strength? How long does this usually last? Thank you.

Answer:

L normal due to the stronger concentration and should be better in 4-6 weeks, hang in there. JG 8.18.11

Question:

Hi Dr. Garcia. Just a ff-up question. Is denatured alcohol in facial cleansers harmful to the skin? Thanks.

Answer:

It strips the natural oils away. JG 8.18.11

Question:

Hi Dr Garcia, How long shall I continue to use 4% hydroquinone before I have reached the maximum results I`m gonna get? (I have melasma, sun spots)

Answer:

Maxes out at about 12 months, but it continues to prevent new spots after that. JG 8.18.11

Question:

Hello Dr. Garcia. Is this a good facial cleanser? It contains denatured alcohol, is it safe for the skin? INGREDIENTS: Water, Denatured Alcohol, Sorbitol, PEG-40, Hydrogenated Castor Oil, Parfum, Benzalkonium Chloride, Menthol, Citric Acid, CI 19140... Thanks.

Answer:

It`s OK, don`t like the alchol or parfum though. JG 8.18.11

Question:

THANK YOU for that reassuring answer about the silver nitrate, Dr. Garcia. I feel much more optimistic.

Answer:

all the best.JG 8.2.11

Question:

I wrote to you a while ago about a 2 year old 3rd degree burn on my neck that re-opened on July 1 after my dermatologist used Fraxel Restore on it. It got infected so I went on Keflex. Today when I saw him, it had shrunk but was still open so he used silver nitrate on it to get it to close and to kill the remaining bacteria in it. I got home and looked that up and read that the black staining from the silver nitrate is likely to be permanent! I`m panicking. Is that true? If so, is there anything that can be used to remove that stain? Another laser?! I can`t believe this. I now have a HUGE black circle in the middle of my neck. Would you have used silver nitrate? Thank you for your help, as always, Dr. Garcia.

Answer:

I will say there is a risk of staining but in all my years, I have never seen it be permanent. Once the skin sloughs off in the normal skin expiation process, it falls off.I use silver nitrate on wounds commonly without problems, not sure I would use it on your case unless it was oozing blood though. Hang in there. JG 8.2.11

Question:

I see you`re answering a lot of questions this week about skin care products. While you`re at it, what do you think of SkinCeuticals in general, and their AGE Interrupter creams and Phloretin CF and CE Ferulic in particular? And how about the SkinMedica line, especially their TNS Recovery Complex and Dermal Repair Cream? Thanks, Dr. Garcia. Have a great weekend!

Answer:

I think SkinCeuticals and the TNS recovery are good lines. JG 7.29.11

Question:

Hi Dr. Garcia, what are the long term effects of doing laser hair removal? I have been doing it for years, for maintenance, on legs every so often but pretty frequently for the face. Maybe every 5-6 weeks for the face for 5+ years. Im deligent about sunblock and havent burned or gotten any discoloration but I am starting worry about the long term effects. I have been using the Candela Gentle Yag.

Answer:

It is pretty safe. JG 7.28.11

Question:

What`s the problem with hydroquinone to which you refer below? I mix it with tretinoin for fade excessive pigmentation.

Answer:

issues arose where patients were buying prescription strength hydroquinone and using it on brown spots without a physician examining them and it turned out that some of the spots the patients were self-treating were skin cancer and there was a delay in treatment, so hydroquinoen was looked at in a way that it required greater physician involvement. JG 7.28.11

Question:

Hi, Dr. Garcia. What do you think of Dermitage? And how about Strivectin and Prevage? Thanks so much.

Answer:

Lots of hype with little to no effect with the Prevage or Strivectin, as to the Dermitage, look at the complaints at consumeraffairs.com. I would skip them all. JG 7.28.11

Question:

Hi Dr, Sorry I wasnt very specific in my recent post enquiring about the best choice between a strong TCA peel and Medlite laser. I am looking for something just to rejuvenate the skin texture to give it a boost, not to remove pigmention etc...and wondered which would offer the best result ... thanks

Answer:

for that, booth would be equal, but effects will be mild and short lived. JG 7.28.11

Question:

Hi Dr garcia, You have probably answered this before but what is your current opinion of the Obagi system of products especially the ones containing hydroquinone which has become controversial of late? Thanks

Answer:

I think it is a good system for pigment problems, and the hydroquinone is safe when monitored by a physician. JG 7.28.11

Question:

What do you think of the Nia 24 line of products?

Answer:

I believe the claims are a bit exagerrated. JG 3.28.11

Question:

I have close to 30 flat moles on my face that are small and completely flat but would like to get rid of with erbium or C02 treatment. I know they come back but will I have to get the laser a few times just to get rid of them the first time like a tatoo and then go back again a few more times if they come back? Or is it one time each?

Answer:

Should be just once and then again when they come back. JG 7.28.11

Question:

Hello Dr, Which procedure would produce the best results between a TCA peel or Medlite laser facial? Thank you

Answer:

depends on what you are trying to improve and what strength TCA peel is used. JG 7.27.11

Question:

I recently had many closed comedones removed from face about 40 of them, my skin very thin, brusie and skin scrapes off easily,its mostly on the forehead. While I was impatient about the brown scab falling off. I rubbed them off prematurly and is left with very pink marks all over face. Is it better to have the scab stay on for as long as possible or does it not matter that the scab is removed for as long as its not bleeding. So its pink and shiny. What can help it lighten up, and will the sun cause these pink scars to become brown if I am in the sun too long? Does this pink color go away and what should i put on it now? Next time should I leave the scab on or does it not matter, I wonder. Thank You so much.

Answer:

removing the scabs prematurely will slow the healing process down, always best to allow the skin to heal below the scab and let it fall off on its own. You need to use sunblock at all times to protect the pink areas and I suggest letting the natural healing process take its course and not to intervene anymore. JG 7.27.11

Question:

Hello, I have a strange situation...Every afternoon around 1pm, my facia skin turns red and fees hot - especially my nose and cheeks. Sometimes it also feels irritated. I thought it might be an allergy; however, it happens no matter what I eat for lunch. It lasts approximately 1-2 hours and then returns to normal. Any thoughts? Thank you.

Answer:

I am sorry but I am not sure what would cause that. JG 7.26.11

Question:

Hello Dr. Garcia. Have you heard of this eye cream - NeoStrata Bionic Eye Cream? Is it good in minimizing wrinkles around the eye area? Thanks.

Answer:

Neostrata makes good products. JG 7.26.11

Question:

Hello! Can I also use sunglasses to protect my eyes instead of wearing sunscreen around the eye area? Thanks.

Answer:

Nope. The glass will not block the sun damage. JG 7.26.11

Question:

Hello Dr. Garcia. Have you heard of this eye cream - NeoStrata Bionic Eye Cream? Is it good in minimizing wrinkles? Thanks.

Answer:

Neostrata makes good products. JG 7.26.11

Question:

Hallo Dr. Garcia! Do you know any good treatment for rocasea. Thank you!

Answer:

IPL treatments and antibiotics help. JG 7.24.11

Question:

Hello Dr. Garcia. What`s your take in using Resonance technology for minimizing wrinkles in the face area? Thanks.

Answer:

Not a believer. JG 7.21.11

Question:

I had microdermabrasion on Saturday on my chest and am now covered in tiny red and purple bruises. What happened? Anything I can do to speed their disappearance? Covering it in the summer is very difficult. No worries -- I use full spectrum sunblock every day of the year. Thank you, Dr. Garcia!

Answer:

it was too aggressive of a session, should heal up in time though. Just avoid the sun, not much else besides time to let them fade. JG 7.18.11

Question:

I have a question about the reapplicaiton of sunblock. After I work out (inside) and shower early every morning, I cover myself daily, head to toe, in Blue Lizard full spectrum sunblock (their very thick block for infants, SPF 50). Of course, if I were to wash it off or to sweat again, I know that reapplicaiton is necessary, but is it necessary to reapply every two hours as we are now so vigorously instructed to do? I live in the Northeast and drive to and from an office job where I work inside all day (with no flourescent light exposure). Including the time I`m in the car, I`m probably outdoors a total of 2-3 hours/day, mostly very early in the morning and at dusk. I`m asking if what I apply in the morning, once absorbed, should provide enough protection to last throughout the average day. (I`m white, very fair, of Irish descent.) Thank you very much for your time and guidance.

Answer:

should give you 3-4 good hours of coverage, a little more at lunch, especially during summer months might be a good idea. JG 7.15.11

Question:

Hi Dr. Garcia, I am 6 weeks post Carac treatment for actinic keratosis. The area is still fairly pink. Should I be keeping the area dry as I have been, or should I be keeping it moist? If moist, what moisturizer would you suggest? How long could this take to fade at the extreme amount of time? Thanks much, kp

Answer:

I think a good moisturizer, whatever brand you used before, and also sunscreen is a must. It will take a few more weeks to have the pink fade. Depending on how irritated you got, it can take 6-12 weeks. JG 7.13.11

Question:

Read your reply to the woman below about estrogen and thinning skin post-menopause. Is it actually possible to regain skin thickness once it`s lost or would estrogen supplements only retard the further deterioration? Also between plasma resurfacing and Lumenis`s Total FX, which is better? Thanks as ever for your kind help, Dr. Garcia!

Answer:

it can rebuild and slow progression, both. I think the Total FX might give you a bit more between those two. best of luck. JG 7.6.11

Question:

I have acne marks (dark spots) all over my back. I also have some spots on my chest and around my nipple where I picked. Can I use Tazorac (what strength?) or something similar to dramatically lighten them on chest and back? No worries about too much sun exposure there unless at beach. What else do you recommend?

Answer:

I think topical creams like Tazorac will not work well and you will need a laser treatment like a Nd:YAG.JG 7.4.11

Question:

Good day Dr Garcia, I am using tretenoin .1% and HQ 4% on my skin at night and sunblock with sun avoidance in the day. I am to the point that I am tolerating it w/o visible irritation. I am wondering though, which goes on 1st? The tretenoin cream or the hydroquinone cream? Is it better to alternate and use one in the morning and one at night? Thanks for your advise.

Answer:

Retin-A first, wait ten minutes and then the HQ. Best to use them at the same time. JG 7.1.11

Question:

Thank you so much for your response about my daughter`s breakout problem and my question about ROC. Just one more question: for a cleanser, would you suggest one with salicylic acid or benzoyl peroxide? Or maybe neither, just something super gentle like Cetaphil? Thank you again and bless you for being so generous with your time.

Answer:

the salicylic acid one. All the best. JG 6.30.11

Question:

Thank you so much for your response about my daughter`s breakout problem and my question about ROC. Just one more question: for a cleanser, would you suggest one with salicylic acid or benzoyl peroxide? Or maybe neither, just something super gentle like Cetaphil? Thank you again and bless you for being so generous with your time.

Answer:

probably the salicylic acid one. JG 6.29.11

Question:

Hello Dr. Garcia - My 17 yr old daughter has had problems on and off with mild breakouts since she was 14, but the last year it has gotten worse. She breaks out fairly frequently all across her forehead and a little on her cheeks by her nose. It does not look like acne, just lots of small pimples. Sometimes it shows up on her back and chest. It seems that her menstrual cycle is often (though not always) a trigger. She tried a product with 5% benzoyl peroxide followed by a toner with 2% salysic acide, and that didn`t work. Then she tried the Proactiv system for about 3 months and that also didn`t work. She has an appt at the end of July with a dermatologist but I`m thinking of letting her try the ROC product that has retin-A in it to see if that works. I would start her on ROC, then ask the dermatologist to give her a .25 prescription for Retin-A. I would like to try all options before resorting to accutane. My questions are: 1. assuming you think the ROC product to start is a good option to try, what moisturizer do you recommend after using the ROC.... 2. are there any other products you can recommend that she should include in her routine; and 3. can you recommend an 15 or 30 SPF sunblock for her? Thank you so much for your help with this. I feel so sorry for her, she`s a pretty girl and this problem is really dragging her down.

Answer:

I agree with the ROC and I would avoid a moisturizer for now. I think most lines with a good retinol are worth it, but ROC is good. As to the Sunblock, it has to be 50 or higher, and it is the other ingredients in it that can cause non-tolerance, so it is a matter of trial and error, but I prefer the brands intended for children, they have less problems. All the best.JG 6.29.11

Question:

For mild neck laxity (just one central band) in a 50 year-old, about how many units of Botox should I expect? Thank you!

Answer:

Sorry, I feel Botox would make it worse as the muscle would be weaker. JG 6.28.11

Question:

Hi Dr Garcia, I took a road trip to Colorado and accidentally left my tretenoin cream in the trunk of my hot car for 3 days. Do you think the cream was harmed? Will it still be effective?

Answer:

it is probably weaker and will need to be mixed again prior to application, cannot say to what percentage the strength has diminished though. JG 6.27.11

Question:

I am having a hard time finding a doctor who does CO2 laser resurfacing under eyes with just local shots. I would have that procedure done instead of using retin-a for undereye wrinkles. Although they cost more, what are some substitutes for retin-a while you are pregnant?

Answer:

nothing that will be as effective and no creams are tested on pregnant females, so just use a good moisturizer and stay out of the sun until you are not pregnant or breast feeding. JG 6.26.11

Question:

Is there any substitute for retina?

Answer:

There is a new medication sold, but is no more effective, and is more expensive, so I see no reason to change. JG 6.25.11

Question:

Will Kinerease work just as well as Retin-A to use for undereye wrinkles while one is pregnant?

Answer:

not effective, but likely safer. JG 6.23.11

Question:

Hi, Dr. Garcia. It`s the progesterone cream lady again just writing to THANK YOU for your help. My hair stopped falling out! It`s been 4 weeks, and my hair has actually stopped falling out fir the first time in years, thanks to you. I`m elated. I have another, unrelated, question: I`m quite exfoliated all the time due to regular use of Retin-A and frequent microdermabrasions. I`ve had a few strong chemical peels in recent months and have not peeled visibly at all. My dermatologist tells me that the peels are still effective, even if I`m not obviously peeling. How are they still effective? Thank you for everything.

Answer:

they can still offer a benefit even if you do not peal, that is common when you are also doing the microderms and Retin-A as there is less damaged skin that needs to flake off. Glad the hair thing got better. All the best. JG 6.23.11

Question:

Hi, Dr. Garcia. Would you please rank order the following procedures in terms of effectiveness for treatment of fine lines, texture, dispigmentation and pore size (1 being most effective, 3 being least effective): A. a series of 3 Rejuvenize Peels (SkinMedica), B. one 30% TCA peel, C. Total FX (fractional ablative erbium) or Fraxel RePair (fractional ablative CO2)? Thank you!

Answer:

C 1, B 2, A 3, but none work well for regaining pigmentation and pore size reduction will be short lived. JG 6.20.11

Question:

Hi Dr. Garcia I have been getting regular Botox injections for crows feet. On my last visit, I had a new nurse injecting the Botox. She injected the Botox at least an inch away from my eyes whereas the previous nurse injected the Botox about 1/2 inch away from my eyes. My question....how far away from the eye should botox be injected for crows feet? How far away from the eye should Botox be injected for crows feet?

Answer:

Best place is just past the orbital rim bone to avoid the eyelid muscle. JG 6.10.11

Question:

Hi Dr. Garcia, I am post Carac treatment for actinic keratosis. If the redness does not completely subside, can a VBeam laser be used after a length of time? If so, how long after cessation of treatment? Thank you as always. You have helped me so much. kp

Answer:

I think it will fade, but if you wish, a VBeam laser is OK after 6 weeks. All the best. JG 6.5.11

Question:

good day Dr . Garcia ... regarding the Tria ( home based laser removal/reduction machine ) why do you say to just save my money ?... thank you for your time

Answer:

I don`t feel it is effective. JG 6.5.11

Question:

There is a lot of buzz about a product called Sea Buckthorn. You can take it internally and put it on you skin in oil form. Would you recommend this or is it hype? Thank you for your time

Answer:

Lots of hype and no science to back it up. JG 6.4.11

Question:

Sorry -- one more question about progesterone cream. Would this product meet your criteria? https://www.life-flo.com/product.php?parameters=product_id/51385/ If not, can you recommend another brand? I`m hoping this will help my long-standing problem with hair loss. For a long time, I used but finally gave up on the topical treatment you used to endorse because it didn`t do anything for me. Thanks very much again.

Answer:

sure does, try it and let us know. JG 6.3.11

Question:

I have mediterraean skin where I can use a lower spf sunscreen like 8 and develop a deep bronze Jersey Shore looking tan in just one day outside. Then for the rest of the summer I use a higher spf like 20 if I`m going to spend time outside and I have a beautiful looking tan all summer. I`m confused though, they say a tan means sun damage, am I doing more damage than a pasty white person who spends the same amount of time in the sun with the same sunscreen because I am tanned and they are not? I don`t really ever burn and I don`t spend that much time in the sun I just pick up color VERY easily.

Answer:

any tan is sun damage, so pasty white is better for skin aging and skin cancer than a light tan. JG 6.1.11

Question:

I had fraxel on my neck one and half months ago. I am going to have a moderate peel on my face with my esthetician. Would it be okay to have the peel on my neck as well or is it too early. Thank you

Answer:

Should be OK if the skin has healed well. JG 5.26.11

Question:

Oh and I forgot to ask can skin tone and hydration improve if you quit smoking? I have a hard time believing it will reverse wrinkles to quit but does it make the overall complexion (tone, hydration) look more healthy?

Answer:

there will be no reversal of the wrinkles, if the skin was dehydrated before and you hydrate it, then it will get better, but smoking does not dehydrate your skin.It just does other bad things. JG 5.25.11

Question:

Is nicotine gum as bad as cigarettes for the skin? I have a hard time believing it`s good for the skin but not as bad considering there`s many more chemicals in cigarettes on top of the carbon monoxide.

Answer:

almost, but not totally as there is no smoke, but the gum will still affect healing after surgery in a negative fashion. JG 5.25.11

Question:

Thanks for your answer to my questions below, but you misread the second question. Does Ulthera (ultrasound) dissolve HA fillers or negatively affect Sculptra? Thanks so much.

Answer:

Sorry, missed the Ulthera part, it will likely cause both of them to dissolve quicker. If you have the choice, best to do them after the Ulthera. JG 5.24.11

Question:

I have two questions for you 1) The first is pretty silly. I use HQ and Retin A to address hyperpigmentation. Of course, I also use a broad spectrum sunblock every day too. I am extremely fair, so much so that my normal blue veins show through my skin, so in the summer, I tend to use a moisturizer like Jergens that stains the skin bronze to provide a bit of coverage to my legs and arms; if I don`t, I look like a translucent vampire whose vascular system is on display. Of course, that stain darkens everything, including the hyperpigmented spots. I`m writing to ask if the staining actually reduces the clinical effectiveness of the HQ and Retin A. (Crazy, right? I spend all year trying to get an even skin tone and get rid of my brown spots, and then I lightly stain my skin in the summer. I`m nuts.) 2) Does Ulthera dissolve HA fillers or negatively affect Sculptra? Thanks. Have a great day, Dr. Garcia!

Answer:

The staining does not impact the creams and it is OK to use HAs and Sculptra together . JG 5..24.11

Question:

Hi Dr. Garcia, My skin is oilly and very dull with melasma and acnes/spots. Can you please recommned; 1- what type of cleanin agents should I use? (scubs, face wash,soap)? 2- what type of night care creams to help the dullness? (vitamin C night cream)? 3- what type of sun blocks? (zinc oxide)? 4- Moisturizers? Many thanks for your kindness always.

Answer:

any glycolic acid facial cleanser OTC, then start Retin-A 0.5% and advance to 0.1% as tolerated, use 4% hydroquinone and also total sunblock, not sunscreen. Moisturizers at a minimum until the acne clears up. Al the best. JG 5.23.11

Question:

Hi, I have an isian oily skin with acnes and melasma, am using a comibination of 2% hydroqunine, 0.5 % of tretonion and cortison for the treatment of hyperpigmentation (melasma) and zinc oxide to protect from sun and clindamicyn for acnes. they are not helping, should I take time and continue. Many thanks Dr.-Kati From Afghanistan.

Answer:

need to increase the hydroquinone to 4% and the tretenoin to 0.15 first. Best of luck. JG 5.23.11

Question:

Dr. Garcia ... what can you say about the Tria for Hair Removal ? does it work .. i mean given that it is just a small machine ? thank you for your time

Answer:

save your money. JG 5.22.11

Question:

Hi Dr Garcia.IM 2.5 months pregnant now and my skin has became severyllu flakey and dull.Is Vitamin C night cream safe to be used by pregnant women? Another question is are pregnant women safe to use JOLEN facial bleach to bleach their facial hair? thank you in advance

Answer:

would not use the bleaching cream but the vitamin c is OK, all the best. JG 5.22.11

Question:

good day Doctor Garcia , you mentioned that it is okay to have both Triamcinolone injection and IPL Intense Pulsed Light on a single area treated for acne ... which one should be done first between the IPL Intense Pulsed Light and the Triamcinolone injection ? what are your thoughts ? thank you and have a great day ahead of you

Answer:

I think they will both help, do the IPL first. JG 5.22.11

Question:

Hi Dr Garcia, Which is more effective for anti-aging: Tretenoin .05% every night or tretenoin .1% every other night? Thanks for your help!!

Answer:

I would use 0.1% if you can tolerate it. JG 5.21.11

Question:

Hi Dr. Garica, Regarding post Carac treatment, you mentioned copper peptide cream. I know nothing about that. Do you sell that product, or can you recommend the best brand? Thank you, kp

Answer:

Neova is what we suggest, sold on the net, we do not sell it. JG 5.21.11

Question:

If HQ is more effective at prevention then treatment, then can I just use HQ indefinitely without taking a break?

Answer:

There are no long term studies evaluating chronic use, I would take a break during winter month. JG 5.11.11

Question:

Hi Dr Garcia, Can HQ prevent hyperpigmentation (with faitful sun avoidance and sunblock of course), or is it just useful for treating hyperpigmentation that already exist?

Answer:

More effective for prevention than treatment . JG 5.20.11

Question:

Hi Garcia, One last question about Carac treatment. After treatment is over, what should I use on skin treatment for optimal healing? Is there any cream that would help area heal better? Thanks, kp

Answer:

copper peptide creams, squalene oil are good options. JG 5.20.11

Question:

Dr. Garcia, Are these expensive skin creams made in Switzerland with live cells really effective and that much better than other less expensive creams? The cost of some of these products are prohibitive. Thank you.

Answer:

they are live when the make the cream and soon die in the jar. Save your money. JG 5.19.11

Question:

Hello, What is the best treatment for orange-peel looking, rough textured skin on face? Thank you!

Answer:

start with Retin-a and microdermabrasion, followed by IPL, not all on the same day. JG 5.19.11

Question:

I just returned from Florida and even though I wore sunblock and was never in direct sun my skin tone and texture looks better.What causes that? And can you buy it in a bottle?! Thank you

Answer:

Likely the higher humidity. JG 5.19.11

Question:

For no apparent reason, My face looks much darker for the past few days. I`ve noticed this before. I haven;t had any sun or anything. I`m an olive 34 yearold woman with pink undertones and look quite tan righ tnow. Can`t imagine why. Thoughts?

Answer:

side effect from some medication or OTC product maybe. JG 5.16.11

Question:

Hi Dr. Garcia, One more question about the use of Carac for actinic keratosis. You mentioned skin will return slowly to natural color of skin after cessation of treatment. Just so I have an idea what to expect, what do you mean by slowly? Like 2-3 months, or more? Thanks again. kp

Answer:

about that, yes. JG 5.16.11

Question:

good day , Doctor Garcia , can IPL ( Intense Pulsed Light ) be used together with Triamcinolone injections for acne in one treatment session with a dermatologist ? ... Both the IPL and the Traimcinolone injections are for acne treatment . i mean can an area that has acne be pulsed with light and also injected with Triamcinolone ? .. thank you for your time

Answer:

likely OK to do, although never been tested. The triamcinolone is injected deeper so it should not be negatively affected. JG 5.15.11

Question:

Hi Dr. Garcia Are you familiar with the use of Carac for actinic keratosis? Is there anything I can do to prevent future scarring while I am on the 4 week regime? And if so, would using something like Aquaphor reduce the effectiveness of the Carac? In your experience, does the new skin return to the same color as before? Thanks

Answer:

I am afraid you need to let it work, not much that can be done while on the Carac. I would avoid the Aquaphor until the Carac treatment is finished. In most cases the skin does regain its color, slowly. JG 5.14.11

Question:

Hi, Dr. Garcia. Two questions for you: 1) You`ve got us all taking a 2 month annual break from Retin-A. Do we need to do the same for OTC retinol products? 2) Which do you think is more effective for general diffuse pigmentation and redness and textural irregularities : a) a series of Fraxel Restores or b) a series of IPL mixed with Alexandrite and VBeam treatments? Thanks so much! Have a great weekend!

Answer:

not as important as it is weaker, but it is likely still a good idea. As to the pigemnt and redness go with the IPL mixed with alexandrite and VBeam, much better. All the best. JG 5.7.11

Question:

Hello Dr. Garcia and thanks from all of us for what you do. I`m wondering if there is anything to help broken blood vessels on the chest and neck. It is not wrinkling or sagging - just persistent redness/broken capillaries from sun damage I think although I do also have rosacea. Thank you for any advice.

Answer:

IPL or VBeam laser are worth trying.All the ebst. JG 5.7.11

Question:

Hi Dr. Garcia. I have two questions about timing of procedures. I had an IPL series for rosacea which helped a lot and also eliminated some brown spots. Now, four months later the brown spots are back. So is it time to do another IPL and are six-month lags between sessions about right? Also should Botox in correct amounts last four months or longer? Thank you!!

Answer:

yes, time to repaet, and don`t forget the sunblock.I think the Botox effect varies from person to person and also on the area injected, no set amount of time. JG 5.7.11

Question:

I am a 61 year old female and I`m beginning to notice stucco keratosis on my ankles, legs and upper arms. 0 Is it fairly rare in females? 0 Is it an inherited condition? 0 Can anything be done? The stucco keratosis sometimes itch and create flaky skin. It`s always comforting to know you`re there with each passing birthday!

Answer:

rare in females, not inherited, spots can be scraped or frozen by a dermatologist. JG 5.6.11

Question:

What is your opinion of Clinique`s products? Any thoughts about their new repair wear laser focus serum? I can`t find a listing online of its ingredients, but I`ve come across a fair amount of praise for the product. Hard to know if such praise is planted by the company, I know. Thanks, as ever, for sharing your opinions and expertise, Dr. Garcia. I agree with an earlier reader: you obviously have a wonderful wife. Please thank HER for all of us too!

Answer:

I think it is a good line, nothing special, and I will tell you that companies frequently have postings placed to drive business, at least until they get caught and then fined. Certainly a worthwhile product line but don`t believe all of the hype. All the best. I will pass the kind words on to my wife too! JG 5.4.11

Question:

Dr. what, if any would these three: Ceramide 3,Ceramide 6-II, Ceramide 1 do for your skin?? Thank you much

Answer:

in general will help with skin moisture content and restore its oil, available OTC. JG 5.3.11

Question:

I see somewhere someone said they take a break of two months per year from retin A. Is it a good idea to not do it all the time, and why? Would it be better to do it once every two days?

Answer:

Better two months, it is good to give the skin a break as long term irritation is not good. JG 4.30.11

Question:

Good morning Dr Garcia, I hope you had a wonderful Easter. Can IPL be as effective as hydroquinone for treating mild hyperpigmentation on the face?

Answer:

if it is pretty recent, a few months, it can be, if it has been there longer, the combination will work better than just the one. Hydroquinone is more effective at prevention than treatment. That is why it is frequently mixed with Retin-A. JG 4.25.11

Question:

I have been using Retin A for quite some time with very good results.I sue th 0.05% and it usually the next morning when I was my face after it being on overnight, the skin on my face will look so shinny and tight looking. It just looks like brand new skin and I get compliments on it all the time. I love the shinny look. Here lately when I use it, I don`t feel the tingle like I did at times and when I wash my face now, it doesn`t get that shinny look to it anymore. Could that be because I need a stonger strength, or what do u think the reason is?

Answer:

you skin has adapted to it, you could try to get the higher concentration, but in time, your skin will get used to that also, Constantly irritating the skin in order to maintain that shiny appearance you desire is not good for the skin overall. JG 4.22.11

Question:

Hello Dr. Garcia. Is Olay Regenerist Derma-Pod Eye System good in removing wrinkles around the eye area? Thanks.

Answer:

they will look better, but no cream will remove them, just soften them. JG 4.18.11

Question:

Hello, I read a previous post where someone stated she was taking collagen supplements and subsequently was noticing fuller lips and smoother skin. Do collagen supplements work in this way? Wouldn`t they be broken down by digestion and not really have any effect on the skin/lips? Thank you.

Answer:

no, I think it was coincidental or due to something else, there are no oral agents that will cause lips to swell. JG 4.18.11

Question:

I am 31 but I have problem when I sleep my mouth is always in a frowning position while I`m sleeping. I`m considering having two units of botox on each side of the depressor anguli oris muscles because they seem overactive. Ia this reasonable and what are the main complications because I hear that many doctors will not do botox around the mouth? Thank you.

Answer:

a common dose, the complications are if it is injected too close to the lip, the the lips might get weak, kind of like when you go to the dentist, but it lasts longer. Best of luck. JG 4.18.11

Question:

Hello, I would like to add vitamin C 10% serum to my skin care. I use retin a at night and azelaic acid 15% in the morning. Is it ok to apply the Vitamin C serum under the azelaic acid? How long should I wait? Thank you;.

Answer:

yes, can be used and you should wait at leas ten minutes between. JG 4.17.11

Question:

Dr. Garcia, Are there any new lasers or treatments that have recently come on the market for rejuvenating the skin that smooths and tightens? Does Titan work well on Asian skin? Thank you.

Answer:

nothing new that is any different and I think the Titan will leave you disappointed in its effects. Sorry. JG 4.17.11

Question:

I have four pinpoint scars on my cheek from a laser 2 years ago. They`re about 3mm deep x 3mm wide. (Type I skin -- extremely fair.) Though the scars are small, they are right in the middle of my cheek and are clustered, which makes them even more noticeable. My dermatologist thinks that a series of microdermabrasion sessions will make them disappear completely. I am quite dubious about this prospect. I suspect you`ll tell me that if I`m lucky, the scars` appearance might be softened by microdermabrasion but they`ll never be erased. Is that right? Anything else I can try? I suppose I could try a fully ablative CO2, but that seems like a long run for a short slide. Thank you so much for your time and generous help, Dr. Garcia.

Answer:

I think the microdermabrasion will not do the trick if the are that deep, maybe a repeat fractional laser around the spots to tigthten the surrounding skin a bit. I think the totally ablative laser would be better, yes. I am at a loss why a laser would leave you with the scars and at the depth you describe. Were they possibly acne scars that were just widened with the laser treatment as it was not deep enough to smooth them entirely out? JG 4.17.11

Question:

Hi Dr Garcia. I noticed your answer to the woman who found Retin A results declining over time - I am finding the same! What do you think of vitamin C serums? Any preference between Kiehl`s and other brands like iS Clinical? I have rosacea so am looking for something that works without a lot of extra ingredients. Any advice welcome - my issues are wrinkles and sagging. Thanks!

Answer:

I think as long as the concnetrations are the same, they work the same, I think you can certainly add the Vitamin c to the regimen, but in time you will see fewer improvements from the Vitamin C also, it is part of the aging process, the creams help to a certain point but they do not stop the process. I think the creams will help with the fine wrinkles but will never do anything for sagging. All the best. JG 4.17.11

Question:

Hi - I have a question about anti-aging creams. There are so many it is confusing. I use retin-A on my face nightly but am unable to apply this under my eyes as it causes redness and swelling there. I have been using retinol under the eyes instead. What other options are there? What are the most effective indredients I should be looking for? I am 35 with good skin use sunblock daily. Also, can I put any night creams on with the retin A? Apply after the retin-A? I don`t want to decrease the effectiveness of the retin A. Thanks for your advice.

Answer:

I think maybe adding a Vitamin C cream with about 10% concentration is OK if you wish,as to the night treatment, just wait ten minutes between your Retin-A and night cream to allow the Retin-a to absorb. All the best. JG 4.17.11

Question:

Hello, I had IPL approximately five days for red spots left from pimples. The red spots seem to be darker now than before - is this a normal reaction and will they fade? Thank you.

Answer:

normal, it fades and gets better, hang in there. JG 4.17.11

Question:

Trying to spend my limited funds as wisely as possible. SkinCeuticals: Between their Phloretin CF or their CE Ferulic Acid, which of these two topicals would you recommend as delivering the most bang for the buck? By the way, what is your general estimate of both these products? Thank you for your generous help! Have a great weekend!

Answer:

I think they are pretty good, between those two I prefer the ferulic acid myself. JG 4.15.11

Question:

In your experience, far apart should microderm-abrasions be spaced in a series of 6 for optimal results? (Over the course of 3 weeks @ 2/week or over 6 weeks @ 1/week?)Thank you, Dr. Garcia.

Answer:

depending on how aggressively it is done, it can be done every 1-14 days. JG 4.15.11

Question:

Hallo Dr Garcia! I dont have Artecoll but a friend has. Is that a permanent filler that will stay in place for the hole life, or do it break down as restylane after let say 20 years? Thank you.

Answer:

it is meant to be permanent. JG 4.15.11

Question:

Hello, Just wondering if IPL can cause swelling? I had an open rhinoplasty about 11 months ago and had an IPL session several days ago - My nose now seems quite swollen. Could this be from the IPL and how long might it last - anything that will help? thank you

Answer:

I have seen it cause swelling,yes.Usually goes away in 2-3 days, ice will help. I suggest avoiding salty foods and keeping your head elevated and try not to sleep face down, it might just take a little longer in your case. JG 4.14.11

Question:

Hi, Dr. Garcia. Do you have any thoughts about home microdermabrasion systems? Worth the investment? Using once/week? I`m particularly interested in this product: http://www.dermstore.com/product_Microdermabrasion+System_29275.htm Thanks for your thoughts.

Answer:

I think the problem will be how to determine the degree of depth of treatment on your own skin, it is hard to evaluate, safe, maybe, if done conservatively. JG 4.11.11

Question:

I have a condition called vascular rosacea. It is not real severe, but I find that my face reddens with heat (especially the sun), wind, coffee (which I have limited myself to), red wine (which I now avoid) and when I have a stressful situation, I am 47 years old, and worry that my face will get redder with the onset of menopause (and hot flashes). What treatment would you recommend. Also, is there any supplements that help with my condition. Thank you.

Answer:

I thin IPL works real well for that, available at most medispas. I do not know of any supplements that help that condition, sorry. JG 4.7.11

Question:

Not sure where my question I has asked went. It was on here last night after I asked it, but now gone. Anyway, I wanted to know if it was possible to get botox or dysport injected to help raise the eyebrows and not let it make the eyelid look heavy or droopy. That is what it seems to do to me because it won`t let me lift my eyes at all and seems to push down on my eyebrows instead of lift them up at all. Can it be injected where it will still let me lift my eyes but not frown or pull them down? If so, where would it need to be injected? Would it make any difference if it were dysport or botox?

Answer:

lifting the eyebrows can be done in most people if injected in the correct places, the muscles of the forehead lift the brow and if you weaken those particular muscles, then your brows will drop not rise. The injector should know that,if they don`t go elsewhere. JG 4.6.11

Question:

I have been using retin a for quite a long time with good results. One of the things I have always liked about it was, that after I wash my face the next day after using it that night, it looks real shiny and tight. Now it has stopped looking shiny and looks dull. I would like to know why it has stopped all of a sudden after years of doing this. It also has stopped flaking and drying out my skin. I use a pretty strong strength, so not sure why I am not seeing the results anymore. Would u have any suggestions as to why, and how to get that back?

Answer:

the degree of improvement will maximize at about one year, after that it is mostly just maintaining and not reversing. Also the skin does get acclimated to the Retin-a and then the flaking stops, but you do not have to flake to get benefits from Retin-A. Having said that, as we get older, it is not as effective as it was when you were younger. JG 4.8.11

Question:

Hey Dr Garcia, i asked a question earlier, but it was deleted. I asked about which chemical peel is best for African American skin, esp when after a bleaching cream is been used for 2 weeks prior.

Answer:

I would not use anything stronger than a 20% TCA peel, and I apologize for the missing question. All the best. JG 4.1.11

Question:

My son is 17 yrs old and his face is breaking out , his uncle who is a Doctor in South America not in USA brought him a cream to put it a night. I am confuse need your advise I am not sure if the best for him if to see a Dermatologist or the para medical esthetician that works in same ofice to put him on a regimen maybe do facials, with salycilic what do you think ? Thank you so much for your advise

Answer:

have him see the dermatologist and then they can decide what creams and peels are best. JG 3.31.11

Question:

hi doc, can you tell me the bestmost affective treatment to close or reduce pore size on the skin and pigmentation? also can having filler injected too near the skin surface cause uneven skin tone and open pores?my pores were less open before the fillers pls advice, thanks.

Answer:

well, to treat both of those I think either IPL laser or microdermabrasion, understand the results are slow, you need a series, and nothing you do will yield permanent results. I have not seen fillers injected being a cause for pigment issues. I have also not seen filler injections cause pores to enlarge, that is likely a different cause, likely thick sebum plugging the pores, rather than the filer. Best of luck. JG 3.30.11

Question:

Thanks. I am the male who had developed a rash on chin area where I shaved after a 15% TCA peel (red/pink blotches/spots that crust over and peel - no pus). It has been 9 days since the rash developed on my chin and it`s not getting much better yet but not spreading either, and you said it was okay to put hydrocortizone on it while waiting, I also have an over the counter fungal cream, can I put both on it incase its a fungas while I`m waiting to see the dermatologist? Thanks a bunch.

Answer:

I cannot see how the antifungal cream would help as the chances of a fungal infection are extremely low. JG 3.28.11

Question:

Hey there how are you? Do you happen to know of any programs or coupons to refill my my prescription for rerin a (the generic trenotin). I lost my job and ins (cant afford the cobra) and its about $100 @ Walgreen]s. I need some help paying for it....do you know of any programs or info you can offer....? Also how about yo get a deal on a clarisonic??

Answer:

about the only option is maybe to get it in Mexico, there are no US programs for that, although you can try contacting the company that makes the product and they will at times have programs for people such as yourself. As to the Clairsonic, I think it is a good device, but no deals there. Sorry. JG 3.2.11

Question:

Hi Dr. Garcia, I tried some 5% lactic acid toner several nights ago; and awoke in the morning to a red swollen blotchy face. I did not apply anything to the face yesterday except aloe vera. Today it is only slightly better. I am surprised because I regularly use 5% salicylic acid in the morning and retin a at night with no problems. I decided to try lactic acid toner as I read this is gentle and hydrating and most people tolerate it well. Is it unusual to have these red blotches after use? It is only on the face in the areas I applied the lactic acid. Anything besides aloe vera that may help it? Thanks!!

Answer:

it can happen, should get better in a day or so, just do not apply any more creams that can irritate the skin, so no Retin-A for now. I think the Aloe is OK to use. Not sure why you had the reaction, I would try it again in a couple of weeks in a non-visible area to test it one more time. JG 3.26.11

Question:

I`m a male and I recently had a full face 15% TCA peel and I didn`t take care of it that well after by shaving too soon after the peel. It seemed to heal fine all around my face for the week after the peel but then around that time, I woke up and my chin was feeling itchy and irritated, I stupidly shaved and then it was really irritated, red and itchy. I borrowed some of my wife`s foundation because I had to go to work and that made matters even worse. Then when I got home my chin area was red, inflamed and very itchy. Anyway, I stopped shaving the area and put moisterizer on it and a couple days later it was not looking or feeling as bad after the initial rash breakout, but since that point it does not seem to be getting any better. It`s been one week. I have pinkish red spots/blotches on my chin, some of them are crusting, peeling and then recrusting again, and it`s still a little itchy. It`s not seeming to go away and it`s been one week. I went to the aetheticisn who performed the peel and she said to see a dermatologist, but I can`t see him for 3 weeks because he is booked. In the interim I have some hydorcortisone cream at home, should I try that? What does this sound like to you and could it be permanent? Thank you.

Answer:

nothing permanent, the hydrocortisone is fine, that should take care of it, what happened is rare with a 15% TCA, that is very mild, especially in males. Best of luck. JG 3.26.11

Question:

I would like to know if your cell matrix peptide would be better than the retin a I am currently using and have been using for years for the wrinkles around my eyes and on my face? I have had good results from the retin a, but always looking for something better. Thanks!

Answer:

I think it is at least as good, does not sensitize you to the sun, causes no flaking nor irritation too. JG 3.24.11

Question:

Hi Dr, I am trying my best to improve crepiness on my neck area by using Retin A. I have only had slight improvement. I am 42. What is the best treatment in your opinion? Yag laser or RF has been suggested to me. Thanks

Answer:

I have not seen any long lasting, and by that I mean more then a few weeks, of improvements with chemical peels and lasers, the skin on the neck cannot withstand the procedures we routinely perform on the face I am afraid. I think the Retin-A is the safest but not effective for all patients. JG 3.24.11

Question:

Hello again - Can you ( or will you) tell me exactly which peptides are in your Cell Matrix Peptide? I`m guessing you will tell me this is top secret information : ) thank you thank you thank you

Answer:

well, not top secret, but proprietary, yes. There are five peptides in the mixture. JG 3.24.11

Question:

Dr. Garcia I hope you can help me.I read in New Beauty magazine that there is a product (I forgot the name) that you can use to make hyaurlonic (sp?) acid fillers last longer. It showed a bottle so I am assuming it is a topical lotion, serum or cream. Is this snake oil or do you think it may work? As always, thanks for sharing your knowledge. Glad you are back.

Answer:

I have not seen any science that would allow either a cream or a pill to be taken that would make a filler last any longer. Thanks for the kind words too. JG 3.23.11

Question:

Hi Dr. Garcia ! Which of your products do you recommend for the under eye creepy creppines ? I have wrinkles pretty bad, thin dry skin. Also - could the products be used on the upper lids? As always....many thanks, you`re too generous ( but dont stop !)

Answer:

can use my cell matrix peptide for both. JG 3.23.11

Question:

Hi Dr. Garcia. The underneath(bottom eye lid) of my 10 week old baby eyes is darker that the rest of his face.I think they are called dark circles. What can this be ? Will they eventually fades away to the rest of his skin. Thak you and looking out for your reply.

Answer:

at that age it is usually just a normal process of small amounts of blood pooling due to crying and sleeping face down, should get better as the baby gets older. JG 3.23.11

Question:

Hi Dr. Garcia. I`m a 52-year-old caucasian with rosacea, which I`m finally getting under control. I also use botox for forehead only. Now my concerns are under eye bags and marionette lines - just basic sagging. I`m using retin A every other night and a 10 oercent vitamin C serum every morning. What else might help for sagging skin? I hear a lot about peptide creams for ex. Or IPL? Many thanks.

Answer:

IPL might help withe Rosacea but not the bags or fine lines. Peptide creams might help the fine lines but not the bags. You might benefit from a filler to the marionette lines and the rim where the lower eyelid meets the cheek.Best of luck. JG 3.20.11

Question:

Hi Dr Garcia, which is better for skin? Eating fish 3 X per week or taking fish oil supplements daily?

Answer:

probably no difference as long as the fish is from the Pacific and is an oily fish like Salmon. JG 3.20.11

Question:

Good morning, Dr. Garcia. What is your opinion of the Stem Cell Therapy Cream being hawked on TV in the last few months, brought to us by the same company that sells Hydrolize ? As usual, if it sounds too good to be true..... right? But I`m wondering if you`ve had any experience with patients who have used it. Of course, the photos they show are impressive, but in addition to adjusting the lighting in the after photos, I often wonder if the subjects in any of these sales photos simply had never had any treatment at all to their skin and look better in the after photos only because they`ve done something...ANYthing! Your thoughts? Thanks, as always.

Answer:

Stem cells is a buzz word used to hawk many products. Stem cells are very fragile and cannot live in a topical cream as they claim. I think you have seen the magic of the pictures, many times the photos are altered by asking the patient to get dry skin on purpose for a period of time before starting the cream to make the changes more dramatic. Save your money. JG 3.13.11

Question:

Dr. Garcia, What is your opinion on exfoliating the skin? I do my face and body 2 to 3 times a week and I don`t see a difference. It may feel a little softer for a New York minute but that is about all. The products are not cheap so if you are not a big fan, I may skip buying this stuff and concentrate on products for something else worthwhile. As always, thanks for enlightening me with your knowledge.

Answer:

I think on the face it is reasonable, but not all exfoliators work well. A more optimal issue is to heave a MediSpa exfoliation every 4-6 weeks. As to exfoliating the body in general, you might as well use a luffa sponge and nothing more. JG 3.10.11

Question:

Dr. Garcia, Please tell me, what would you recommend: VBeam or an IPL for treatment of age spots, light freckles and light wrinkles on face? Which one would you think is the most effective? They are both the same price per treatment pretty much, but unsure of which one is better? Thank you Very much.

Answer:

I would go with the IPL as I think it is effective and not as much downtime as the VBeam, although the VBeam is stronger and might take fewer sessions. The reduction in fine lines will not be much and any improvement in the age spots and freckles is not permanent, in time, they will come back. All the best. JG 3.7.11

Question:

Hello dr, I have been having botox around the eyes and forehead for almost ten years. I have tried several different doctors and increased the dosage, but not matter who I go to, the botox only seems to last two and half months and the wrinkles, especially around the eyes are back 100 %. is this normal? Thank you

Answer:

without knowing the dose they are injecting, I cannot say whether that is normal, sorry. JG 3.1.11

Question:

Thank you so much for answering my question about chemical peel for the lips. What kind of chemical peel is best for the lips? TCA, glycolic or lactic acid? Wouldn`t it cause any cold sores on the lips?

Answer:

My preference is TCA, and we always pretreat all chemical peels and lasers woth anti herpes meds as we want to prevent or avoid that.JG 3.1.11

Question:

Hello Dr Garcia, can chemical peel be used directly on the lips? My lips have become noticeably darker after sometime and HQ doesn`t seem to be working. Im dark-skinned btw, if chemical peel doesn`t work, can permanent lip color work on my lips? Thanks.

Answer:

it can be done on the lips, yes, but any improvement in pigment issues is likely temporary, ad with time, will likely come back, just like on normal skin. Best of luck. JG 2.28.11

Question:

thoughts on neotrogena booster serum ??

Answer:

OK, nothing special, just like most others out there. JG 2.26.11

Question:

Hi - just wondering if it is ok to use a salicylic acid toner under retin A? If so, how long should I wait to apply the Retin A? Thanks!

Answer:

wait ten minutes. JG 2.25.11

Question:

It looks like my question didn`t post or it was deleted. I asked about the glutathoine injections. I researched about on every medical website and it states that if it is administered with vitamin c injections, it can produce whitening effects. Is there a reason you said it won`t work?

Answer:

just because it is on the web does not make it true,also not sure what medical websites you are referring to, at least not any I routinely read, if you wish, try it and let us know, but I have expressed my doubts that anything like that would work, for if it did, there would not be any patients left with the problems you have as Vitamin C and glutathione are cheap. JG 2.23.11

Question:

Hello Dr Garcia, is it safe to use IV glutathoine 600gm for whitening? I know a lot of celebrities use it for their skin, coupled with Vitamin C injections. Do you think it is safe to use, if injected by a dermatologist? Are there any side effects, esp if u dont have kids yet? Thanks for your help.

Answer:

don`t think it will work.Sorry. JG 2.22.11

Question:

Have you heard of the Palomar RejuveLux Process for a photofacial? If you have, is it any good? Thanks!

Answer:

yes, pretty mild effects. JG 2.20.11

Question:

Hi Garcia, I am the one that just wrote the question about the sebaceous hyperplasia. I did not make my question clear. Yes, the erbium laser went too deep. But if my skin in those two circle areas is pink, could the vbeam be now used to remove the redness? Or because the skin in compromised, would it not a good idea and could cause further damage to the skin in those two areas? Sorry I wasn`t clear. Thanks again. kp

Answer:

sorry, my confusion, yes, it should help the redness. Best of luck. JG 2.02.11

Question:

I am 28 and from working on computer i have slight lines in between my brow. I dont not want to botox yet; I do resylne and thats enough to keep up with. My question is is there a skin product I can use that can help me at all?

Answer:

sounds like it is due to the muscles being overactive, common when working on computer screens. A filler will hide it but will not stop the cause and in time will continue to get worse. If you cannot avoid scrunching your eyebrows together when looking at the screen, then I think Botox is the best option.There is no skin product that will help stop the muscle flexion causing the wrinkle and will do less than a filler. JG 2.19.11

Question:

Hi Dr. Garcia: I am the 63 year old lady who had a C02 Laser Resurfacing (over entire face) ~ 15 years ago. One area became infected (horrible experience)and today I have hypopigmentation. I have been told there is nothing to treat hypopigmentation. Is this true? Thanks for your help. 2/18/2011

Answer:

I am afraid it is true, there have been some attempts with lasers but all they do is cause redness that needs to continually re-treated. Sorry. JG 2.19.11

Question:

Dr. Garcia: I am 63 years old and have fine lines around my mouth and over the top of my lips. I have laser resurfacing over 15 years ago that left my face very sensitive. I do not care to have injections. Question: Are these any skin products, i.e., exfoliators along with moisturizers that you would recommend. And, am I a candidate for a (several perhaps)light laser peel around this area? Thank you so much. 2/16/2011

Answer:

I think exfoliators will keep your skin and pores clean but will not help with the lines. A series of lighter peels will not give the degree of collagen promotion that a deeper one will. Either way, you might get 18 months of improvement on the fine lines if done deep. You can use Retin-A for a slow and mild assistance too. All the best. JG 2.15.11

Question:

You still didn`t tell me what u think of the procedure yourself called the Exilis, and why do the plastic surgeons advertise it like it is something spectacular, and then when u get to the office, act like it wouldn`t be worth the money?

Answer:

sorry, thought I was clear before on my earlier post, I think it is a waste of time. They advertise it to get you in the office and then they talk you into something else, is called bait and switch deceptive marketing. JG 2.15.11

Question:

I just received a pamplet in the mail from a plastic surgeon I have visited in the past. On the front of the cover it has a new procedure being offered in his office now calleld the Elilis. It says it for fat reduction and also skin tightening and wrinkles. It seems everytime something comes out and it says it will tighten the skin, and they advertise it, then when you go somewhere to get it done, the say it really doesn`t work that well, and try to push you into something else. My question for you is, what do you think about this procedure honestly and whey do all the procedures like the titan and thermage not get reviews by you? Do you think this one would work for the skin tightening?

Answer:

they will likely tell you the same thing they have said before. Sorry. JG 2.14.11

Question:

I`m Asian but I used to have a very fair skin tone. I`ve always been avoiding the sun and wearing heavy sun protection but last summer, I had to work outdoors and my face got tanner but no visible age spots/freckles. The tan isn`t fadding at all even with hydroquinone. Would light laser help the skin return to its previous color (combined with skin avoidance/protection)? Thanks again for your help!

Answer:

it might, but there can also be a reactive hyperpigmentation, so if you decide to do it, it should be done very lightly. Best of luck. JG 2.14.11

Question:

I was reading some procedures that were offered at a plastic surgeons office and ran across portrait plasma. I have never heard of this. I read about it and was quite impressed and it got alot of good reviews from the patients. What do you think about this procedure and would it be something that would be worthwhile?

Answer:

I use the technology, it was more popular but the company closed down and now it seems there are competing companies coming out with the same technology. I think it is between a pixelated fractional laser and a fully ablative CO2 laser, can be done in one deep session or a series of three lighter sessions three weeks apart. More fine pigment and fine lines. JG 2.10.11

Question:

Hi doctor, i want to have more information concerning mesotherapy treatement? how far is it beneficial for the face. thanks

Answer:

all of the information I have about mesotherapy is not good, sorry. JG 2.10.11

Question:

Good afternoon Dr Garcia. Is consuming flax seed meal good for my skin? Or should I be avoiding it due to the high omega 6 content?

Answer:

I like to avoid the Omegas 6 unless you have a need for something to be pro-inflammatory. JG 2.9.11

Question:

Saw your answer below about how much fatty fish to consume each week for optimal skin (and heart) health. Are fish oil supplements just as good as eating salmon or sardines? If so, how many IU`s? I`m taking 2000 IU`s/day. I had been taking 3000 but read somewhere that it might simply be wasteful to do so. We all appreciate your advice and guidance, Dr. Garcia. Have a great day.

Answer:

as long as they are a good source, I think they are as good, the fish has to be wild lien caught, not farmed, and I prefer Pacific, and not Atlantic. I think as long as there are no problems with your medical hx, then 1-2000 mg per day is fine, people with heart disease and high cholesterol can take more, up to 6,000 mg per day of EPA/DHA. The only side effects at higher doses is a little more easy bleeding, like when on baby aspirin. Best of luck. JG 2.7.11

Question:

Hi Dr Garcia, Can I get the same skin benefits from eating fatty fish (wild salmon, sardines)as from taking daily fish oil capsules? If so, how much fish would I have to eat in a week to reap those same benefits as daily fish oil capsules?

Answer:

need to eat 4 oz, at least three times per week. Give or take. JG 2.6.11

Question:

PS in the Essex/Passaic County Area HI again. The PS I recommend is Dr. Larry Weinstein. The best!! Ive been going there for 10+ years. http://www.docweinstein.com (Tell him Kim) referred you. Any questions you can email me at kimp885@yahoo.com. Would be glad to help :)

Answer:

thank you.JG 2.6.11

Question:

Dr. Garcia, which protects my skin better from sundamage Ocean Potion zinc oxide 45 or the Neutragena sunblock 70? Can I use Retin-A and another cream containing copper and peptides every night or do I have to alternate? Thank you.

Answer:

go with the Neutragena and I don`t think you need the copper peptides unless you have a sunburn or a recent laser or chemical peel, so just stick with the Retin-A. JG 2.4.11

Question:

Dr. Garcia, Do creams with ingredients of copper and peptides really help the skin in developing more collagen? What are the benefits of these ingredients? Thank you.

Answer:

I think some peptides do help the cells stay more healthy by stabilizing cell membranes and helping restore the energy of the cell and I believe copper is a good additive after an acute injury like a chemical peel or a laser, otherwise not much help. JG 2.3.11

Question:

Sorry to bother you again, I`m using the Tretinoin cream .025 2x a day and now my skin is flaking and my skin is very dry and stinging a little. It`s only been 2 days.. I have quite a few broken blood vessels on my face that were already there and on my cheek I see a about 3 red little bumps coming up where some of those are. I`m wondering if I have rosacea now or if it`s just a reaction to the cream? Should I continue as recommended or go to 1x a day also. Or is this all normal and will it get worse then better lol? Ty Ty! :)

Answer:

I would stop the cream totally for 3-5 days and then restart at only once per day and lets see what happens. If it gets better it is just the normal irritation from the Retin-A and you can then restart, but increase it slower, maybe using it twice per day every second or third day only. Best of luck. JG 2.3.11

Question:

I use Retin A every night and have had good results from it. I also see where u approve and like the oil of olay line. Have you seen results from it? If I use retin a is there anything I could be using any better to get any different results from than just it? Would the oil of olay products help also with the retin a maybe with contouring or lifting?

Answer:

I have many patients that have had good results with the Oil of Olay line, as to using it in combination with Retin-A, just apply the Retin-A first, wait ten minutes so as to not dilute it, and then apply the Oil of Olay. Best of luck. JG 2.2.11

Question:

Hello, it has been some time since I have posted a question. I can`t tell you how much I appreciate the time you take to answer all of these question. Anyway, my husband has RA and because of the meds he is on his skin is very thin and he is always getting red blotches on his hands and arms when ever he gets a scratch or bruise. His doctor says it is normal. I think RetinA thickens the skin. Do you think he would benefit from using it on his hands and arms?

Answer:

might be a little too irritating for him with his RA, might suggest some topical Vitamin K cream and also some Arnica Montana gel, the latter sold at health food stores, to help with the bruising, not much else that can be done I am afraid.JG 2.1.11

Question:

Thank you for the advice with the tretinoin cream .025%. If I use this 2x a day, morning and evening. When should I moisturize? And,I`m putting it on my upper chest/neck area is that okay too? Thank you so much! You`re so wonderful to be here helping so many! xo

Answer:

OK for the chest and neck. If you want to use a moisturizer, apply the Retin-A first, wait ten minutes, then apply the moisturizer. All the best. JG 2.1.11

Question:

In response to Barbara below, may I recommend a PS to her on here?? Passaic/Essex County area of New Jersey. Can you recommend. Thank You. Barbara

Answer:

feel free, yes. we are here to help. JG 1.31.11

Question:

Hi :) My Dermatologist prescribed tretinoin .05% but I already have it in .025%. Is it worth using what I already have? (For wrinkles and evening out skin tone) And should I use toner after washing my face and let my skin dry then apply the tretinoin? Since it`s weaker should I used it twice daily? Thanks for any advice! :D xo

Answer:

The 0.05% is stronger, but would use up what you have first, and yes to the twice per day. I think just lettting your skin dry and then applying it without the toner is OK also. All the best. JG 1.31.11

Question:

Hi, Thank you for answering my previous question. One more if you will, I have been using Obagi Skin Care Line for about 3 years now. It is very pricey and now the only way you can purchase certain items is through a plastic surgeon. I have combination skin and I am 50. Can you please let me know what skin care system is compareable to Obagi or can you recommend something else for combination/aging skin. My skin is very sensitive and I cannot use Vitamin C or any Glycolic products. Do you also need a toner?

Answer:

most people do not need a toner, can try the Oil of Olay Pro-X line, pretty good for a better price. JG 1.31.11

Question:

I haven`t been to this website in about 2 months and wow...i love the new look! I have a quick question, what laser is available to treat severe hyper-pigmentation for dark skin? I have tried AHA and TCA peels and it gets darker when the area heals. Btw, the area is on my boy and its very stubborn..

Answer:

might want to try a YAG laser, but it is risky in darker skinned individuals and also is never permanent, no matter what method is used to lighten the area. Sorry. Thank you also for the feedback on the website updates. JG 1.31.11

Question:

Hi. I hear you talk alot about the CO2 laser. I had Active FX done on my face about 9 months ago. I noticed a little improvment but not alot. Is Active FX a CO2 laser. What type of CO2 laser do you recommend for acne scarring? My scars bother me but they are not too bad. Some scars and red marks. I was thinking of dermabrasion which I noticed you do not recommend, but the CO2 laser instead. I am just unsure of which type I should be looking for. Thank you so much for your help!!

Answer:

Let me clarify my stance for you regarding Co2 laser. When I recommend a CO2 laser, I mean a totally ablative non-fractional laser where the ENTIRE surface of the skin is treated. In pixelated or frational lasers session, only a small fraction of spots of the skin are treated, leaving intervening non-treated areas in an attempt to reduce risk, speed healing time, decrease pain, and increase patient acceptance But as one can imagine, when you only treat a small fraction of the skin, you will get a small improvement. Active Fx is a very mild fractional laser and I think they are likely safe but in my opinion are not worth the money for the length of time of improvement you get. Having said all of that, acne scars never respond to lasers as well as wrinkles as the lasers treat the surface and acne scars are in the deep layer of the skin, even if improved, with time, as the skin gets looser, the appearance of the scars returns, so it is not a permanent removal or improvement of scars. I think the variables with a dermabrasion make it a less than optimal choice, although 20 years ago it was the gold standard, it can leave linear scars, thicker scarred skin and irregular loss of pigmentation. I would suggest a totally ablative CO2 laser for acne scars. All the best. JG 1.29.11

Question:

I have read that Pure noni juice will build collagen and is high in antioxidants and polyphenols. Any truth to these claims? Especialy the collagen building one? Plus must it be injested or will it work as a cream? Thank You!

Answer:

more hype than anything. JG 1.24.11

Question:

I read that dry brushing on our FACE using a very gentle face brush is excellent.Is it better to substitute with cleanser on the brush ( like clarisonic) or dry brush and cleanse it later?

Answer:

most of my patients use a cleanser on the brush. JG 1.21.11

Question:

Dr. Garcia...I have been using Retin A .05% daily for the past few years with no irritation or redness so decided to graduate to the higher concentration .1%. Within a few days, I started with some red, peeling areas especially around the mouth. Would it be better to use the .05% daily or the .1% every other day or every two days. Is it likely my skin will adjust to the stronger formulation - I`ve been using the .1% for several weeks now and still have continued peeling/redness. Thanks in advance for your invaluable advice!!

Answer:

the skin will adjust and the stronger concentration will yield better results, but you need to allow the skin to acclimate. The acclimation can take 6 weeks. If it is too much, just alternate between the two and increase the 0.1% slowly over time. JG 1.20.11

Question:

i have a glycolic acid 12% ((combined with aloe vera) cream by the name of Glycovira Cream. Can i use that on my hyperpigmented areas that were caused by the intralesional bleomycin injections? do u think it might improve the areas? what else can i use? what about hydroquinone, retino-a etc? i would like to try some creams before i try the lasers (if u think the creams could help).

Answer:

certainly OK to try it, not sure how effective it will be though. I think hydroquinone and Retin-A will be much stronger and more effective, but it still might need the laser. JG 1.17.11

Question:

Is it true that drinking a lot of water makes the skin look better? I drink a lot of orange juice would that be even better because of the added Vitamin C?

Answer:

normal hydration is important, but overdrinking it will not be beneficial. Large orange juice intake is not good because of the carbohydrates. Just stick to the water. JG 1.17.11

Question:

Dr.Garcia I just post a question about my son who is 17 yrs and started breaking out 4 months ago you suggested retinol cream . I use Tretinoin 0.1 % or my question I see in the internet Green Cream Retinol level 9 is safe to buy it ?

Answer:

I always think it best to see a doctor for the presciption so they can monitor the patient`s progress. JG 1.16.11

Question:

Dr.Garcia thank you for your answer but my son make a change on his routine of products it was not my choice his father made the change I just want to make sure he is in the right pad he is using Acne Solution Burts bee purifying gel cleanser with Salycilic Acid 1.0% and Oil Free Acne Stress Control triple action Toner with salicylic acid 2% but I do not see his face doing well .Question I used Tretinoin Do you think okay this cream for him bcz Retin A is a prescription cream and does he need to use the pads of salicylic acid at night or will be too much please let me know your opinion I appreciate so much !!

Answer:

He can use the salicylic pads at night followed bu the Retin-A, I think it is best to get his own prescription though so a dermatologist can follow his progress, he would need to start slowly, every third night with the Retin-A, increasing the frequency when he can tolerate it more. Al the best. JG 1.16.11

Question:

I had some intralesional bleomycin injections for scar tissue lumps under my eyes. They worked. However, they left hyperpigmentation and, after 5 to 6 months, there is still hyperpigmentation there. it is only very slightly faded but most of it is still there. is there any way to get rid of the hyperpigmentation or will it be permanent? what can i do/use to get rid of it?

Answer:

might try some YAG laser sessions to fade the brown, all the best. JG 1.16.11

Question:

Is it possible to acheive lightening of melasma with a series of PCA chemical peels without using a daily HQ product? Love the new website! I enjoyed the intro.

Answer:

possible, yes, likely, not so much as the chemical peels are irritants and any irritation can, at least in the short term, cause post-inflammatory hyperpigmentation, and the hydroquinone helps settle the tyrosinase enzyme down that creates melanin, so I use if for that issue. Thanks for the comments on the website too! JG 1.11.10

Question:

Dr.Garcia my son is 17 years old and around 4 months he starts breaking out on his cheeks I am afraid bcz I had the same problem and still always needs to take care of my skin I bought him a cleanser Neutrogena sensitive skin, Toner Neutrogena non Alcohol, pads with Salycilic Acid 0.5 % to put at Night than a Moisturize (Neutrogena oil free )and also when I can I take to an esthetician that do a acid salycilic peeeling ( he had 2 already ) Questions is okay to by in a Drug store Pads with Salicylic Acid 2% or do I must buy the other pads with 0.5% that I got from my esthetician . 2nd question Does he need to use Moisturizer ?? Also he is taking one pill for Men Multivamins and 1 Vitamin A (10,000 mg) and vitamin D Pls I would appreciatte your response I do not want my son to suffer like I did ..Thank you

Answer:

the pads form the drug store are fine, might also use some retinol creams or better yet, Retin-A. I would likely avoid a straight moisturizer but would use a sunblock when outside. The vitamin regimen he is on is fine. Best of luck. JG 19.11

Question:

Hello Dr, Iam 42 with fair skin and have lived in a hot climate for over 15 years. I have started to get lots of age spots on my hands and lower arms. What is the best treatment for this? Thank you

Answer:

start with sunblock, SPF 50 or higher, and then also with Retin-A and Hydroquinone typically twice per day. Best of luck. JG 1.8.11

Question:

My sister is thinking of buying a pill (choline-stabilized Ortho Silicic Acid) that`s a scientific breakthrough to generate collagen. Any truth to this or should she save her money?? Thank You

Answer:

save her money, sorry. JG 1.5.11

Question:

question, i been using latisse for a while and my bottle just emptied. money is tight right now so if i bought the careprost (i think thats the name), nothing will change from results, right? it will be like i am continuing with the latisse??

Answer:

same stuff, yes. JG 1.4.11

Question:

Hi, i have been using latisse for a long while now (i know your not a fan). I have not had any bad effects except a dark line where applied which I actually am ok with because it looks line eye liner. Anyway what are the bad effects you always refer to, maybe i am missing them??

Answer:

The worst side effect is that the colored part of your eye will turn permanently darker, secondly is the effects of chamber pressure on the eye as it was originally a glaucoma drug. JJ 1.2.11

Question:

Hi Dr Garcia! Happy new year to u!I have 2 questions for u ; 1) For exfoliating,I`ve tried using warm soft facial cloth gently on my face,but after a week I`ve noticed my skin produces more oil and bumps started appearing.What are your thoughts on Clarisonic brushes on our facial skin?Specifically acne prone skin? I found a japanese facial brush ( cheap alternative for clarisonic)at a health store called Hinoki brush, the bristles are very soft.Overall are these brushes are any good for our face? 2) Does any night creams/cleansers contains AHA, glycolic acid and lactid acid are safe to be used by woman who`s trying to conceive or pregnant?What is the right percentage of AHA that should be beneficial for sensitive acne prone skin? 12%?

Answer:

the skin producing more oil is tto due to the cleanser, it is because you need more moisturizing after the cleansing. I do think Clairsonic is a nice machine, but pretty expensive and not sure it is any better than other exfoliating cleansers with crystals. As to safe creams for pregnant females, I am afraid that they have never, and likely will never be tested on them, so it is a question impossible to answer with absolute certainty. In general the problem product would be the retinols as it is a Vitamin A derivative and Vit A is well known to cause problems in fetuses, the others have not had an established negative effect. Best of luck. 1.2.11

Question:

If one is pregnant can she use hair removal equpment.Doese it have any side effect on the baby or not?

Answer:

should be safe as there is nothing absorbed. JG 12.29.10

Question:

Hi Dr. Last year my plastic surgery injected my face with inter fall gel and he said that it is permanent.Now my face is runied because there is no balance between the 2 sides of my face and in some areas it melted away while there are aereas that I try hard to melt them by massaging it but I can`t.In these aereas the gel is like peas and I can fell them.The most damaged part is around my mouth in a way that there are lots of lines and wrinkles due to this.Please can you tell me the way to melt these areas from this gel to regain my beauty.I am 34 and not too old to have all these wrinkles around my mouth.Please help.Thanks.

Answer:

I am sorry but it sounds like you will have to have the lumps cut out, and that will leave scars.JG 12.28.10

Question:

Hi Dr. Garcia, since September I had a tiny dot rash which now is the size of a nickel. No matter what I use it seems to just get bigger. It is on my shin and when I wear pants it will rub against it. I believe that is the main reason the rash formed. It no longer itches, but the skin is reddish, sometimes pink, areas are lump and bump very unevenly. I have used aveeno lotion, aquaphor, cortigel, and zinc oxide. Non has made it look any better. It appears to just be a scar now with no discomfort only very blothy reddish lumpy bumpy areas. Do you know if anything can make it look normal again. Thank you.

Answer:

might want to see a dermatologist to make sure it is not a fungal infection or early psoriasis. Best of luck. JG 12.28.10

Question:

Dr. Garcia is Squalene oil a good moisturizer for facial skin? I live in the East where the dry heat in winter is rough on the face. Thanks and a Happy New year to you.

Answer:

Excellent product for skin,Happy New Year to you too! JG 12.26.10

Question:

Is this the same as Latisse....Careprost ( Generic Latisse)? Do you get the same results??

Answer:

it is the ingredient in Latisse, if applied the same way has all the good and all the bad of Latisse. JG 12.26.10

Question:

I just read egg whites contain proline, an amino acid that serves as a building block for collagen. Egg whites contain more proline than most foods we eat, thereby making this a great facial? Can your skin realy absorbe this proline? Thank you for your time and merry christmas!

Answer:

fills in the skin lines for a short period but it is not absorbed, sorry. JG 12.26.10

Question:

is it safe to buy Latisse online??

Answer:

well, you need a prescription for it so not sure how you would do that. JG 12.21.10

Question:

La Mer The Powder....your thought??

Answer:

overpriced. JG 12.21.10

Question:

New! Vivite - Defining Lip Plumper...........YOUR THOUGHT??

Answer:

sorry, have not had anyone use it to give you a response. JG 12.21.10

Question:

Hi Dr Garcia, advance merry christmas to u! I would like to know is it necessary to use a night time cream or serum at night? I`ve read before that its best not to apply anything on our skin at night and let it breath, plus I`ve also read that during our sleep, our skin will repair the cells the most so its best to use a night cream. What cream do u suggest for acne prone sensitive skin ( besides retin A and retinol)? Since its winter now, my skin has became so dull, flaky and ashy despte wearing thick mosturizer day time

Answer:

I think using a Vitamin C cream or serum at night is good, instead of the Retin-A or retinols. Merry Christmas back! JG 12.21.10

Question:

Hi Dr. Garcia. I have a problem with cystic type acne on parts of my face. On my left cheek side they look like whiteheads. I can extract some of the material out but it just makes the area more swollen and bumpy and they don`t go away. The others are located around my scalp and jaw line but don`t appear to be filled with anything. Other than the extraction I keep my hands off my face. I have tried chemical peels, all the different creams from the derm, i.e. retin-a, etc, also pro-activ,and roc and nothing will eliminate these. Some of the products will appear to bring the whitehead looking cysts up to the surface where it looks like you could extract them but if I do that the whole process I mentioned earlier is the result I get. I cleanse my face 2x a day with Cetaphil using the clarisonic mia. Use Eucerin redness type moisturizer, even though my skin is oily, it makes my make up go on better. All my make up is non comedogenic as well. I am 49 and perimenopausal as well. I used to have beautiful skin with a few breakouts and blackheads but nothing like this. I only take 2mg of ativan at bedtime as my medication. Nothing else.I am tired of going to the derm and not getting anywhere. Any suggestions? Happy Holidays! Thank you!

Answer:

sounds like its time for Accutane to control the problem, all the best for the Holidays to you also. JG 12.17.10

Question:

Hi dr Gracia. Hope all is well with you.Ive been taking Diane 35 for both my hormonal acne`s and contraception purposes for the past 8 months now.It worked charmly and I`ve just stopped taking it since we r deciding to start on a family.Im quite concern about my skin getting back to normal state before I started the pills, as now its relatively clear( just been 3 weeks Ive stopped) For my night cream, Im using La Roche Posay Active C ( 5% Vit C) every night.I do use mild cleanser like Noxzema day and night, basic moisturizer and a scrub.The prob is each time i uses any kinda scrub, I`ll break out or my skin get irritated.As for the record, I use the gentlest motion plus my scrubs is more like a creamy beads.I do this twice a week.Can I be allergic to scrubs?? Ive opted for Retinol products for night cream but since im keen on getting pregnant, I opted for Vit C(LRP) cream as an option.Lately,I do get beakouts mainly inner cheeks and foreheads.The rest of the face is clear.Is vit c safe for ppl who`s planning to conceive? Any other options? I dont want to be an ugly mum to be and afraid of the pregnancy mask as well Pls advice, thank you

Answer:

doubt you are allergic, might just be too big of a bead, just use a softer scrub. Although retinol is not Retin-A, retinols have not been tested for safety in pregnant females. I think once you get pregnant the progesterone from your ovaries and placenta will keep the acne at bay. Best of luck. JG 12.16.10

Question:

Hello Dr. Garcia. Is l`oreal men expert vita lift eye double lifting effect good for reducing eye wrinkles and lifting the eye around the skin? Thanks.

Answer:

might help the fine lines a bit but will not lift anything. JG 12.11.10

Question:

What would you recommend to get rid of the sagging at the jaw line and thin skin/wrinkles under the eyes?

Answer:

a facelift and a lower lid blepharoplasty. JG 12.10.10

Question:

I want to know your opinion on using ULTHERAPY. Will it produce collagen and thicken up the thin skin under the eyes and get rid of lines/wrindkles under the eyes and around the eye area. Will it also correct marionette lines by producing more collagen around the mouth area? Will it correct sagging under the chin from ear to ear? How long will ULTHERAPY last?

Answer:

I do not think Ultherapy will produce a clinically significant amount of fat to cause a visible change after the swelling goes down. I do not think it will give a long term correct for marionette lines and I do not think it will help the sagging skin of the neck.I would not perform it. JG 12.10.10

Question:

hello Dr. Garcia, which of the following chemical peels do you use or recommend? Hydroquinone Peel, Lactic & Carbolic Peels, Jessner Peel, or Glycolic Peel

Answer:

I use glycolic peels, lactic acid peels and Jessner`s peels. JG 12.10.10

Question:

I have purchased your terrific peptide cream in the past and have liked it very much. I see that you think highly of Skin Medica`s TNS Recovery Serum, which I believe is similar in nature to your peptide cream (though more costly). I was recently given a bottle of the TNS product and am wondering if your product and this one are essentially interchangeable. If so, I`ll go back to yours when this gift runs out! If not, I`ll use them together. Thank you for the guidance. I agree with the other poster here -- wish I lived close enough to have you as my surgeon. May you and your family have a beautiful holiday season and a peaceful, healthy new year.

Answer:

they are pretty close, I have a couple of things they do not and vice versa, but the meat of ft is very similar. No harm in trying it after mine and then deciding which one you like. I appreciate the kind words and I wish you and your family a joyous holiday and my best wishes for a healthy New Year. JG 12.8.10

Question:

Hey Dr.Garcia can u tell me which make-up is a better choice of use,in terms of ingredient and won`t clog pores Mac or Lancome, or can u recommend a brand? Thank you an have a great day!!

Answer:

the plugging of pores differs from person to person I am afraid. I think they are both pretty good make up lines though. Best of luck. JG 12.8.10

Question:

If I just don`t want to mess with bleaching creams for my faint melasma, is there a procedure that could remove the melasma in one shot? (I realize it would be temporary. I would be willing to take a week or two off of work for healing.

Answer:

very very doubtful that a single session will remove it safely, and no matter what you do to lighten it, in time and with sun exposure, the discoloration will return, there is nothing that will permanently erase the memory the skin cells have to hyperpigment. JG 12.7.10

Question:

I have come to the conclusion that hydroquinone is just too irritating for my skin. Do you think that a product containing kojic acid and arbutin would be a worthwhile alternative to treat my (mild) melasma?

Answer:

worthwhile to try. JG 12.7.10

Question:

I used a compond dexamethsone acetate cream, cortistriod on my face for itchy skin. I did lay it on thick last night and in the morning when I washed the cream off. My skin area turned whiter than my normal skin. Several hours later the skin still have not turned back to normal. Have you heard of this type of cream, and do cortisteriod creams discolor skin? How long does the discoloration last. Thank you so much.

Answer:

I have not seen that happen in a single application, sounds like the carrier in the cream where the medication is dissolved is just adherent to your skin as it was partially more porous due to the rash.I think as you wash it, gently, over the next few days, it will get better. JG 12.5.10

Question:

When the erbium yag laser is used for sebaceous hyperplasia, is it the short or long pulse that is used? Thanks much.

Answer:

Sounds like a doctor question, not a patient question. If the doctor does not know the answer to that, they should not be doing the treatment. JG 12.2.10

Question:

Hi Doctor from the very cold UK.Looking for options with under eye / crows feet improvement after a relatively good L/bleph a year and a half ago. What are your opinions on Laser , peel or portrait which I can get done in London.Not too bothered about the cost but bang for the buck and downtime etc. are important. Thanks in advance and best wishes to you.x

Answer:

Light CO2 laser or a deep Portrait. All the best. JG 12.1.10

Question:

Hello, Dr. Garcia. Another skin question. What do you think of Cosmelan? Is it good for removing brown spots? I was concerned about one of the cleansing ingredients: acetone? Can you really put acetone on your face? thanks for all of your advice. This website is a godsend.

Answer:

I have used acetone for years as a degreasing agent, it is safe as a single application prior to a chemical peel, yes. I see no distinct advantage of Cosmelan over traditional TCA peels. Thanks for the kind words and best of luck. JG 11.29.10

Question:

Thanks for the answer about the AK on my nose treated with Efudex. Unfortunately the skin on my nose is very thin with no skin to pull together for sutures. If in fact, if there is still some Ak left in the wound as you suggested, could I treat it again with Aldera .This was my first time using efudex so I was not sure how my skin would react to efudex. Not real happy with results of efudex.I have used Aldera before on AK & was very successful. Is it too late to re-treat AK with Aldera or is it too late & my nose will not heal on its own??? Any other options..I am desperate!Thank for your time

Answer:

If the Efudex did not clear it up in 4 weeks, then a cream will likely not be effective and you at least need a biopsy to get an diagnosis, I fear it is no longer just an AK, but a frank cancer now. The reason it will not heal is that there is residual cancer that has developed,the non-healing is not because of the Efudex it is a known eventual possibility in AK`s I am afraid. I think you need to see a dermatologist now, sorry. JG 11.29.10

Question:

Hi Dr. Garcia. I had an AK on the bridge of my nose & put Efudex on it. I stopped treatment about 4 weeks ago & the area I treated with Efudex does not seem to be healing. No improvement at all...just looks like red raw indentation on my noise.It is still oozing/weeping and a scab forms instead of new skin. I am concerned...why do you think that the area is not healing??? Any suggestions?? If this area does not heal, what are my options? Thank you so much for your help.

Answer:

You might have had a small precancerous lesion there and that is why it is not healing after this amount of time. I think a biopsy and closure with sutures is indicated for safety sake. Best of luck. JG 11.29.10

Question:

Hi there, in response to your previous message about Obagi clear and Obagi blender. They both contain 4% Hydroquinane so which one should I buy? The clear or the blender (as they are both the same right)?

Answer:

The Clear. JG 11.20.10

Question:

whats the difference between the obagi clear and the obagi blender as they are both in the obagi nu derm starter kit? They both seem to have the same ingredient and do the same thing so whats the purpose of them BOTH being in the kit?

Answer:

marketing. JG 11.18.10

Question:

Hi Dr Garcia. Your website is great! I have a question which I really need your help on. I suffer from Chloasma Melasma and have been told the Obagi Nuderm system will be great to treat my condition. Only problem is I am finding it very expensive and instead of being the whole set, is there any specific obagi products from the range that you recommend which will help save money?

Answer:

what works is the 4% hydroquinone and the Retin-A 0.1%, you can get those as a generic from your doctor as a prescription and save lots of money. JG 11.18.10

Question:

I have finally quit smoking and tanning at the age of 32 because I do not want to further accelerate the aging process. When people quit addictions like this is I know it is mostly preventing more damage, but is there any effect at all of the skin actually looking better as well?

Answer:

sorry, but was is done is done. JG 11.18.10

Question:

Hello, I have another question about the progesterone cream. If using for hair loss - what is the suggested use and where is it applied? For PMS/breakouts before period? Is it applied to inner forearm and absorbed systemetically? Thanks again!

Answer:

it is applied to the inner forearm or arm or inner thigh, on areas with little to no hair. Usually applied at night, about the size of a pea to start and the amount can be increased as needs require. For PMS, it is started a day or so before the symptoms normally start and then stopped on the day you are supposed to have your flow. All the best.JG 11.16.10

Question:

Hello, I would like to try progesterone cream for PMS and some thinning hair. Every bottle I have found has a warning on it stating this contains an ingredient known to cancer in the state of California . What is the ingredient? Is this safe to use? Thank you for your help.

Answer:

not sure which bottle label you were reading,but it is the same for all birth control pills as they contain non-natural synthetic sex hormone analogs I will say though that certain breast cancers have receptors for progesterone and in some states they will place that warning on the bottle although in most states they do not. I think before you start using any creams for PMS, and hormone imbalance that you should consult with your doctor to make sure all is OK before you start. In the case of a woman, a normal mammogram and PAP smear before starting are a must. Best of luck. JG 11.16.10

Question:

My 12 year old daughter has a recent acne scar on her chin that has been there about a month. What is the best way to try and get rid of it. I have purchased Mederma and also have retin-a. What is the best way to use either or both or something else? Thanks for you awesome services!!!!

Answer:

those things are about all you can do, hopefully the infection was mid enough that it will repair and fill in on its own. At that age, she should do well, Al the best. JG 11.15.10

Question:

Should I apply the antioxidant serum first, then the sunscreen over it, or visa-versa? How long to wait between antioxidant serum and sunscreen?

Answer:

anti-oxidant first, wait ten minutes and then the SUNBLOCK, not sunscreen. JG 11.15.10

Question:

Is it beneficial to apply an antioxidant serum beneath my sunscreen in the day? Or does the daylight just break down the antioxidants before they have a chance to even work in my skin? (I already apply an antioxidant cream at night) Bless you for your kind advice!

Answer:

the light wil break it down, need a sunblock if you are going to do that. All the best. JG 11.15.10

Question:

Hi Dr garcia, I am choosing antioxidants to incorportate into my skincare regimen. Is it better to apply the same antioxidants morning and evening so that they have a chance to work twice, or is it best to apply different antioxidants in the morning than in the evening so that my skin gets exposure to different ones?

Answer:

probably better to split them up. JG 11.15.10

Question:

I asked about the phenol peel. So what do you recommend instead of the phenol peel? Ive used Obagi peel and every other peel out there on it except laser, but the area seems to get darker.

Answer:

I suggest a YAG laser. Best of luck. JG 11.13.10

Question:

Hello Dr Garcia, can i have a surgeon use phenol peel on a very small area of my body that is very dark and is resistant to TCA peel and whitening creams? By the way, im dark skinned, but i want the area permanently depigmented. Thanks for your help.

Answer:

I think phenol can be dangerous on the body, I only use it on the face. JG 11.13.10

Question:

Hi Dr. What do you think about MD Formulations products. Looking for a good skincare regimen for morning and night. Can you give me your input. I am 46 and need something with good results. Thanks

Answer:

I think it is a good line. JG 11.11.10

Question:

I have what looks like some light leftover bruising from Juvenderm filler placed in my cheeks. Would hydroquinone 4% help with that? Also, would it help sun damaged areas? And last, I heard that hydroquinone can turn skin darker...how do I avoid that???? Thanks so much!

Answer:

hydroquinone is for brown spots, it will not do anything for the bruise. Sun exposure while bruised can lead to brown spots from the iron in the blood becoming oxidized. Hydroquinone can only darken the skin if it is applied in too high of a concentration which can irritate the skin, not a common occurance. JG 11.10.10

Question:

Hi Dr Garcia, WHich would be more effective for resolving some mild facial hyperpigemtation? .1% tretenoin mised with Obagi blender the covered by Obagi #3, or to just use Triluma? Thanks!

Answer:

they are about the same, maybe a little less irirtation with the Triluma. JG 11.7.10

Question:

What do you think of melantotan?

Answer:

I cannot recommend it, sorry. JG 11.7.10

Question:

Hello, I began using Obagi Nuderm about three weeks ago. My skin looks terrible! I know it is supposed to get worse before it gets better but my face has broken out, my pores/blackheads look the same or worse, and the texure seems rougher. My face also looks blotchy and a little red. Do you agree that this is part of the process? Thank you for your advise.

Answer:

yes, allnormal it is the purging process, will get better in 2-3 weeks, go to hang in there. JG 11.7.10

Question:

What is your estimate of the IS Clinical line of products, particularly their Super Serum and Youth Complex? Particularly effective? Worth the price? Thank you, Dr. Garcia!

Answer:

the difference betwen them and others priced for less makes it no better. JG 11.6.10

Question:

I`m olive complexion and tan easily in my early 30`s. I look pretty young for age, but I go tanning at a salon for 10 minutes a week. Is this amount enough to to do sun damage later down the road?

Answer:

without a doubt, YES. JG 11.6.10

Question:

Dr. Garcia, what would you recommend for sun damaged skin on the chest. I had a series of IPLs that removed the brown spots but I also always have a red appearance of the skin, which I know is also from the damage-almost a flushed appearance. What treatment would alleviate the redenss?

Answer:

might want to try a YAG laser or a VBeam laser for that. JG 11.5.10

Question:

In your opinion is this an effective Product? + Made from fish peptide collagen + Daily dosage contains 5,000mg of fish collagen, 60mg of hyaluronic acid (hydrating essence), 10mg coenzyme Q10 (anti-oxidant power)My sister is wanting me to try this yet I`m skeptical?? Thank you for your time and oppinion.

Answer:

don`t think it will do much better than most other things out there. JG 11.5.10

Question:

Hallo Dr. Garcia. Thank you for your kind answers to everybody. Now to my question, I have restylane and afterwoods I read that it contains a protein who binds it. This protein will it stay in the skin after all HA is gone, does the body break that down too like the HA. Thank you :)

Answer:

yes, it does, thanks for visiting. JG 11.4.10

Question:

What are the best lasers for age spot or freckle removal on face? Is the fraxel laser effective?

Answer:

I use an Nd:YAG laser for those, I would not use a Fraxel laser for that. JG 11.4.10

Question:

Thank you for taking the time to answer our questions; that is much appreciated! Could you tell me your thoughts on the Accent laser for the face to treat ice-pick type acne scars. Do you think this is a good type of laser to use for this (in someone who is not using this for wrinkles,etc, and around 30y.o.). Thank you.

Answer:

I am sorry, but I do not think it would do much for ice pick scars, they are best treated by cutting them out and stitching them closed, a laser after that might be worth it, but the laser alone, no matter which laser, will dissappoint you I believe. All the best. JG 11.3.10

Question:

Hi doctor, i have been using Retin a for many years and read were you answered a question in regards to usage. Should i take a break & how long and what would you suggest i use to take its place in the meantime. Thanks a bunch!

Answer:

I suggest 2-3 months per year, bes tto do it when the sun is strongest as Retin-A sensitizes you to the sun. All the best. JG 11.3.10

Question:

Hi Dr.Garcia! What are your thoughts of Vi Peels? I am an Eastern Indian female who has had problems with hyper-pigmentation from microdermabrasion in the past (yrs ago) due to spa clinician performing procedure too aggressively on my face. My local dermatologist office has suggested Vi Peel for me. I would love to hear your thoughts on this. Thank you!

Answer:

I think the effects will be mild as they cannot go to too strong a penetration for fear of damaging your skin with more hyperpigmentation. I think it is OK to try, just temper your expectations. JG 11.2.10

Question:

Hallo Dr.Garcia, I must first of all thank you for answer all question. You are brilliant. Now to my questin, I had 1 cc for each cheek 16 m. ago. I have small lakes of the fillers left. I have been on a website Real Self and one Dr. in Canada who had experince with Sub q said that it may bee that my body built a capsule around the filler. If this is the case, will the capsule dissapear with time or do I have to drain it out? He suggest that it will resolve but can take years, what do you suggest out from your knowledge because you are so experinced.

Answer:

if it has developed a capsule from a large amount of the filler being injected into one spot, the absorption will be very slow,it might need to be removed with a liposuction minicannula. It might dissolve, but with a capsule around it, the time to do so would be quite unpredictable. All the best. JG 11.1.10

Question:

Hi Dr. Garcia, thanks so much for your quick response. I`m the one who stupidly got silicone injected into an acne scar only to develop an infection/lump that needed to be cut out. It is 1.5 inches on my line of symmetry on my cheek below my right eye. I was expecting a hairline scar but instead got a broad open scar, I am thinking because the technique done by the dermatologist in the excision was not the greatest. As I mentioned, I have had it for five years, for two years, I tried to get it improved by going to dermatolgists who tries lasers/etc and it kept getting worse so I just said forget it, let it heal on its own. It has not unfortunately and for some reason under certain conditions gets extremely red (like in the cold). This is when the scar appears at its worst. Might you happen to know why this is happening? If it is something to do with the blood vessels, would getting another excision just increase the trauma/blood vessels? Lastly, I did see a few plastic surgeons six months ago to get their opinions. One pointed that there were two issues, the assymmetry between the two cheeks because of the scar and the other the scar itself. He suggested trying to inject juvaderm into both cheeks to try to make it look more even but because the scar is broad and not a line, the juvaderm just made the right cheek scar stick out even more than before. I`m not sure if getting a much thinner scar and then trying to balance the cheeks is a good idea but this was essentially his suggestion. He even suggested cheek implants after the excision which I do not know much about. It seems kind of like a major procedure but it beats going to see dermatologists who I do not have any faith in. Would the cheek implants perhaps change the vascularity of the scar, maybe cause it to get less red all of the time? I am so, so sorry to take up your time and ask you all of these questions. If I didn`t live in New York I would rush to your office in a second. Thanks again, I really cannot thank you enough for your honest and really generous help.

Answer:

scars can look red at times when the tissues below the skin are not of a normal thickness, this allows the thin scar to show the blood vessels below the skin. If the tissues below the skin are better approximated together, that would push the blood vessels lower and not be as red. Laser can be used to improve some of the redness on the scar, I use a YAG laser or a I might suggest a VBeam laser, resurfacing lasers will not work. Cheek implants are placed on the bone and will make the cheeks larger, but will likely not alter the appearance of the scar for good or bad. If the difference between the cheeks is due to loss of cheek tissues, then fillers are a better choice as the defect can more properly be placed whereas implants are hard to customize like that. All the best, just find a plastic surgeon you feel comfortable with. JG 10.30.10

Question:

what is the best glycolic wash then..?

Answer:

I do not think there is any one that is much better than the others, the glycolic acid is not on your skin long enough to make any difference. JG 10.29.10

Question:

have you heard of aqua glycolic face wash?? thoughts??

Answer:

OK, nothing super though.JG 10.28.10

Question:

Thank you person regarding restylane sub q. Well you got much filler in your face. I must say that conservatims is the key regarding fillers, but there is much hope for you. First no more filler in face if you dont meet Dr. Garcia. He has a lot experienc. Take care of your self and do some exercising. Varm compresses. Be careful not burn your skin. Good luck to you and take Dr. Garcia advice.

Answer:

thank you for the support. JG 10.28.10

Question:

Dr. Garcia. I must answer the other person here who got restylane sub q in face. I dont know how much that person had a had 1 cc in each cheek. I in 16 m with this filler and some is left like some small lakes. I have begin to put warm compresses on my skin and that have help a lot with swelling issue. There is not much left and I have seen a lot improvement with my sauna treatment. I know that you are the expert but I think I want to share my experience.

Answer:

Thank you so much for sharing your story. JG 10.26.10

Question:

How many units of botox should be used in the chin to prevent the dimpling/pebble effect? (My dermatologist has been recommending this to me for a while. He says he`s never had any problems with paralyzing the lower lip because he places it carefully, but I`ve been reluctant to try it becuase of that risk.) Thanks.

Answer:

I have seen doses of between 2 and 10 units used. JG 10.26.10

Question:

will laser tracks from laser resurfacing disappear over time? Also, is the Triniti series worth while?

Answer:

they should fade in time and I personally would not waste my time and money on the Triniti. Sorry. JG 10.25.10

Question:

I had botox 3 day ago and I can kind of see some parts improved but is this the final result? how long after does botox fully work?

Answer:

it takes about 10 days to get its maximal effect. JG 10.24.10

Question:

I love your intro page! I had Mohs surgery on Aug 28th which left me with a 1.5 inch incision from the top of my nostril down to the top of my lip. The Dr. did a great job and I think I`m lucky and it will heal nicely! Is there a yearly laser resurfacing or anything preventative I can do to help prevent skin cancers from forming rather than waiting for something suspicious to come up and have to have it burned or biopsied etc. And can I over do the massaging my Dr suggested to help soften the scar? When I massage I feel like I need to press hard enough to break up the scar tissue is that too hard? Thank you.

Answer:

I think better than a yearly laser I might suggest using Efudex on your skin, using it twice per day. If anything is cancerous or precancerous it will become irritated at which point you use it twice per day for one month and if it is superficial, it will be taken care of. If anything remains at that time it needs to be cut off. If you use the cream for 10 days and there is no irritation, then there is likely no cancer present. Hard to over do the massage. Glad all is doing well. JG 10.23.10

Question:

Thanks for your answer about DMAE and Alpha Lipoic Acid. How else would these oral supplements help the body, beyond the skin?

Answer:

just general cell wall stabilization, part of what happens as we get old is the cell walls leak and get fragile and therefore more easily damaged. JG 10.22.10

Question:

Hello Dr.Garcia. Regarding fillers break down, in my case restylane sub q, I had the smallest amount 1 cc for each cheek. Now to my question. If I had injected a larger amount then it should take longer for the body to break down it? Maby a stupid question but your knowledge is the best! Thanks

Answer:

the smaller the area it is injected into, the longer it will last, if it was injected over a larger area, it will dissolve a little faster. Not a stupid question at all. JG 10.21.10

Question:

Hi Dr. Garcia. I have very bad sun damages skin from head to toe.I have had Portrait on my face which improved my face greatly. However, I still have few brown spots on my face, neck, and many brown spots on chest, arms & legs. Do you think that 4% hydroquinone fades brown spots & if so, what would the regime be. Would you sugggestthe same regime for delicate face vs legs???? How long does it take to see results. Thank you so much for your time.

Answer:

I think the improvemt on the neck with the hydroquinone might be worth it but not on the other areas, you can try to get them lighter bu using a YAG lser for the spots alone if you want to try that. I think chemical peels and lasers over the entire leg is not safe or worth it. Sunbock is a must, everywhere, if you want to keep it under control. JG 10.19.10

Question:

Dr. Garcia, Do OTC scar products like Mederma really make a difference in the appearance of scars or would the scar eventually look the same given time? Is there one product in particular that you like better than others? I would appreciate your opinion on this. Thanks!

Answer:

I think they help things get better sooner, but likely not much difference if you were just to wait it out. I use Mederma and ScarGuard, both pretty comparable. JG 10.19.10

Question:

Hi Doctor, what sre your thoughts on the glamoxy snake serum . 125GBP a bottle?

Answer:

snake oil, skip it. JG 10.18.10

Question:

I am a 45 year old female. Currently I use retina-A and a neutrogena night cream on my whole face and undereye at night. That is all. Should I be using something else, like a specialized eye cream or anything else? Results are pretty good, as I have light olive skin. Also, I am about to take the recommended break from my retina a. Should I use anything to replace it while I am on break? Thanks! This site is great!!

Answer:

I would stay with what you are doing. As to the off time, OK to use a moisturizer, but no glycolic acids or retinols. All the best. JG 10.17.10

Question:

I recently moved and changed dermatologists. I`ve been using botox for the past 12 years -- glabella, forehead, crow`s feet -- and have been increasingly dissatisfied with the results. My previous dermatologiist used 26 units; my new dermatologist thinks that was an utterly inadequate dosage. She uses 50-60 units for those three areas. Does that sound right to you? I`m 52. Thanks very much for your advice.

Answer:

I am surprised you got a good resposne with just 26 units for those three areas to be honest, the 50-60 is more like it. 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 10.17.10

Question:

I have used Retin a for sometime with good results, but have heard conflicting advice if it is ok to use on the sensitive under eye are. I do have fines lines forming there but was afraid it would make the skin thinner or worse there. Do you recommend retina a for this sensitive area? Thanks!!!

Answer:

yes, I do. But it wil irritate the skin so you might not be able to use it every day depending on what strength you have. JG 10.16.10

Question:

How much is a min per visit to remove a tattoo I have a very small tattoo on my ring finger.

Answer:

we bill in 15 minute increments, at $100. JG 10.15.10

Question:

What do you think of the PinPointe laser for onychomycosis? I am skeptical but desperate enough to be interested. While the laser will indeed kill the active fungus (I believe that this is the source of the company`s claim to 88% effectiveness ), if the nail matrix itself has already been destroyed by the infection, it is not possible for those cells to generate new nail growth, right? Like millions, I have tried every oral antifungal on the market to no avail, so I confess I`m a prime target for clever marketing on this front; but at $1200/treatment and with the lack of any peer reviewed double blind studies to provide significant evidence of positive outcomes, I`m afraid that this might be nothing more than snake oil in the form of a laser. Are you aware of any new research that supports this device`s promises? If it`s truly effective, why doesn`t every dermatologist and podiatrist in the country already own this laser? Their waiting rooms would be overflowing, I suspect. Thanks, as always, for your sound advice. Enjoy the show of tonight`s debate in Nevada! Oh my....

Answer:

I too am skeptical. Nail matrix does not grow back after an injury, it can leave a permanently distorted nail if it does injure the matrix. I have never seen any legitimate research to back up the claims I am afraid. I agree as to all of the podiatrists having a machine. As to the show, I think it will either be boring or fireworks I am afraid. Best of luck. JG 10.14.10

Question:

So is titanium dioxide and Zinc oxide really all that superior to Avobenzone, mexoryl, etc? I have a hard time finding a titanium/zinc sunscreen that is not to thick/heavy for my oily skin.

Answer:

I feel they are, yes. JG 10.14.10

Question:

Which provides better protection from photoaging? An SPF 15 sunblock or an SPF 30 sunscreen?

Answer:

well, there is no true sunblock with an SPF of less than 50-60, in general, if it is a true sunblock, it will be better for photoaging than a sunscreen.Otherwise, go with the higher number. JG 10.13.10

Question:

Hi, Dr. Garcia. What is your preferred method to treat AK`s? Cryotherapy? Hyfrecator? Laser (if so, which one - Q-switched YAG)? I have many pinkish/light brown-reddish, flat early AK`s on my arms, and they haven`t responded at all to IPL.(Type I skin) Hydroquinone and Retin A don`t seem to help much either. Thanks, as ever, for your wise guidance. Hope you`re having a beautiful week!

Answer:

hyfercator, and you continue to get more with time, nothing is permanent I am afraid. Week so far is good, thank you. JG 10.12.10

Question:

Thank you Dr. Garcia for your quick answer regard restylane sub q. It seems like mine residue its under the eye making a swelling apperence. It feels like it will take years to go away because it is such thick product. There fore I asked you about the enzym. But should I wait anyway. Thanks

Answer:

If you are bothered by it, maybe you should have it dissolved. Best of luck. JG 10.12.10

Question:

Hello! I am a women who got small amounts sub q in cheeks 16 m. ago. The filler is almoust gone but some residue remains. I swelled extremely in the beginning but that is over now. Should I use the enzym breaking the residue down or will this filler leave with time?

Answer:

I think it best to allow it to dissolve on its own with time. JG 10.12.10

Question:

Hi ... 3 quick questions: 1.I use a Chamonix Vitamin C serum, daily. Is it best to use at night or in the morning? 2. Is it true that if the C has oxidized,it can actually cause free radicals and be harmful? 3. What do you think about B-5 serum as a moisturizer? Thanks, as always!!

Answer:

night for the Vitamin C serum.If it has oxidized it might not work but I seriously doubt it will cause new free radicals. As to B5 as a moisturizer, it is fine, nothing special about it. JG 10.8.10

Question:

Hello Dr. I am 30, noticing larger pores, dull skin...no deep wrinkles or anything, maybe teeny tiny fine lines but I use juvederm to fill nasal folds already...I would like to use a peel or maybe a laser to have better skin quality, I just feel like I look so dull and ive been using retin A but that isnt really helping so good maybe a little....i was thinking of the blue TCA peel but idk if thats really gonna help, i just want glowy skin back like i had a few years ago...also losing firmness some too, what do you think my best option is??? Thanks in advance, everythings so expensive I dont wanna waste my money :)

Answer:

I think the peel will help, but only short term, as for a more reasonable expense, look into fotofacials with an IPL and microdermabrasions to help your isses, at your age, that should be enough. JG 10.7.10

Question:

I am uncertain if my orginal question when through. So,here goes again and sorry if this is a duplicate. Do you recomment the use of retin a for under the eyes to increase the skin density or is there something else. Mine is getting somewhat papery.

Answer:

I do think it is usefull, but that skin is thin and gets irritated easily, so you need to proceed slowly. Best of luck and sorry for the question not getting posted, I will look into it. JG 10.6.10

Question:

Dr. Garcia, I have been using MD Forte highest strength glycolic acid for years with good effect. Should I give my skin a break such as you recommend when using Retin A? Also, for skin laxity, what would you recommend that is non ablative to firm sagging skin? Thermage? IPL? Thank you for your advice.

Answer:

not as needed with glycolic acids as with Retin-A as they are weaker. As to sagging skin and non-ablative therapies, I understand the desire, but save your money, the do not live up to the hype. JG 10.5.10

Question:

When using Retin A cream, you are supposed to give your skin a rest for about a month every year. What will happen if you don`t give your skin a rest? Would it be okay to give your skin a rest one day a week instead?

Answer:

it can cause over-irritation and problems associated with that, such as skin break down or skin growths. It needs to be a substantial break, one day per week will not cut it. Sorry. JG 10.4.10

Question:

Dr. Garcia, What is the best treatment for removing old acne scars?

Answer:

ice pick scars can be surgically excised, superficial rolling scars can be improved with a CO2 laser but it will not be permanent. JG 10.4.10

Question:

Dr. Garcia, How is Fraxel different from other laser treatments or peels? Is this nonablative? Thank you.

Answer:

it is ablative in a minimal sense as it leaves normal skin between spots of ablation. I think that comparing it to peels or lasers depends on which lasers and which peels I am afriad. It is too generla of a question for me to give an accurate answer. JG 10.4.10

Question:

I live in Chicago IL area and I`m trying to find someone with a Lamprobe who can treat facial hyperplasia. Can you help me? I found one Dr. in New York but can`t travel that far. Please help

Answer:

I am sorry, but I do nto know anyone there with a Lamprobe. JG 9.30.10

Question:

I have malar bags (festoons) and have tried co2 laser, laser lipo, a lower bleph, tri-active sessions and can`t get rid of them. My left side is more prominent than the right. What else do you think I can try? I don`t want scars from malar removal. How would kenalog injections work? What kind of radiofrequency do you suggest? Thanks for your help.

Answer:

if you are unwilling to have scars, looks like you will have the festoons. Kenalog will do nothing, nor will radiofrequency, sorry. JG 9.30.10

Question:

Hello, I had a diode laser to under eye area and now have raised red dots along the line where the laser was used. Is this normal and when will it begin to resolve. Also, I had some kenalog injected into my nose and now my nose is swelled up, I am hoping this is just the medication sitting in there? When will this be absorbed? Thanks so much.

Answer:

I have to admit, I am unsure why they used a diode laser on the lower lids, not sure what they were trying to improve, it is not a commonly used laser for wrinkles. As to the kenalog, I can only say that I hope the swelling is due to the liquid of the kenalog itself, otherwise, besides a hematoma, not sure what else it could be. It should be absorbed within a few days if it is just the fluid, if it is a hematoma, it needs to soften up before it can absorb. Best of luck. JG 9.27.10

Question:

DR.Garcia, Are you familiar with the Philosophy brand products? If so, what is your overall opinion? Thank you for your help.

Answer:

good products, very similar to many out there, nothing greatly seperates it from the others. JG 9.27.10

Question:

Hello Dr. Garcia.. have you heard of acne-aid soap. Is it effective for acne? Will it not dry the facial skin? Thanks.

Answer:

no different than other acne products, can still dry your skin out, yes. JG 9.27.10

Question:

Hi Dr. G :) I`m going on Tuesday for MOHS surgery on a basil cell carcinoma. The area is to the right of my nose, between my lip and nose and it looks like it`s almost dime size. It was just a pin size scaly area for years then this may it started bleeding and not healing and growing or just became more obvious so that`s when I went to have it checked. I`m 45 and wasn`t expecting cancer this soon.. My question is how big an area on average do you think would have to be cut out to remove a cancer that appears this size and based on that how would the reconstruction be done? My MOHS surgeon is doing the reconstruction also. My dermatologist referred me to him, he has 22 years experience and works at Emory in Atlanta GA. Do you think these surgeon`s can do as good cosmetic surgery as a PS? I`ve been going crazy today looking at before and after pictures online.. and I`m so scared now. :/ Thank you so much for any advice and information.

Answer:

there are many dermatologists that do many Mohs reconstructions and do a good job. The reason for the Mohs thechnique is to remove as little skin as possible yet safe, so the reconstrcution is easier, no way to tell how much they have to take off until the Mohs part is finished. Best of luck, sounds like you are in good hands though. JG 9.26.10

Question:

hey doc bout the veins popping up on legs, says sclerophary can be done but it can couse amputation as well... is there any other safer things to try ??? will ipl or something be done too? please suggest sotmhing????

Answer:

veins htat pop out are poorly treated with sclerotherapy. Sclerotherapy properly done should not cause an amputation. JG 9.26.10

Question:

i have veins popping up on my legs when i stand up straight, long thick 3 of them and 1 on the other and also looks bumpy, im 30 f. what can i do to treat these? is there anything to do to get rid of them permenantly? or maybe soemthing that needs treatment to maintain good smooth legs?

Answer:

they are varicose veins and they can be surgically stripped, vascular surgeons do that type of surgery. There are lasers that are used inside of the vein that can also be done. JG 9.26.10

Question:

Hi. Two months ago I had a single IPL which really damaged my skin. I have very large pores all over my face and a few areas where I have indentations from what appears to be fat loss. I would like to know what product would be best to help rebuild the collagen in my skin so that my pores will shrink and it will not cause scars from the procedure from getting worse. Any recommendations? Thank you so much.

Answer:

as for topicals, likely Retin-A will have the strongest effect on the skin issues, the fat loss should get better on its own as the heat from the IPL is not as much as that seen in radio-frquency treatment fat loss. All the best. JG 9.24.10

Question:

Hello, I have a couple questions. I have a pretty severe case of poision ivy for which I was prescribed a very short course of prednisone - 40mg tonight, 20 mg tomorrow at breakfast, and then 10 mg tomorrow at lunchtime - I am a little worried due to all the side effects of prednisone - is this a safe tapering schedule in your opinion? Also, is there anything that will help prevent scarring from these hives? Thank you for your help.

Answer:

safe to taper that way, side effects should be almost zero with that short of a course of the Prednisone. I do not think it will have any positive or negative effect on scar prevention though, but if the rash gets better sooner with the medicine, it might decrease the risk compared to letting the rash persist for longer, maybe. JG 9.23.10

Question:

what is the diff between retin a and retinol??

Answer:

Retin-A is a prescription stength product and retinol is a weak OTC product of same source. JG 9.23.10

Question:

is the best time to stop retin a for nj people like nov and dec??

Answer:

I think it best in the summer when the sun is most intense. JG 9.23.10

Question:

what is the purpose of taking a break from retin a. Well actually the benefits??

Answer:

the purpose is that long term skin irritation can lead to unwanted effects,myriad in number, from broken blood vessels to abnormal skin growths and you do not want to have that happen. Stopping once per year eliminates that risk. JG 9.22.10

Question:

Dr. Garcia, I want to rejuvenate my skin as it is looking a little sun damaged and with old acne scars. I am Asian and trying to decide which is the best course of treatment, TCA, Starlux 500, or the Palomar 1540 laser. Thank you

Answer:

I think all of those will yield mild improvements, but nothing dramatic will be possible as harsh treatments in Asian skin that would give dramatic results are quite risky, sorry. JG 9.22.10

Question:

Oh, one more question. Is there a better cream with AHA/BHA than Skin Medica?

Answer:

they are all pretty similar. JG 9.22.10

Question:

what are your thoughts on neostrata products? Can i use glycolic wash in conjunction with retin a??

Answer:

good products and can be used with glycolic acids and Retin-A. JG 9.21.10

Question:

WHAT PRESCRIPTION CREAM WOULD YOU RECOMMEND FOR SOMEONE WITH A FEW SMALL POCK MARKS AND LARGE PORES. BEEN USING RETIN A BUT IT SEEMS TO MAKE MY SCARS LOOK WORSE OVER THE PAST YEAR. WOULD I BENEFIT BETTER FROM RETIN A BEING USED SAY 2 TIMES A WEEK RATHER THEN EVERY NIGHT? ALSO DOES RETIN A REALLY THIN SKIN?

Answer:

I would suggest continued use of the Retin-A, maybe every other night, the pores are there because there is oil plugged down deep in the pore, microdermabrasions might help, or an IPL at a medispa. Retin-A thins the epidermis but builds the dermis, all good things. JG 9.21.10

Question:

Just looking through your blog and noticed the question below about itchy fat. I have the same problem -- though not transplanted fat in my own case -- unfortunately, just my excess native fat! Why does this happen?

Answer:

something is causing inflammation, can try antihistamines or anti-inflammatories. JG 9.21.10

Question:

thoughts...stem cell cream as seen on tv??

Answer:

no cream can contain viable stem cells, they are too fragile to exist in a cream, sorry. JG 9.20.10

Question:

Hello, Is there any laser or other treatement that may help fade bluish/grey discoloration? Thank you!

Answer:

from injection of fillers, no. JG 9.19.10

Question:

Hi Doctor, will Retin A make rosacea worse? I have used it for years. Thanks

Answer:

in most cases it does aggravate it, yes, but nothing is ever 100%. JG 9.16.10

Question:

Hi ive developed internal scar tissue in my right side cheek due to surgery. This makes my cheeks look assymetrical as the right side cheek looks enlarged and puffed out. Ive heard about Serrapeptase enzymes can this help in dissolving the internal scar tissue hence making the cheek look more flatter?

Answer:

I have no personal experience with it myself, I have used kenalog and 5FU only, sorry. JG 9.16.10

Question:

Hi Dr. The one on a mission for her husband. So, any OTC creams/you recommend? thank you jg cda.

Answer:

for the fine lines,OTC, I think Oil of Olay Regenerist is a very good product. JG 9.16.10

Question:

H Dr. My husband is 50 w mild roseaca,under eye circles (hereditary) and some wrinkling. He was wants to begin a facial regime but has no idea what OTC creams are good for him. (there r so many). I don`t have under eye darkness and my issues r not the same. Pls help..he has heard of Dr. Renaud products sold at a Man Spa her in Cda. Not sure though if they r very effective.

Answer:

look for things with retinol for the eyelid area but that will exacerbate the rosacea, for that he will likely need some topical antibiotic medication or IPL sessiosn at the spa can also help the Rosacea. JG 9.16.10

Question:

DR. garcia, I meant to say hypopigmentation on the upper lip area (whiter than the rest of my face. As a clarification, I am not asking about microderm for that specific problem but just in general what do you think of the money spent vs results you could expect for overall skin.

Answer:

pretty unimpressive, to be honest, it is a very superficial treatment, just to take dead skin and get a healthy glow, not much else. JG 9.15.10

Question:

Hi Doctor, would you say Retin A is not as effective for woman over the age of 50. As far as wrinkles are concern. Thanks

Answer:

the older one is, the less effective the Retin-A will be due to lesser capacity for the skin to generate new collagen. JG 9.15.10

Question:

Hi Dr. Garcia, what do you think about the Obagi Nu-Derm System. I have some mild rosacea, no pigmentation problems though. Just wondering if it would help my skin look younger and healthier. I use Re-tin A at bedtime,and just turned 46. Thanks so much.......

Answer:

it will likely aggravate your Rosacea I am afraid. JG 9.15.10

Question:

Will microdermabrasion make any acne scarring worse?? Can u have it done while you are using retin a??

Answer:

if not done properly, maybe. Should stop the Retin-a for 2-3 days before and after. JG 9.12.10

Question:

Hi Dr. Garcia I was wondering if you are familiar with the skin care line known as Metrin..If so, what is your opinion??

Answer:

sorry, no personal or patient experience with it. JG 9.2.10

Question:

I recently started tattoo removal treatments. I have dark blue rings on the tops of 4 of my fingers. The treatment I am recieving is Salabrasion ....It is a new treatment discovered by a ladie Physician where she opens the skin with a needle gun and applys a salt gel that sucks out the ink into the scab. Im sure you`ve heard of it. Im going in for my third treatment soon. I have very very little or no results after two treatments. She said it would take 7. I believe it will take more with method. Since it is new I can not find any solid reviews about it online. If the next treatment is not more succesful I was thinking of switching to laser. Do you have any thoughts or advice on the situation? Do you do removal yourself? by laser? It says on her site that her method is cheaper, less painful, less chance of infection, and less treatments. Its only $300per, very very very painful, and Im not sure about less treatments yet. The establishment is Tattoo Vanish in summerlin. Also, they did not seem very professional as the grandaughter came in for kisses while she had the needle gun on my fingers! I was also left sitting there for 10 minutes with my hand on a bloody torn up cloth which made me ill. Most likely Im not going back after the third time so can you help with any advice or recomendations? thank you for reading my long story :) I was recomended to you by someone at my workplace.

Answer:

lasers work well with much less chance of scarring but it does take a series of treatment sessions,done every 4-6 weeks and no way to tell how many sessions it will take, although fingers do well. Our fee is $100 for every 15 minutes and that should be more than enough for all of the fingers. We would be glad to see you if you wish, just call the office to make an appointment. JG 9.1.10

Question:

Good Morning Dr. Garcia, is it safe to used Proactiv Solution during Pregnancy? Thank You..and have yourself a Blessed Day...

Answer:

it has not been testd so no one can say 100%, but the amount that would be absorbed is essentially nil. JG 8.31.10

Question:

i wash my face about 11 each night and then put on eye cream and retin a. i dont get to be until like 12:30 or so. am i still geting the full benefit of retin a since its not put on right before bed??

Answer:

yes, still good. JG 8.31.10

Question:

with the olay microsculpting serum, will you get full benefit by putting it over retin a a while later, or does it need to be full contact with your skin??

Answer:

you will likely get better penetration with the Retin-A first. JG 8.31.10

Question:

Hello Dr. Garcia. Is the new product of oil of olay which is oil of olay professional pro-x good fro fighting wrinkles? thanks.

Answer:

pretty good, yes. JG 8.29.10

Question:

In your professionial opinion...for a 28 yr old (smoker...embarrssed) that wants to try and firm skin with benefits of anti age, would you suggest SkinMedica TNS Essential Serum or olay micro sculpting serum. Obviously a big price differnce but it doesnt matter if one will potentially work better. please let me know your thoughts...thanks!

Answer:

buy the Oil of Olay. JG 8.29.10

Question:

whats a good medical grade cleanser for anti age>

Answer:

Oil of Olay and Lancome are good. JG 8.28.10

Question:

SkinMedica TNS Essential Serum....whats your thoughts??

Answer:

good.JG 8.27.10

Question:

hi Dr Garcia, if I have a weekly mild glycolic peel (20%) at my local medispa, is there any reason why I should need to use a weaker daily product as well? Can I get good exfoliation from just weekly peels?

Answer:

in thin pale skin that might be enough, thicker oily skin can benefit from daily applciation of lower strength. JG 8.26.10

Question:

Hi Doctor, I`m not sure this is your field but I wanted to ask anyway, Some time ago, while I was on strong topical acne cream, I was out while it was snowing and windy, and I got home and there was a red spot on the corner tip of my nose. The area was already a little irritated from the meds but it became just cherry red (about a few millimeters wide). You could see blood vessels at the time. Over the past year and a half, it has faded and now only I can really notice it, though my wife can`t. I can`t see blood vessels there anymore, it just looks a bit more like a shadow but only in certain light. It is still fading, though very, very slowly. What do you think was/is going on there? Thanks

Answer:

a little wind burn on irritated skin, should slowly get better, nothing to really worry about, not much that can be done to fix it either, sorry. JG 8.26.10

Question:

Hi Dr Garcia, my HQRA lotion has turned brown...is it still effective? And can I use it in conjunction with metrogel? Brown spots and Rosacea problems.

Answer:

might have lost some of its potency but likely will still work. JG 8.26.10

Question:

Hi Dr Garcia, Does a BHA peel offer the same benefits as glycolic peels in terms of faint/mild melasma, pores,general antiaging? Do you prefer one over the other?

Answer:

pretty similar, yes. JG 8.26.10

Question:

i have been experenceing problems with a parasite.i have finly found out the name of it through the internet.it is called collembola.everything i have read has described what has been going on with me from being unable to trap the culprate breaking out in a rash ect.what i would like to know is what my treatment options are and are there any homeopathic options also what should i do when i go to the doctor.i realy need help with this i cant sleep i have had to go to the emergancy room because of the rash they have caused my life has been turned upside down and there are things i have to do every nite just to get a few hours of sleep befor these parasites wake me up biteing and running across my face and body.any help u can give would be great.

Answer:

I am sorry but this is a plastic surgery website and I am not familiar enough with paraistes or infectious diseases to answer your question adequately. JG 8.22.10

Question:

Happy Weekend to you Dr. Garcia! I`ve been using Tazorac .1% cream for about 6 months now (increased from .5 gel), & it`s still very drying & leaves my OILY complexion red & flakey. The past couple of weeks, I`ve actually mixed the Tazorac together w/Olay Regenerist Serum (fragrance free) & have found the dryness & flakiness has reduced significantly. I still have some peeling, but it`s more of a moist peel (if that makes any sense) & much less unsightly. However, am I totally cancelling out the anti-acne / anti-aging effects of the Tazorac by mixing it with the regenerist? As always, thanks for your time and advice! :)

Answer:

well, yes to reducing the anti-acne and anti-aging effect as all you have really done is dilute the Tazorac down to a lower concnetration, bt if you cannot tolerate it any stronger, you do not have many other options. JG 8.21.10

Question:

I had a steroid injection n my buttock last october that caused a large bruise & as the bruise healed it began depressing I assumed it wld go away over time but it just got worse...I saw the Dr. where it was given who told me it wld go away on it`s own probly by this october...but if ne thing it looks worse the tissue loss has traveled arond my thigh & completely ruined the line of my hip & buttock...what could of caused this & while it most likely go away on its own as my Dr. has stated? What can I do abot it if it does not?

Answer:

that is common when a steroid injection is done and the incorrect needle is used, the needle should deposit the medication in the muscle and if a shorter needle is used it will go into the fat and cause fat atrophy. Whatever is going to come back will do so in 6 months, otherwise it will have to be fixed, usually what we do to correct the depression is fat injections. Best of luck. JG 8.19.10

Question:

Hi Dr. Garcia, I am confused about something - do IPL`s actually help with fine lines or not? Would a good retinol or vitamin C cream do the same? I have had 2 complete rounds of IPL`s in 5 years and several maintenance one-offs. My dermatologist says I should have another round but everyone tells me my skin is flawless except for one or two fine lines on my cheeks. I am wondering if I am getting a bit of a hard sell and could better spend the money on something else? Thanks so much - I know this is a long question.

Answer:

I think their effect on fine lines is very small and short lived. I think the Vitamin C cream will get pretty much the same result, yes. as long as it is 10% concentration. Sounds like a hard sell to me, I would skip it, why would it help the third time if the previous ones had not? Best of luck. JG 8.15.10

Question:

had the same amount in each cheek of juverderm (that looked stupid) had the dissolver put in yesterday. my right side is almost completly dissolved now and looks wayyy better. Left side hasnt dissolved nearly as much. do you think its just a question of time or need more in left side? ughhh i dont want to look uneven now....had syringe with same amount put in both sides of the juverderm and of the dissolver...

Answer:

might just need more dissolving on the left side is all. Best of luck. JG 8.11.10

Question:

wait u will see full results of what was dissolved in 24hrs or it only begins to dissolve in 24 hrs??

Answer:

whatever it will do will happne in the first 24-48 hours, it can be repeated again if needed after that. JG 8.12.10

Question:

i know you dont prefer fraxel but that is what my doc recommends for my acne scars. he said it was the fraxel repair (i think), do you think that is it for acnce scars and some ice pick scars. I know theres a few fraxels. just want to make sure i research the right one. he said like only 2 days a redness. how many sessions normally and what is average cost??

Answer:

I think you are wasting your time, but that is my personal opinion, especially when it comes the the ice pick scars, no lasers will help those. I cannot say how manny sessions you will require nor cost becasue I do not perform it but if I had to guess, it would be too many sessions and too high a cost, for what you get. JG 8.11.10

Question:

how long after dissolve agent is put in will u see what it did

Answer:

should be in 24-48 hours. JG 8.11.10

Question:

Hello Dr Garcia, Thank you for providing a forum for answers for antiaging. Please explain the law of diminishing returns for example A fifty year old getting a face lift versus a sixty year old getting a face lift. Also same example with Co2 laser. Thank you so much - as I always say thank you for saving me thousands of dollars by not having useless procedures/laser. Sue

Answer:

in a facelift example, the tissues that are lifted and supported are less strong with advanced age so the tissue do not hold up as well, in the case of the CO2 laser, the body as one ages loses its ability to ceate new collagen form an insult such as a laser, so the older one is the less robust the formation of new collagen so the less degree of skin wrinkle reduction.JG 8.11.10

Question:

What is your general opinion of the Environ Skin Care products? They have four or five different product lines for different skin conditions. Do you think any of their product lines are better than others? Thanks for sharing your thoughts, Dr. Garcia.

Answer:

do not think they are any significant improvement over the majority out there. JG 8.11.10

Question:

One last question about the frost bite mark on my face. I stopped the retin A and have continue to use sunscreen and have been applying Mederma as you recomended. Why Mederma and not a hydroquinone product? I just read about this product in New Beauty a magazine. Thank You, Thank You!

Answer:

because it helps fade brown spots only. JG 8.11.10

Question:

Thank You for all your help, skin stuff can be very stressful and the help you provide for people is amazing.

Answer:

You are most welcome, glad I could help. JG 8.9.10

Question:

I have PIH from a Fraxel Restore treatment 8 weeks ago. It`s reddish-brown and quite pronounced. (I have Type 1 skin, extremely fair, blue eyes.) I`ve been using hydroquinone and Retin A, and it`s fading a bit, but very, very slowly. Would a mild chemical peel help? If so, which would you recommend? The aesthetician at my surgeon`s office thinks Skin Medica`s Revitalize might help. Hey, thanks so much for all you do for all of us out here.

Answer:

well, the chemical peel might help, but like the Fraxel, you could have PIH from it also. Lighter peels like the revitalize are likely OK but nothing stronger. Best of luck. JG 8.9.10

Question:

Thank You for your response, it is much appreciated. Two more questions, As I stated before I got frost bite/burn from a chemical. It has been 3 months, could the redness just eventually fade, maybe within a year? If not, are there any laser treatments that are good for frost burn redness? I do not want the redness to get worse, and am nervouse about getting laser treatment. I hav eseen the V beam used for rosacea, blood vessels and acne marks but what about frost burn? Thanks!

Answer:

it might improve to some degree, yes. As the injury heals, the skin might get a little thicker and lessen the redness to some degree, but to what extent is unpredictable. Lasers for redness are the Nd:YAg or a VBeam laser, it can be done at any time. The lasers are good for the redness which is all the remains from the frostbite, the mechanism of injury of what caused the redness is not so important at this point. JG 8.9.10

Question:

ever since using retin a i have noticed alot blood vessels on my face. esp my nose. i have always had very white porcelin skin..what can i use to help combat that and still continue to use retin a??

Answer:

not much I am afraid, Retin-A can cause that in some individuals, but it also happens as part of the aging process, you can try to settle them down with some IPL treatments. JG 8.9.10

Question:

When I asked the question - I had a skin biopsy that revealed post-inflammatory hyperpigmentation - sparse superficial perivascular infiltrate with numerous melanophages in the papillary dermis. What treatment can I use for this other than hydroquinone? - I was actually asking if a laser procedure or something else could be used to treat this? Skin bleaching doesn`t have an effect. Thanks.

Answer:

can use a Nd:YAG laser, will need a series of treatments, and it will come back in time. JG 8.9.10

Question:

I had a skin biopsy that revealed post-inflammatory hyperpigmentation - sparse superficial perivascular infiltrate with numerous melanophages in the papillary dermis. What treatment can I use for this other than hydroquinone? Thanks.

Answer:

Kojic acid and Retin-A, and don`t forget the sunblock. JG 8.9.10

Question:

How deep does an ActiveFX treatment set with 80 MJ and density 2 go into the skin in microns? I`m wondering if it will reach into the papillary dermis. Thank you.

Answer:

it should, but not in the skip areas.JG 8.9.10

Question:

I have an aggressive case of onychomycosis in the great nails of both feet. I have been treated with terbinafin, itraconozole and fluconozole to no effect over the past 4 years. I`ve also tried topical treatments, such as econozole nitrate, in addition to the oral meds. Of course, I am meticulous about hygiene and keeping my feet dry. My dermatologist says she`s never seen a more resistant case of this infection than mine, and she now recommends that I file down the thick stubs of the nails that are left and apply a plastic nail over them for cosmetic purposes; but that solution seems like it would only aggravate the root cause of this problem, providing a perfect environment for the proliferation of fungi. Are you aware of any other treatments that might be promising? Could any laser therapy kill the fungus in the nail bed, for instance? This is a really embarrassing, unsightly problem. I`d love to get it taken care of. Thanks so much for your help.

Answer:

I am sorry but I have no other solutions besides what has already been tried. JG 8.9.10

Question:

I received a chemical burn on my face while plumbing. The box said the chemical could cause frostbite. I have a red/purplish spot the size of a dime in between my nose and lips. It has been three months and the dis-coloration is not improving. Following the injury I used biafine and hydrocortisone cream, neither has addressed the redness. My dermatologist reccomended (since it has been three months) that I start using retin A on the area to help the redness fade. Is it safe to use the retin A or will it make the redness worse? If I should not use it, is there anything I can do about the discoloration? How long will it take to fade? I`m fair skinned with blue eyes and dark hair. Any help would be appreciated! Thank You

Answer:

Retin-A will make it more red, not better, same for steroid creams. I suggest using sunblock, avoiding any anti-aging creams to the area as most have Retin-A like ingredients,you can use OTC ScarGuard or Mederma though. All the best. JG 8..7.10

Question:

Is BBL photorejuvenation worth getting done to get rid of brown spots and an uneven skin tone? Does it help with collagen production?

Answer:

might help some, the longer the spots have been there the less effective it will be, and no matter what you have done to improve the spots, they will all come back in time, even with sun avoidance. I think the collagen production is small and usually not clinically visible once the swelling goes down. All the best. JG 8.6.10

Question:

Hello again, I am the one who posted the recent question about retinol and retin-A - thank you for the quick reply. So would a cream called vitamin A cream provide the same benefits? Thanks again!

Answer:

all depends on what strength or concentration it is. JG 8.6.10

Question:

Hello, I am wondering if you can tell me the difference between retin A and retinol? What strength retinol is required to be effective? Is vitamin A cream the same thing and would this offer the same anti-aging benefits? Thanks for the info and help!!

Answer:

Retinol is a weak, non-prescription form of what Retin-A is. Effectiveness of both retinol and Retin-A varies from person to person, one should use what is effective but with the least irritation possible, there is no concnetration that fits everyone, it is a trial and error basis.Retinol and Retin-A are both Vitamin A derivatives with good effects on collagen production in aging skin. JG 8.5.10

Question:

Is it OK to use Retin A on the lips? I already use vitamin C and aquafor at night, but I`d like to improve the texture a bit. Thanks for your advice.

Answer:

it can be used, but it might irritate it quite a bit. JG 8.2.10

Question:

Hi, Dr. Garcia. I`ve been reading your blog long enough to think I know what your answer to this question will be, but I thought I`d ask anyway. My aesthetician is enamored of Environ`s micro-needle Roll-Cit. She claims that topical products penetrate the epidermis more effectively with the use of this device. I appreciate the theory behind it, but it seems like a gimmick to me. I suspect you agree, but before I invest, I thought I`d get your official opinion. Thanks for sharing your thoughts. Hope you`re having a a beautiful summer, Dr. Garcia!

Answer:

it is a gimmick, the needle hole will fill with blood and the product will likely not be absorbed any better, or worse can cause an infection in the needle hole. JG 7.31.10

Question:

what is the best non invasive way to help ice pick scars (small ditches)?? Will maderma help?? Im not looking for surgery or really down time, so I know not much change will happen, but looking to atleast help, minimize or soften...any suggestions.

Answer:

I do not think anything non-invasive will help ice pick scars, sorry. JG 7.31.10

Question:

Hello, I am wondering if your peptide cream helps crepey skin under/around the eyes? If so, how long before results are seen? Should it be applied once or twice daily? Thank you for the info!

Answer:

it does help there, should see some improvement in 4 weeks or so and continue from there, the older one is the better to apply it twice daly. All the best. JG 7.27.10

Question:

Hi Dr. Garcia , i would like to ask mainly for educational purposes ... if one has 10 mg/ml of Triamcinolone in a 5 ml vial .. how many ml of Triamcinolone should be added to 1 ml of normal saline to produce a concentration of 2.5 mg/ml of Triamcinolone ? ... thank you for your time . good day to you .

Answer:

0.25ml. JG 7.27.10

Question:

Good Day , i like to ask for educational purposes ... if one has 40 mg/ml of Triamcinolone in a 5 ml vial and 30 ml of normal saline ... , how many ml of Triamcinolone should be added to the 30 ml normal saline to produce a concentration of 2.5 mg/ml of Triamcinolone ? ... thank you for your time . i hope i can get an answer though it is not about some cosmetic procedure :) . good day .

Answer:

I do not think you should be doing your own injections and I do not know where or why you have come up with the dose of 2.5mg/ml. It is a straight mathematical division problem though. 1.8cc approximately. JG 7.25.10

Question:

Is it ok to use a toner that contains 2% BHA prior to applying my retin-a at night? (this toner as well is free of alcohol and other irritants)

Answer:

you can try it, there is no way to guarantee that it will not make the Retin-A more irritating though. JG 7.23.10

Question:

Hi Dr Garcia, If I use a toner prior to my retin-a at night, will it affect the absorption of my retin-a? The toner I am looking at is free of alcohol and other irritants (has water, glycerine, niacinamide, butylene glycol for the first 4 ingredients).

Answer:

it might absorb better and but it also might cause mroe irritation than without it. All the best.JG 7.23.10

Question:

i use retin a every night with a night cream over it. is it better to alternate retin a one night cream the next to get the most benefit of each product. right now i layer the cream over retin a about half hr later but i feel like im diluting retin a and wasting cream because its too much to absorb both. any opinions??

Answer:

I would stay with the technique you are using. JG 7.22.10

Question:

I had some itching on a part of a leg (lower near ankle but fleshy part) for a few days. I scratched it good but only a few times a day when it felt irritated. Today, it is red,irregular border about an inch wide, slightly raised, and a bit scaly. No oozing or crusting. Could this be eczema or dermatitis? I don`t know if its a bug bite, no obvious marks. How should I treat it?

Answer:

could be either, I suggest using some Cortaid 10 which is a steroid first for about 5 days, twice per day, and if not better, then I suggest seeing a dermatologist. Best of luck. JG 7.21.10

Question:

Dr. Garcia, I had my first IPL treatment with a well respected dermatologist. I was surprised that in lieu of goggles, adhesive patches were placed over my eyes and I saw intense flashes of light. Is this a standard medical procedure when administering IPL? You are a welcomed source of information.

Answer:

can be used as an IPL is not a true laser, just intense light and not as dangerous. Thank you for the kind words and all the best. JG 7.21.10

Question:

I`m interested in purchasing sun protective clothes that have been rated UPF 50. The fabrics have millions of tiny particles of zinc oxide embedded into every fiber. Is it possible that these ZnO particles cannot wash or wear out and will provide protection for the life of the garments as the company claims)? Thanks!

Answer:

I think in time they likely will wear out, but no way to tell over what period of time or over how many washings. I would guees a year to two or so. JG 7.19.10

Question:

Hi Dr Garcia, whats the difference btw an 8.8% and a 15% body wash? Does one work better than the other? I know the acid percentage is much but does it make any difference?

Answer:

I feel it is on your skin for such a short period of time it likely does not make a large difference. JG 7.19.10

Question:

I asked about the jawline acne and scarring; thank you for your response. I`ve tried Retin-A for both the acne and spots around there (I`m too sensitive elsewhere for it) and after a day or so, it becomes too tender/raw. But the acne and spots improve. Should I use it a few times a week only and d/c toners around the mouth? Do you think that might help with the sensitivity?

Answer:

yes to both, you can also weaken the Retin-A by mixing it with a moisturizer in equal amounts and as your skin gets acclimated, then use less moisturizer each time to allow the Retin-A to get to a higher concentration too. JG 7.16.10

Question:

I pick at my face a lot and the scabs generally heal fast and the skin fills in. Lately, I`ve been noticing that its not doing so as well, especially around the jawline. I started Spiro 50 mg a few months ago for the acne/hair around the jawline; could that be impacting the healing? What can I do differently?

Answer:

doubt it is the spiro, it is more likely that you are picking at skin that has been scarred from before and the healing is impaired due to the scar tissue, the most important thing you can do is stop picking at the scars as you are creating a larger problem for yourself. I suggest seeing a dematologist too so they can determine what else cna be used to control your breakouts. JG 7.16.10

Question:

what is the differnce between retinol and retin a? Which is better?

Answer:

Retin-A is much stronger than retinol. JG 7.14.10

Question:

I have thousands of little white bumps on my lips I`ve noticed over the last few years. I beleive they are Fordyce Spots. Is there any way I can remove them?

Answer:

can try Retin-A, or have them hyfercated by a dermatologist, in some mild cases a chemical peel will help, but in most cses they likely will come back and or you will get more in the future. JG 7.13.10

Question:

Short of surgery (due to cost and downtime)what would you recommend is the best procedure for an overall more youthful/tightened look; main area of concern is the skin above the eyes, and slight bagginess under the eye, but would also like the entire skin of the face, in general, to have a more lifted look. Not looking for miracles...just something no matter how slight the effect. Also, what is your recommendation on lotions/potions...etc?

Answer:

I would suggest a light CO2 laser for the first question, as to the lotions, either Retin-A for the entire face and neck or my cell matrix peptide. JG 7.13.10

Question:

I have been a smoker for 10 years, and I have also spent time in the sun. Lately I`ve noticed that some parts of my lips appear darker and some lighter. I`m guessing this is from the cigarettes and the sun, and it also could be that I scrubbed my lips with a toothbrush every morning to get a fresh new layer of skin every morning but not as gently as I should have. So I really haven;t been treating my lips too well. Is there any kind of multi purpose chapstick that will lighten the darkened areas? Or will this require laser to fix? Thanks

Answer:

I think it will take a laser or chemical peel to improve, sorry. JG 7.12.10

Question:

Hi Dr. Garcia, Just read a book by a well known dermatologist who reccomends eating a tablespoon of extra virgin olive oil daily and promotes this as the miracle med for smooth skin. His book was a little over the top, but did have some usefull info. What is your opinion of the olive oil? Would one see a remarkable difference in thier skin by including it daily into thier diet?

Answer:

it helps if you are replacing olive oil for other saturated fats in your diet, but not just by taking it on top of all other bad fats that can have negative effects on your skin. Saturated fats are bad for you skin, just as they are bad for your heart. JG 7.12.10

Question:

hi, how long can triamcinolone reconstituted with multi dose bacteriostatic normal saline be kept ... can it be kept as long as both the triamcinolone and the bacteriostatic normal saline haven`t expired ? or is there a shelf life so to speak when it comes to reconstituted triamcinolone . thank you for your time .

Answer:

I would not store it in a diluted fashion, there is also no need to reconstitute it, all the triamcinolone I have used comes already mixed. JG 7.8.10

Question:

what r ur thoughts on the clairsonic?

Answer:

good as long as you keep the brush new frequently. JG 7.7.10

Question:

how come tazorac is a category X for pregnancy but retin a is category C?? Arent they the same thing? Do you think that a face cream actually causes birth defects? Have you ever encoutered a patient u had on retin a that got preg?

Answer:

they are essentially the same thing in terms of their effects on the skin but the FDA has chosen to classify Tazorac as more restrictive, I cannto speak as to why they made that decision besides potential fetal development questions that were reported or feared possible. I have had patients that were using Retin-A and became pregnant and then stopped using it, showing no adverse effects. It is more of an issue of development of the fetus rather than damage to the eggs before fertilization from what I have read. JG 7.6.10

Question:

hi, i had juverderm put in, which was suppose to go in my marinette lines however ened up in my cheek. It looks really puffy and I hate it. I chose not to dissolve it as i was afraid i would make things worse. howver its been months and only dissolved a little and im sick of it. my question is by dissolving it will my cheeks look worse now like they been deflated? iim afraid of the outcome?? des the dissolver do anything to your own tissue? any help please

Answer:

that short of a term of filling should not leave any negative effects if you have it dissolved now. The hyaluronidase used to dissolve the injection material should not have any negative long term efects on your normal tissues. Best of luck. JG 7.6.10

Question:

hi doctor garcia. i want to know if there is any remedy or treatment for sweating? everytime i go outside in the heat the skin on my face produces alot of sweat and even my makeup just melts. makes me look awful. i do have open pores, and i dont know if this has anything to do with it,but ive seen so many other women who dont sweat like me, and their skin still looks fresh. ive heard of botox for reduced sweating, but iam not sure if it works on the face. if you have any info on this problem please do advice. thanks!

Answer:

I am sorry but I do nto have anything I can offer you, Botox or Dysport have been used for excess sweating in armpits and plams but injecting your whole face is impractical and could weaken facial muscles that you do not want weakened. JG 7.5.10

Question:

is there any anti age and acne fighting products you can use while trying to concieve? Like proactiv or something along that lines...and a firming cream??

Answer:

none have been tested, sorry. JG 7.4.10

Question:

Hi can u use retin a and proactiv together, like the proactiv wash then later put on retin a, or will the micro crystals possibly lead to more irritation from the retin a?

Answer:

can be done as you say. JG 7.4.10

Question:

SINCE THEY SAY RETIN A CREAM CAN CAUSE BIRTH DEFECTS, IS IT POSSIBLE THAT FROM USING IT FOR A WHILE ALL YOUR EGGS WILL BE AFFECTED??

Answer:

it more likely affects the egg after fertilization as it develops rather than causing egg damage. JG 7.3.10

Question:

Hello Dr. Garcia, At what age is a woman no longer able to cause collegen remodeling in her skin by use of retin-a, peptides, ipl ect? Is it inevitable that a anglo woman over 60 will have thin skin or is there anything that can be done ? THank you very much, Sue

Answer:

there is no age at which it stops as wounds will always heal, there are also the variables of amount of sun damage of the skin that can lower the ability to create collagen, and also the effect of genetics. Those treatments will likely slow the progression down but not halt it or reverse it to any great degree. All the best. JG 7.2.10

Question:

Good Morning Dr. Garcia, I have a tattoo that I would like removed. I have recieved several laser treatments and understand that laser treatments are the most effective method for tattoo removal. I was wondering if you would be willing to do a procedure where you would surgically remove my tattoo and then possibly skin graft the area. I would not be concerned about discoloration of pigment or scar tissue, but just concerned about how deformed the surface of my skin would be. Would you ever perform a procedure like this? Sincerely.

Answer:

the skin will not look anywhere near normal as the skin graft would leave a depressed scar with no subcutaneous tissue, just scarred skin and muscle. I haver never agreed to do that for that specific reason, in a small number of cases, where the tattoo is very small, I have cut them out and closed the wound, leaving a longer wider scar, but I have never skin grafted one, sorry. JG 7.2.10

Question:

Hello Dr Garcia, Is it advisable to mix my glytone glycolic acid body lotion with HQ lotion or use one before the other?

Answer:

they can be mixed together. JG 7.2.10

Question:

one last question....tazorac in this case would be worst then the retin a??

Answer:

same, no difference, they are essentially the same thing. JG 6.29.10

Question:

OK so u think the use up to this point will be ok??

Answer:

yes. JG 6.29.10

Question:

Im sure you have encoutered patients with this. I been using retin a cream 0.1 and just found out im pregnanat. Had my period last with it ending around june 2. What would you say to that since retin a is bad in this position. Is a cream really able to cause that much trouble. Is it early enough that it will be ok? Please help...so nervous.

Answer:

I think it best to stop it until the baby is born and you are done breast feeding, although the amount absorbed is likely small, but no need to take chances. I do think it is early enough that the risk of damage to the baby is extremely small. Congrats on the baby and all the best. JG 6.29.10

Question:

Hello, What sort of peel would you recommend to improve blackheads/large pores? Thank you.

Answer:

any hydroxy acid peel should help. JG 6.29.10

Question:

Opps I should have read my question before submitting. Let me try again. Hello Dr. Garcia, Please give us an educated guess on type of procedures Joan Rivers may do to keep no wrinkles and such smooth skin? Thanks for your allowing us to ask questions. Sue

Answer:

most celebrities, because they can afford to hide out for awhile and not have to work, do lesser procedures more often than those of us that work for a living in normal jobs. That can make the subtle changes be seen less as they get it done over and over again, no way to tell how many, but likely many. JG 6.28.10

Question:

Hell Dr. Garcia, How is Joan River is able to have smooth skin at her age? What would your educated guess be for skin procedures she may have done.

Answer:

my educated guess is way too many. I know she is a fan of plastic surgery, but her skin, albeit smooth, likely does not look as good without her makeup and does not move that way normal healthy skin should move. Things that look good from afar are sometimes far from good. JG 6.28.10

Question:

I am desperately fighting deep wrinkles on the side of my mouth! Is there anything better than ProX, a product found in the drugstore, that I can use without having surgery or injections?

Answer:

sorry, it is injections or surgery. JG 6.27.10

Question:

Would using proactiv while you have large pores and some ice pick scars make them worse? I read somehwere that exfoliants that are like little crystals can make them look bigger? What do yo think>

Answer:

it should not, no. JG 6.27.10

Question:

Hi Dr Garcia, I`ve been supplementing with omega-3 fatty acids, vitamin E, B complex, and vitamin C per your reccomendation that I found in older posts. I actually do see some improvement in my skin though feeling like I`m swallowing a lot of capsules. So, the question I have is this: Since I am really dilligent about getting my 5 fruits/veggies a day, which always includes several good vitamin C sources, do I really need to bother with the vitamin C tablet? Thanks for your help!

Answer:

if you are eating well like that you can skip the Vitamin C, yes. JG 6.27.10

Question:

Hi Dr. Garcia, I hope you are enjoying your summer. I am perplexed about self tanners. The one I am using has a moisturizer in it which I didn;t know until today. I have been using in the am: Vitamin C serum and then a moisturizer and then the self tanner. Should I be putting the self tanner on first since it dyes the skin? Shpuld I omit the vitamin c on top of the tanner?

Answer:

I think the tanner is best on top, OK to use the Vitamin C before the tanner though. JG 6.27.10

Question:

is maderma like retin a in that after you stop using it the results will slowly go back to the way they were when you stared? in other words you will have to keep using it??

Answer:

no, Mederma helps the wounds mature, heal and fade and once they have done that, they do not return to the way they were. As to returning to the same after Retin-A, that only occurs because once you stop using the Retin-A, since it did nothing to halt the aging process, your skin will age once again. JG 6.25.10

Question:

Hello, Dr Garcia, is it effective to use micro-dermabrasion crystals as a body scrub, if i mix it with oil? Would it be more effective than a salt scrub? Thanks.

Answer:

pretty similar, not much difference I think. JG 6.24.10

Question:

Good afternoon Dr. We all want to take care of our face. What would you recommend -ie Regenerist eye cream, vit c, Vit A...and should we get the odd facial or peel..if so what kind. I have recently had CO2 and want to take the best care of my new skin as possible. ty jg june 24

Answer:

I think Vitamin A derivatives are just weak Retin-A, can be used, do help, easily found. I think Vitamin C serums are also good at a 10% strength, and I think the Oil of Olay Regenerist line, for the money, is a very good product. As to peels, for maintaining things a light alpha hydroxy acid peel every 6-8 weeks is OK, along with sunblock, no more sunscreen. All the best. JG 6.24.10

Question:

Hi Dr. Maybe i will rephrase my previous question. I currently use Tretinoin 0.1% and had CO 2 laser under eyes at the end of Jan. Is it ok to use this strength on this eye area now or will it cause crepiness. Thx jg june24

Answer:

should be OK to use now. JG 6.24.10

Question:

will maderma over retin a even penetrate skin enough to work, or is it best to alternate nights? Thank for always answering all ny questions for free and on your time. You are greatly appreciated! When I have any doubts, I come here first and even though I never met you in person, I always take your answers or advice as solid gold and follow them, and u never failed me. So thanks again!!

Answer:

I rarely use Retin-A over scars as it can irritate the scars and keep them red longer but if you are set on it, apply the Retin-A first, wait ten minutes and then the Mederma over it. Best of luck and glad I have helped in the past. JG 6.23.10

Question:

Hi doc garcia do you think this cream really helps the skin? www.byonik.net?? whats your opinion on it? thnssss

Answer:

my German is rusty but there appears to be not significantly different from most things out there already an dlikey costing less than Byonik, but the packaging is very nice. JG 6.23.10

Question:

wat is the best scar cream for face thats fairly cheap??

Answer:

ScarGuard or Mederma are good. JG 6.23.10

Question:

HI THERE. Welcome back! which maderma is best for face, the gel? is it effective put over retin a? Also what do u think of the aqua glycolic line by the company that makers maderma?

Answer:

if tolerated, it is OK over the Retin-A, as to which is better, they are the same, most people seem to like the gel though. No experience with their glycolic acid product but it is likely OK to use. JG 6.22.10

Question:

Morning! Are you familiar with the Galvonic system and the gels used with this home procedure? Their handout brochure has a `testimonial` photo on it, and this same photo is on numerous other product sites, only changing her name, address, and story about the product success. Certainly questions my belief in their product and all the others! Also the SkinTyte procedure...any thoughts? Quite remarkable before/after results on web sites. Thanks!!

Answer:

yes, I do not feel they are worth the money, sorry. JG 6.21.10

Question:

Would you recommend Retin A or Mederma for minor skin redness caused by old acne? Also, have you ever heard of using Strivectin-SD (for stretch marks-5% Striadril) for off-label use for the minor aftermaths of acne?

Answer:

not Retin-A as it will make it worse, but yes for the Mederma. I have heard of Strivectin, have had patients try it and I am not a believer in it, sorry. JG 6.10.10

Question:

What do you think of the at home LED light therapy that has just been FDA approved. I did use it for a few months and saw no difference. (Though they claim you see a diff in 4 days!!) Also the at home Crystalift microdermabrasion...featured on the Drs. Show and said to work?

Answer:

save your money, both will not give you much. JG 6.10.10

Question:

hat do you think of the nuface toning system for firmer skin?

Answer:

I would save your money. 6.10.10

Question:

Good morning dr garcia. Can I mix retin a with my body lotion? Would it have any effect on my body, as in make my lotion penetrate better?

Answer:

might help the penetration a little, yes. JG 6.9.10

Question:

Hi dr garcia, Its me again! Vitamin C jabs mixed with Gluthathione seem to be a hit in Asian countries lately.Many dermatologists are doing the service by injecting pure Vitamin C ( Roche brand ) into the patient`s vein to achieve a fairer and smoother complexion.There`s even Gluthathione tablets for fairer complexion.I`ve seen some people whom have done it with good results.What Im concerned is this procedure safe?Is it legal? 2nd question, I believe I was given retinols by my derm earlier, but the brand never been revealed.Plus it doesn`t cause me much flaking n peeling.Ive experienced just a mild flaking.Having had success with lower dosage,got cystic pimples and oily skin only after changing into higher one but finally got cured wt Accutan.Tell me doctor which one should I go for again, retinols or retin A? Is the strength of Skinceuticals 0.3% is lower than LA Roche Posay Biomedic Retinol 0.15%? Im on Diane 35 and bactrim to control my hormonal breakouts.

Answer:

safe, yes. Legal, yes. Effective, I seriously doubt it.I think stay with the weaker retinols in your case. The Skinceuticals or LaRoche Posay are fine to use. JG 6.7.10

Question:

i know vitamins cant erase aging but can u recommened a vitamin that may help with facial anti aging (i like the Olay vit but i cant find them anymore)? is there one you can buy at like walgreens? Also what do u think for anti age rosehip oil or olive??

Answer:

Vitamin B, C E and omega three fish oils. JG 6.6.10

Question:

What do you think of Allergan`s Vivite skincare line? Worth the price? I am particularly interested in one of their newer products, a skin brightening serum. Do you think it`s effective? Thanks, Dr. Garcia!

Answer:

lots better out there for less money, Oil of Olay Regenerist for example. JG 6.5.10

Question:

Hi Dr Garcia, Im glad that I`ve come across your site while searching for Retin A`s. 3 years back, I was prescribed with a night cream by a local dermatologist here in Asia.The consistency is yellowish milky pasty.My breakouts had dimished, my spots faded and my skin never looked this good.I had success with the cream for 8 months before the derm switched me into a higher percentage.That`s when I know the cream is actually a Retin A or Retinol in a night cream form.As I was quite newbie to Retin A, I went ahead n tried the higher %.After one month applying it 4 X a week, my skin suddenly became oily.Within a week, it became too oily almost like oozing even thou I washed it like just 1:2 hr before.Ive never had this problem.5th week, I began experience with mild breakouts and whiteheads on my cheeks and foreheads.I was devastated and went bk to derm, he assured me the cream is working but just keep continuing using it.I coudn`t take it anymore as it turned into cystic pimple and too oily.I switched to another derm and he said the problem is due to higher % Retin A I`ve been using.No choice, I had to be on accutane for 6 months (20 mg) per day and my skin got better.Now after 1 yrs, Im having hormonal breakouts again,and thinking of purchasing a retin A.I didnt know what was the previous brand lower dosage of Retin A that Ive had success with, the derm never revealed.Ive a sensitive combo acne prone skin.Currently Im on Bactrim for 3 months, and Diferrin 0.3%,its too dryish on my skin but it works on my pimples.Ive stopped since my skin became severely irritated. Ive read abt OTC retinols about Skinceuticals 0.3% and LA Roche Posay Biomedic Retinol O.15.Which one do u suggest in my problem?I was prescribed with Retacnyl 0.025% but I didnt use it yet.

Answer:

I think with all you have been through that using the LaRoche or Skinceuticals is a good place to start, once tolerating them you can get some Retin-A 0.25% and start that by using it twice per week at night, increasing it slowly at night and once tolerating it adding the morning applications as tolerated. Best of luck. JG 6.5.10

Question:

Dr.Garcia What is your opinion of taking oral Hyaluronic acid tablets (hope I spelled it right)? I was told by a very reliable source to take 2 tablets a day for two weeks and then one a day. I was also told to only buy it online from purityproducts.com. I was told it works great for the joints. Can it be mixed? By that I mean can u take it orally if you use it in a filler or topically? I am confused and really not interested in spending money on a snake oil product. Thanks for all the help and guidance you have given me and others. Much appreciated.

Answer:

although there is lots of hyaluronic acid in your joints, the chances of oral intake of that getting into your joints is almost impossible, it woudl be broken down into smaller fragments in your stomach and intestine and would not reconstitute into hyaluronc acid again on its own. Save your money. JG 6.3.10

Question:

Hi Doctor, what do you think about Nu Skin products, worth trying or not?

Answer:

overpriced as it is a multi-level marketing company so you pay alot more than you need to for a product that is not significantly different than most on the market. JG 6.2.10

Question:

Dr. Garcia, Thanks for answering my question about the itchy forehead and sunscreen/sunblock. I did think about my leave in hair care products before I wrote you and nothing new as far as products go. My forehead is now flaking as well as itching. I am just going to toss all the sample products and look for one for sensitive skin even though I don`t have that. Is your sunblock/sunscreen on your shopping cart geared toward all skin types? Have you had any complaints about allergic reactions? Thanks for your help in advance and have a wonderful time this holiday weekend.

Answer:

ours is geared for all skin types, if you are going to buy OTC, by stuff for kids as they tend to have less problems with irritation. We have not had any problems with tolerance with our product but it can always happen. Best of luck. JG 5.27.10

Question:

what do you think of Cutera® XEO® Laser? is it worth it?

Answer:

no better than older IPL treatments, the results are mild and the spots will come back in time. JG 5.23.10

Question:

I have about 6 dark scars from bumps that i had on my leg. i am dark skin african american and i have tried everything to get the scars to lighten but they are still dark dark circle scars. To the point that i cant wear skirts or shorts, just pants. i want to know is there any kind of procedure to get them earased or to lighten them someway to make my leg not look so gross.

Answer:

you can try a YAG laser btu it can be risky in darker skinned people. JG 5.23.10

Question:

I`m looking for a physical sunblock without the greasy, white mask look? Any suggestions?

Answer:

we have one on our shopping cart. JG 5.23.10

Question:

I really want to start using Tazorac (or another good retinoid) for acne, scarring, general tone but am afraid because I`ve had redness problems (in scars and otherwise) and had it treated with IPL in the past. If I use Tazorac 2/3 times a week to keep it gentle, is it still helpful for all the problems mentioned or not worth the effort? Can I still get IPL done if on it or stop using it a few days before?

Answer:

it will be more gentle and less effective I am afriad, there will be no good without the bad with retinoids. The IPL can be done but you need to be off the retinoid for a few days before and after. JG 5.23.10

Question:

Hello, Dr.Garcia, does Refissa cream work? Is it better than peel? Thanks.

Answer:

just old fashioned 0.05% Retin-A , nothing new by any means, might work safer than a peel. JG 5.19.10

Question:

Hi doctor i want to have clear skin and many of your answers you mention glycolic acid?what is it, where should i get it and it there any cream with glicolic acid? thanks

Answer:

there are many creams sold OTC with it and there are peels done in medispas with it. JG 5.18.10

Question:

hi dr, sorry to ask again, but to quote you: # hi dr, can skin thinned by a few weeks of medium strength topical steroids ever regain its thickness? will anything help? copper peptides for example? Answer: copper peptides are OK in the short term and then Retin-A for longer term. Best of luck. JG 5.17.10 just to confirm, are you saying that the skin can regain thickness? and will it on its own, or is it dependant on the use of those products? thanks!

Answer:

those products will help it get closer to the previous thickness, the older one is with the steroid use the less likely it is they will get back to the prior without intervention. If it was just a short period of time once it should have a minimal effect, if it was more, the effect will be greater. JG 5.17.10

Question:

hi dr, can skin thinned by a few weeks of medium strength topical steroids ever regain its thickness? will anything help? copper peptides for example?

Answer:

copper peptides are OK in the short term and then Retin-A for longer term. Best of luck. JG 5.17.10

Question:

Sorry for the confusion; let me rephrase. What is the approximate percentage of UVA light blocked by your sunblock? Thanks for your input.

Answer:

should be functionally 100% if reapplied every two hours. All sunblocks are total blocks, it is sunscreens that allow some sun through. JG 5.17.10

Question:

Hi Dr.Garcia, What`s the estimated ppd of your sunblock? Thank you!

Answer:

the bottle should last 6-8 weeks if not more, depends on how often you reapply. JG 5.16.10

Question:

Hi Dr Garcia, in reading through old posts, I see the vitamins you reccomend for the complexion are B vits, C, E, omega-3, and antioxidants. So my question is, as B, C, and E vits all come in multivitamins, is the multivitamin adequate or do I need to take them separately in larger amounts? Also, How much Omega-3 to take?

Answer:

I think a little higher dose is a good idea and as to the Omega 3, I suggest 1-3 grams per day in most cases. JG 5.16.10

Question:

Hello, I have a skin care question. I have noticed in the posts that several people are using Retin A and your peptide cream. I am interested in purchasing your cream - is it more effective with retin A? Is it necessary to use both or will I get the same effects with your peptide creams as the Retin A? I currently use differin gel for acne and am quite happy with it just want to add something for firming and fine lines. Thanks!!

Answer:

I personally do not feel the Retin-A is needed with my cream but soem people insist on using it in conjunction, so I tell them to put the Retin-A on first. You can apply the Diffferein first and then follow with the peptide cream if you desire, no problem with that. JG 5.16.10

Question:

I has some dark hyperpigmentation that TCA peels seemed to get rid of. If I go in office light or the sun, will the hyperpigmention come back? It looks like it is gone from my skin so would it come back int he same exact streaks where it was located? Are there any products I can take (besides skin bleach) that will prevent it from coming back?

Answer:

eventually, with time, yes, they will come back in the same exact spot and you would likely get new ones too. Sunblock will help, but there is nothing that will stop it forever. Bleaching creams do not need to be used once the spot is gone, that is for treatment and less for prevention. JG 5.12.10

Question:

Good Morning Dr.Garcia, I normally get Urticaria Allergy on my skin , my derm would treat me with 10%GLY in 1/2 Strbetacortc oitment...is this oitment safe to use during pregancy..Thank You, and do have a good day...

Answer:

it has never been studied on pregnant patients to the best of my knowledge, so I cannot say 100%. The 10% Gly is likely OK though. JG 5.12.10

Question:

Hi Dr Garcia, I just received my order of your cell matrix cream. The bottle says to apply at night. Can I apply it in the daytime instead?

Answer:

yes, but wait at least 10 minutes before applying anything over it, including make up and sunblock. JG 5.11.10

Question:

Hi Dr Garcia. I have been using the Obagi Nuderm system for a month now and I am very pleased with the results. My skin is less rough, acne has almost gone, and pigmentation has improved. Only thing is, I still with some red marks from previous acne spots that have not gone yet. Will the obagi nu derm get rid of red marks too, I will I have to look for a new treatment? pls advice what I should. If it wasnt for these red mark, my skin would be looking great! x

Answer:

not so much, anything that fades the brown spots and controls acne will potentially aggravate the redness, or at least not make it any better. The redness can be made better with some IPL treatments. Best of luck. JG 5.7.10

Question:

What`s the percentage of zinc oxide in your sunblock? Thanks!

Answer:

5%. 4% for the Titanium. JG 5.7.10

Question:

Greetings Dr Garcia! I`ve read in the archives that you reccomend taking omega 3 supplements but not omega 6. Does this reccomendation apply to topical oils as well? For example, I am looking at a face cream that contains rosehip seed oil (know for is linolenic and linoleic acids, one of which is an omega 6.) What is your reccomendation?

Answer:

I think it is less important when applied topically on the skin than when taken internally, but in general, alhtough they, the Omega 6, are all over the place in skin oils, I would avoid them as they are all pro-inflammatory and we have enough inflammation as it is. JG 5.7.10

Question:

Dr. Garcia, Can hydroquinone actually cause the darkening of the skin? I have been using a mixture of Retin A+ hydroquinone to lighten a dark spot on my forehead ( plus sun block SPF 100 at all times)for about 5 weeks now. I have been applying the mixture to a larger area than the dark spot itself, and it appears that the cream has caused the hyperpigmentation to spread. Now the area that has been in contact with the cream has an uneven,darker and freckled appearance (otherwise, the effected skin is smooth, healthy and does not flake).This treated area is now darker than the rest of my forehead, when previously only a small dark spot was the main problem. What should I do now: stop the cream or continue to use it? what are my options? Thank you.

Answer:

if the skin becomes irritated from the mixture, for a short period of time it can be darker and then should progressively lighten over time, by that I mean months, not days. I would continue it if you are not having any skin irritation. JG 5.6.10

Question:

What is your preferred treatment for sebaceous hyperplasia? Cautery? Thanks for your help, Dr. Garcia! Hope you`re having a beautiful spring in Las Vegas!

Answer:

essentially, yes, with a variety of different devices. They will come back in time and the treatment will have to be repeated though, all the best. JG 5.5.10

Question:

My dermatologist prescribed both Propecia & generic Accutane. Are these both safe to take at the same time daily with dinner?

Answer:

I know of no bad interactions between them. JG 5.5.10

Question:

Hello, Just wondering if the OTC retinol in many products is effective as an anti-aging product or does it have to be the prescription retin A? Thanks.

Answer:

well, it will be effective to some degree but never as much as the prescription strength. JG 5.4.10

Question:

Hello, Is it ok to put mederma on over the top of stitches or should I wait until the stitches are removed or does it not matter? Thanks

Answer:

never when sutures are in place, wait a couple of days after the sutures are out to begin using it. JG 5.4.10

Question:

Hello Dr Garcia, I was the one that showed you the before and after pictures of the dark knuckles. Well, just like u said, they turned dark again. What do you suggest I do? Do you think i should do the peel again in the same strength or in lesser layers or should i opt for a laser treatment? I`m really confused right now.

Answer:

anything you do will not be permanent I am afraid, repeating the peel can be done, but they will come back, sorry. JG 5.4.10

Question:

I am developing some laxity in my skin, just under my chin/jawline. Would your peptide cream help w/ that and if so how much? Is there a better treatment shy of surgery since I am only 34?

Answer:

sorry, but no, it will not, it is meant for improvement in the fine lines that are from poor skin quality, and the lose skin that is starting on your neck is a quantity not a quality issue. JG 4.23.10

Question:

Hi Dr Garcia, Are all forms of topical vitamin C firming for the skin, or are some forms more firming than others?

Answer:

its a concentration thing, look for 10%. JG 4.23.10

Question:

Hello Dr. Garcia, I have a 10 inch long orthopaedic scar on my upper arm. It is about a half an inch wide. What can be done surgically, topically or with lazer for this kind of a scar? Is skin grafting recommended? Thank You

Answer:

skin grafting would make it worse, the laser can only fade redness, short of a prolonged option of placing a tissue expander to stretch the skin for 6 months and then revising the scar, there is not much that can likely be done, the scars in that area tend to widen due to the activity of the muscles of the arm. The tissue expander is essentially a large balloon that is stretched slowly over months and it stretches the skin but the arm will look pretty weird while undergoing the stretching. JG 4.22.10

Question:

It would come back??? Even if i wear sunscreen and gloves in the day time and continue on my HQ and Retin a regimen? Actually, that was my 3rd peel on my knuckles and they didnt give me dramatic results so thats why i went stronger this time. So, its actually been gradual. I had to, i was desperate...lol.

Answer:

yes, it will come back, even if just from friction on the skin. I guess all you can do is hope. JG 4.21.10

Question:

What are your thoughts on the Nia24 product line? Any particular advantages to it over your own excellent peptide cream? Thanks for your opinion!

Answer:

I am not a believer of the claims made for Nia24, sorry. JG 4.20.10

Question:

Hi Dr Garcia. Have you heard of Lifecell and does it work? Have heard a lot of people raving about it so thought I would ask your opinion. x

Answer:

no better than all of the other OTC products out there I am afraid. Julio Garcia MD 4.19.10

Question:

Is the Yag Laser also good for darker skin type? Wouldn`t it cause more hyperpigmentation?

Answer:

the darker your skin is to start with, the riskier it is with PIH, post inflammatory hyperpigmentation. JG 4.18.10

Question:

Hi, which one would u recommend? Glytone mild gel wash or Obagi Mild cleanser? Also, are there any lasers for hyperpigmentation?

Answer:

both very similar, as to the hyperpigmentation I would use an IPL or a Q Switched YAG laser. JG 4.17.10

Question:

have you heard of cold plasma by MD perricone and is it good?

Answer:

lots of unfounded hype, your skin cannot select individual ingredients that are in liposmal carriers, your skin will absorb them all and then use what it can, but there is no skin sensitive selectivity to absorb one product over another. He cleverly never quite says that but allows you to make that assumption from what he writes about it.JG 4.16.10

Question:

you say Obagi elastiderm eye gel any is good but it doesnt contain DMAE and coenzyme Q10, so what is so good about elastiderm?

Answer:

DMAE and CoQ 10 are good skin care product ingredients but by no means are they the only ones, I am afraid you are looking for something that willl never exist. A single, non-changing answer to what is best for your skin. There are many things that are good but no one thing is ever best. Rotating products to get a variety of good ingredient can be a good idea as one cannot apply all things that are recognized as helpful and get them all to absorb in adequate amounts. JG 4.16.10

Question:

Is the Obagi elastiderm eye gel any good?

Answer:

yes. JG 4.16.10

Question:

Is the Obagi elastiderm eye gel any good?

Answer:

yes. JG 4.16.10

Question:

what do you make of Creme de La mer? Is it worth the money?

Answer:

Sacre Bleu, not even close to being worth it.JG 4.16.10

Question:

I am looking for a good eye cream for during the day as I use a retin a eye cream at night. What are the best ingredients to lookout for in an eye cream? x

Answer:

DMAE and CoQ 10 are good ones for OTC products. Alternatively you can use my cell matrix cream on our shopping cart.JG 4.16.10

Question:

Hi Doc, what do you recommend for stubborn dark knuckles caused by lightening creams? Ive been using 8% HQ for it for the past 2 wks and still no luck. Will 10% HQ work for it? Also, is there any laser or cream out yet that is effective for stretch marks? Thank you.

Answer:

you can add Retin-A but for it to work will take months not weeks. No on the lasers. JG 4.15.10

Question:

I know that fluorescent lighting emits UV rays that damage the skin. What about incandescent and hallogen lighting?

Answer:

no, they do not. JG 4.15.10

Question:

Hello doctor I am 30 yrs old and i have skin discoloration around my lips and neck for the past 15 years. I have never been to a doctor to treat this. Recently i went to a dermatologist in Arkansas and he suggested me Hydroquinine USP 4% and desonide oinment 0.05% to treat this. i have been using them for the past 15 days. i want to know whether it works. doctor has suggested me to use them atleast for 3 months. Is there any other way to treat these. Also i have dark spots in my face because of acne and the doctor have given me a SODIUM SULFACETAMIDE 10% AND SULFUR 4% WASH for my face. do i have to use only the prescribed face wash or i can use any other branded face wash above using this. I am really confused with all these medications.Please help me getting a clear view about this.

Answer:

I think what he has suggested is a good start, as to a facial wash, anything with glycolic acid will be good enough, many are sold OTC. All the best. JG 4.13.10

Question:

Why do you no longer sell the DMAE cream. I use DMAE 4% on my skin - is this bad. Thank you

Answer:

we stopped selling it not because there was anything bad, it was just that when I started offering the cell matrix peptide cream, everyone wanted that one and no one kept buying the DMAE cream. 4% is what the DMAE should be in the cream. JG 4.12.10

Question:

hi Dr, what do you think of Elastoplast Scar reduction patches? do they help? and what about for other skin ailments, or just improving the general texture of skin? thanks!

Answer:

am not convinced the elastoplast does much and as to the skin ailment, it all depends what is itching you as to what I would recommend. JG 4.9.10

Question:

Hi Dr, For anti ageing and skin improvement, which would be the best option, Cosmelan peel or Retin A and what is the difference? Thanks

Answer:

Retin-A I feel, it has the longer time period studying it for its effectiveness. The Retin-A is a daily application where the other is a chemcal peel administered every few months or so as needed and is riskier for developing post-inflammatory hyperpigmentation. JG 4.8.10

Question:

Hello Dr, I noticed you stock the Obagi range. I am extremely confused which range from their brand to use. What is the difference between Nu-derm, Condition + enhance, Obagi-C Rx etc. I am 42 years old and want to address the onset of ageing, sundamage and crepiness but have no idea which of the above to buy - they all seem to be advertised as doing the same job. Your help would be greatly appreciated! Thank you

Answer:

we used to sell their products but no longer do. I cannot really tell you what the differences are, sorry. In general the Obagi product line i good though.JG 4.8.10

Question:

I dont know what cream to buy that contains dmae to firm me help. PLease recommned one. Im so confused.

Answer:

I no longer use DMAE creams, so I cannot recommend one, I suggest the peptide cream that we sell on our website. JG 4.7.10

Question:

I used electolysis on my body, from dark thick hair it lessened and then some lighter finer hair grew back. If i was to continue treating these will they lessen or become lesser obvious? or this is the final outcome?

Answer:

it might still improve with more treatments. JG 4.7.10

Question:

hi doc for how long after will normally hair grow back with vaniqa? typically? or will it not as long as your using the product?

Answer:

need to keep using the product for it to stay gone. JG 4.7.10

Question:

Hello Doctor Garcia Can you explain what is DMAE that others ask about. thank you to the answer to my question re best creams for lip lines and chin wrinkling. I will ask the doc for prescription for Retin A, can it stop the wrinkling on lip and chin area, the rest of my skin is excellent or will it help remove any lines? I appreciate your answer. thanks a lot Beth

Answer:

Recent studies involving a gel formulation containing DMAE have shown that the compound can increase skin firmness, even in younger subjects.Thirty healthy adults between the ages of 36 and 49 were given tests that measured changes in skin tautness after application with the DMAE gel, compared to placebo. Results indicated that the placebo had little or no effect on skin firmness, while the DMAE-treated skin exhibited greater tautness.Researchers offer two possible explanations for these results. First, DMAE may enhance water retention in connective skin tissue, causing the surface of the skin to tighten. The second, and more likely, explanation involves DMAE’s cholinergic feature, which enhances the skin’s ability to transmit acetylcholine. The neurotransmitter’s function in sending signals from nerves to muscles may promote a form of muscle tightening in the skin. It is important to note that although DMAE cannot fully reverse existing facial sagging, it may reduce its further progression. Some people report a cumulative effect with continued use of the compound.Age spots, or “liver spots,” also may respond effectively to DMAE in cream, gel, or tablet form. Studies have shown that DMAE’s membrane-stabilizing properties reduced the accumulation of lipofuscin deposits inside cells. Lipofuscin, a brownish cellular pigment consisting of aggregated chunks of molecular waste formed by the inefficient metabolism of fatty acids, tends to occur in the cells of older people and is primarily responsible for age spots. DMAE has been shown to flush excess lipofuscin from affected skin cells.DMAE is a potent, site-specific free radical scavenger. An in-vitro study found that adding DMAE to myocytes (the heart’s pumping cells) protected individuals from cell damage resulting from ischemia, a lack of oxygen and blood flow to the heart, and from metabolic inhibition. Taken in the proper dosage, DMAE’s antioxidant effects can offer probable benefits of value in the maintenance of overall cellular health.As to the Retin-A, it should help with the lines, yes. JG 4.7.10

Question:

Hello Dr Garcia I have developed quite suddenly (one year) lip lines and small wrinkle lines around my chin area, I would like to ask you if Cosmedix or Hydroxatone cream for the face, which one is more effective, as I cannot afford trial and error, and would appreciate an honest opinion from an expert. Thank you so much Beth

Answer:

neither, buy some generic Retin-A with a prescription for the best option. JG 4.6.10

Question:

Further to my question below about saline injections to cortisone induced atrophy, the theory as I understand it is that attempts to shift or dilute crystals of cortisone that have remained after injection causing atrophy. Also on further reading some papers suggest that tretinoin can prevent or reduce the risk of atrophy without affecting other action of the cortisone, ie prevention, not so much for recovery. Still some suggest recovery. Best wishes.

Answer:

well,the dilution is what I mentioend earlier, but I personally do not think the crsytals stay intact for very long after injection for the saline injectiosn to work days or weeks after the injection is first done. I guess you can hope they are correct in their assessment, but I have not seen it be effective in practical treatmen terms. One can always hope. JG 4.6.10

Question:

Hi Dr Garcia. I have read that either saline injections or tretinoin can help reverse atrophy from cortisone injection. Have you had any success with this? Also, if atrophy appears quickly,say 3 weeks, is it likely to be worse that atrophy that appears slower, like after 6 weeks?

Answer:

well, if the saline injection is done in the first day or so it might dilute the kenalog enough and spread it out over a larger area to decrease the effects, but once it has a negative effect, injecting saline will no longer help. As to tretinoin, I seriously doubt it will help as the steroid is much stronger than the tretinoin. The faster the atrophy occcurs the worse the potential long term effects can be I am afraid. JG 4.5.10

Question:

I have had some scars revised with dissolvable stitches. Often the area will get raw and weep (and grow into big circle instead of straight scarline) and take forever to heal where the stitch is tied. Then the scar area looks bigger there. Why does this happen? It seems like the stitch is the cause. Also, what can I apply on it to heal it up faster?

Answer:

the dissolvable sutures might have gotten infected or you are allergic to them. Might just use neosporin to help it heal. JG 4.5.10

Question:

what is the best dmae cream by name that will help tighten firm skin?? also what do they mean when they talk danger of dmae creams??

Answer:

I think the dangers of DMAE creams are hyped and not really true,as to the best, it is impossible to tell because none of them tell you the concentration of the DMAE in the cream. JG 4.5.10

Question:

Happpy Easter to you and yours. I am 60 and have had oily skin most of my life and still do. I have enlarged pores, and slight pigmentation. I am not a fan of hydroquoinine, what other suggestions do you have? I also use the clarisonic cleanser but I am afraid it has not helped much with the pores. They are not drastic, but what suggestions do you have for either? Thank-you.

Answer:

might suggest some IPL treatments and also some Retin-A. Micordermabrasions might help with the pores too. Happy Easter to you too. JG 4.4.10

Question:

first off, thanks for your generousity on this site! Question regarding carnosine or lcarnosine as an anti-ager: how effect is? can you recommend a dosage? i heard it`s best taken w/other nutrients like dmae. thanks again!! Have a Blessed Easter!!!

Answer:

Carnosine is a small molecule composed of the amino acids histidine and alanine. Carnosine is found in relatively high concentrations in several body tissues—most notably in skeletal muscle, heart muscle, nerve tissue and brain. The exact biological role of carnosine is not well understood, but many studies indicate that carnosine has antioxidant potential. Carnosine may also act as a neurotransmitter (chemical messenger in the nervous system). Carnosine has been called a longevity nutrient since laboratory studies on tissues indicate that it can delay senescence and provoke cellular rejuvenation in cultured human fibroblasts. Carnosine has been called the anti-aging and anti-oxidant dipeptide. The exact role of carnosine supplementation in human health is not clear at this time. L-Carnosine is a dipeptide composed of the covalently bonded amino acids alanine and histidine and is found in the brain, heart, skin, muscles, kidneys and stomach. L-Carnosine is naturally produced in the body by the enzyme carnosine synthetase.L-Carnosine supports healthy aging and cellular rejuvenation by its effects on two mechanisms: Glycosylation and free radical damage. Glycosylation is the oxidation of proteins by glucose resulting in cross-linking of proteins and which is implicated in loss of cell function, genome integrity and accelerated aging. L Carnosine also protects the aging process of the brain by retarding lipid peroxidation and stabilizing cell membranes. There are more studies doen on the L-carnosine and its effects. When you buy Carnisien you get both R and L isomers of the carnosine. The dose I take is L Carnosine (alanylhistidine) - 500 mg each pill. I take 1 carnosine capsule before or with breakfast daily. Happy Easter. JG 4.4.10

Question:

Hello Dr. I have been reading about the Raw Foods Diet. Some of the claims are interesting, such as improved skin appearance and decrease in wrinkles. Is there any scientific proof of these claims? Thank you for your time

Answer:

no scientific proof I am afraid. JG 4.4.10

Question:

whats true co2 laser called wihout the fraction? can u give me some other names to address co2 laser on its own? im searching but it comes up with other co2`s. I dont know what is what . Please suggest other names for co2???//?? so i can search upppp for it

Answer:

totally ablative CO2 laser.UltraPulse CO2 was the most widely known. JG 3.31.10

Question:

Dr. Garcia, Can your peptide cream be used under the eyes to diminish wrinkles or should I get the specific eye cream or serum? Also how would you use the peptide cream along with retin a and skinceuticals c & e? Do I need to use all three? Thanks.

Answer:

it can be used on the eyes also, no need for a different cream. I think if you desire you can apply the Retin-A first and then my peptide and skip the Skinceuticals. JG 3.30.10

Question:

i have heard of retin A does it make skin thicker?can it be used on the under eye skin to thicken it? and are there any creams on the market that stimulate collegen and plump skin? if so what are they? thankyou

Answer:

yes, it can. DMAE creams and my peptide cream also help. JG 3.30.10

Question:

thanxx for the tooth question, just that is says the root of these damn teeth or so long and they support da contour of da face. And if the tooth is replaced superficially i guess with the screws and all is it still ok? and wont effect face to sag? jst double checking and worried of the bad outcome ...... thank u , I kno weird question

Answer:

if it is a bridge, it is just superficial, if it is a tooth implant, that goes into the bone and is better in terms of losing contour. In cases where a bridge is palced, the bone lessens and then there can be contour changes.JG 3.29.10

Question:

ok, I have crooked eye tooth, the canines from each 4 corners, like the 2 upper ones and 2 lower ones.... It may sound like a dental question but seems while i was reading into this problem it effects the aesthetic part of face... now ya I want to remmove these 4 tooth and get tooth implants... I read at some net search that these tooth impact the contour of the face if ther to be removed. And that the face will sag and or age some how.. is this true? 30 yrs old female here. my dentist seems not care to answer properly but u know this is important for women ! so will removing these and getting implants effect dramatically the face to sag or age?

Answer:

If the tooth is replaced it will not change the face negatively, it is only if the tooth is removed, not replaced and the amount of bone in the jaw lessens. JG 3.29.10

Question:

sorry for the questions, I have just read that 4% hydroquinone is banned in the UK as it very harmful to the skin and can burn it?? But is this not the main ingredient in the Obagi nu derm system?

Answer:

a burn is highly unusual, what the problem was that it should be a prescription written by a doctor and that way the doctor can make sure intermittently that all is OK and that the hydroquinone was the approriate medication. When a patient self medicates, they could be using the wrong thing or not realizing that they might need a biopsy of a brown spot to rule out cancer. JG 3.26.10

Question:

is the Obagi nu derm system an effective system for sun damaged skin or is it overrated? Not sure to use Obagi now as a friend of mine said I would get better results with a 20% TCA with lactic acid. what do you think? x

Answer:

nothing special that most of the others do not have. In many cases it is a combination of skin care along with peels done to get the best effects. JG 3.25.10

Question:

Hello, Just wondering if hydroquinone works to help fade red spots or only brown? Is there any creams that will help fade flat red marks on the face (post blemishes)Thanks!!

Answer:

just the brown ones, it cna make the red ones more irritated.For the blemishes you can try ScarGurard or Mederma. JG 3.25.10

Question:

Hello, Just wondering if you can give your opinion...What ingredients should I be looking for to help thin/crepey skin around the eyes? What ingredients to help pores/texture? Thank you in advance for your help.

Answer:

retinols, glycolic acids, DMAE are good places to start. JG 3.25.10

Question:

is tca peels like 8% stronger then glycolic peels that are 20% in general?

Answer:

at that concentration, pretty similar. JG 3.25.10

Question:

would erbium laser be good for younger patients? i had it done once years before im 30 now. it had good results before. so don`t know if 30 is young or old for erbium laser results now.

Answer:

the older oen is the less impressive the results will be with Erbium lasers. JG 3.24.10

Question:

hi doc which tca is good?

Answer:

the concnetration to be used depends on what the patient needs, but as to TCA, it is generic, no brand better than another. JG 3.24.10

Question:

will retina help with the pores?

Answer:

to some degree. JG 3.23.10

Question:

im 30. female. i have pores on me nose and now i can see the wide pores alot. its seems like the tip of my nose is getting thick with a crackly look! you know like its not very smooth with some thickness. im scared it will get worse. what can i do to make it better? even if its a temporary fix i will maintain it. plzzz suggesssttt soemthinggggggggggg. thnxxxxxxxxxx

Answer:

IPL, microdermabrasions and beta hydroxy acid peels in the spa. JG 3.23.10

Question:

Hi Dr Garcia, I have purchased Revitol Stretch Mark Prevention cream for my pregnancy. I used it for my first pregnancy in the last 2 trimesters and avoided stretch marks. I noticed however it has Vitamin A in oil in its ingredieents and it is marketted as a natural product that is safe. I have been using it twice a day for the first trimester of this pregnancy. Should i stop using it because of the Vitamin A? Regards DG

Answer:

should be safe, but no studies have been done, the percentage of the Vitamin A absorbed is unknown. JG 3.22.10

Question:

Hi Dr Garcia. I have a small atrophy on my cheek after Kenacort injection, about 6mm diameter. It appeared after 2.5 weeks and is slightly white. Is there any way of telling how severe it is and how long it might last ? I read some atrophies can bounce back in a few weeks. Is there anything I can do to assist?

Answer:

in many cases it will fill in, it might take 6 months or more though, not much you can do at this point except wait, sorry. JG 3.20.10

Question:

Is Oil of Olay Regenerist Night Firming Cream a good moisturizer? Thanks.

Answer:

yes.JG 3.15.10

Question:

Hello Dr. Garcia. What is your opinion about Oil of Olay Regenerist Regenerating Serum? Is it good in fighting lines and wrinkles? Thanks.

Answer:

I think it is good, yes.JG 3.15.10

Question:

Let`s just preface this question by If I knew than what I know now . Too many days in the sun, I`m 40 and my neck is sun damaged looking in addition to some initial saggining and being that I can`t wear a turtleneck 24/7 I need a solution. Asides from a neck lift, are there any creams, lasers, peels, whatever that you can recommend--of course with the understanding that it wouldn`t yield as great of an effect as surgery?

Answer:

Retin-A and hydroquinonealong with a series of light TCA peels, 20-25% at most. Best of luck. JG 3.14.10

Question:

I wwould be grateful if you could answer a couple of questions for me. First, I always seem to have this dry flaky skin along either side of my nose. Is this a skin condition or is it just dry skin. My adult daughter seems to have the seem skin issue, although her skin is oily/normal and mine is dry/normal/sensitive. Second, I am currently using your Cell Matrix product at night. I was wondering if I can still use the Kinerase cream in the morning before sunblock and makeup. Or would this be overkill for my skin. Thanks.

Answer:

the nasal skin sounds like a skin issue that a consultation with a dermatologist might be able to prescribe some medication for. Even oily skinned people can have that problem.You cna certainly alternate the skin products you mention as you are doing. Best of luck. JG 3.14.10

Question:

TNS Essential Serum....your opinion?? thank you

Answer:

good. JG 3.12.10

Question:

Hi. I use Tretinoin (0.1%) - is it ok to use it under the eye area..and if so, how soon after CO2 laser can it be used. Final question, DMAE 4% is this in your cream. t.y.

Answer:

OK to use around the eye but might need to build up to it by not using it every day at first. As to using it after the CO2, I suggest at least 6 weeks if possible. As to the DMAE %, yes, correct, but we have switched our creams over to a multiple peptide cream. JG 3.10.10

Question:

Is it the cell matrix peptide cream you carry that is good for under eye wrinkles and crow`s feet? And also will it work compatibly with retin A .05% used at night . i am 61. Regards P.H.

Answer:

yes to both, apply the Retin-A first and wait 10 minutes before the matrix cream. JG 3.9.10

Question:

I am a 37 year old male. Do you know of a cream that can be usedd to remove dark circles under my eyes? My mother and sisters seem to have the same problem.

Answer:

we have one on our shopping cart that hessp many but not all patients. JG 3.8.10

Question:

I am a 63 year old female trying to soften my wrinkles. I have read about a deep chemical peel and the results (I have seen) are amazing BUT the thought of something that strong (and recovery time of almost 2 weeks) is scary to me! Do you know of a product that can be used at home that could be used for a few months and get the same result. In other words.... a few mini chemical peels, etc. Thank you.

Answer:

there is no free lunch, you can have something that heals shorter, such as a lighter chemical peel or a lighter laser but then there will not be as much of a difference.Sorry. A series of light ones does not equal one deep one. JG 3.8.10

Question:

Good day. have u heard of MLAB products based in the UK. Expensive but apparently very effective. Am currently trying the Anti-aging cream but as i said, they are pricey so don`t know if i can afford to keep buying this stuff. Looking 4 your honest opinion. Are yours similar. Thank u.

Answer:

I think ours are at least as good if not better. The company has alot of hype with nearly nothing to prove their claims besides testimonials. No scientific evidence aywhere. JG 3.7.10

Question:

Hello Dr. Garcia - just wanted to thank you very much for the advice you gave... I posted the question about the pimple causing eye swelling. I did see my doc as the swelling became worse and she said it was peri-orbital cellulits and prescribe augmentin x 10 days. Said it could be serious if not treated promptly. Thanks again!

Answer:

my pleasure. JG 3.7.10

Question:

Hello, I am wondering what is the most effective method of removing/preventing blackheads? I have tried pore strips and microdermabrasion without much success. Thanks for your advice.

Answer:

glycolic acids products and IPL lasers might help, best of luck. JG 3.6.10

Question:

hi. i have been taking yaz birth control and i am on my 7th or 8th pack now. i have been seeing very slow improvement in my skin over the time i have been taking it. my skin was almost better, i was feeling hope again that my skin would clear up and then all of a sudden i started breaking out in this weird way. i am getting these weird patches on my face. they start out as looking like these little clogged pore bump things and then they start clumping up into these clusters. they look like little patches of bumpy clusters and sometimes they itch a little. i have been researching and eczema sort of looks like it, but i have oily skin, doesnt eczema appear on dry skin? also they are only on my face. i heard of milia, which sounds like the kind of acne i was having before the yaz and a little still. but i am so confused. i cant figure it out. i have seen 3 different dermatologists and they all just throw the next drug at me without really seeming to care or listen to me. i have a 2 hour drive to any dermatologist and it is so frustrating to take the time and drive there hoping for something that helps just to be even more depressed when i leave. i am hoping you can give me some hope?? can you help me figure out what is going on with my face please?

Answer:

impossible for me to tell without seeing it I am afraid, sorry. JG 3.5.10

Question:

Dr. Garcia, I had a couple of hypertrophic white spots on my face, that sort of looked like moles, treated with the surgitron device to see if they would improve in appearance. The procedure was done almost 4 weeks ago and the areas are healing fine and are still pinkish/ red. I was wondering how long you would recommend I wait before I start using my obagi nu derm system again on those treated areas? Can the retin-a and hydroquinone cause some sort of delay in healing or make the areas worse?

Answer:

wait 4-6 weeks, it can be irritated by those products if applied too soon, yes. JG 3.5.10

Question:

I am taking yaz birth control. i am also take murad skin clarifying dietary supplements which contain yellow dock and burdock to support the bodys ability to remove blemish producing toxins. I am wondering if you could tell me if these vitamins will interfere with my birth control?? I have tried looking it up online and have a hard time finding what im looking for, so i hope you can help me with this.

Answer:

I know of no studies where the two have been studied for that comparison, I do not think they would interact, but no way to tell 100%.Sorry. JG 3.4.10

Question:

Hi. Dr. Garcia. Thank you so much for taking the time to answer all these questions. I am blonde hair, blue eyes, medium skin, 39 and I feel my skin is rugged. I currently have mild to moderate acne and mild pitted type acne scarring. I feel my skin looks dull. I was thinking of having the Levulan done with the Blu light; however I was also considering having dermaplaning done. What are your thoughts on dermaplaning(I heard this can also get rid of blonde peach fuzz facial hair)? Could these two work well in conjunction with one another? Also, what do you think about follow up with squealene oil? Thank you again for your time!!

Answer:

I am not a fan of the Levulan treatment as it erases the safety profile of the light source and makes it essentially no better than an older chemical peel, just sounds newer. I think dermaplaning, in experienced hands does quite well, or traditional chemcial peels or lighter lasers. All should improve your concerns. Best of luck. JG 3.4.10

Question:

Hello from Canada. I just received the two products that I ordered from your office: cell matrix peptide and dark circle (eye) cream. I am applying before bed, as your instructions. My question is as follows: after I apply the eye cream, there seems to be a tightness that follows a few minutes later. This also occurs with the cell matrix cream, especially in the forehead region. I don`t apply any other creams, lotions, etc. I cleanse my face with Cetaphil cleanser, pat gently dry, and then apply your products. Is this a side effect of using the peptides? I use very small amounts. Also will the cell matrix cream help with freckling and hyperpigmentation. Thanks.

Answer:

yes, it is a temporary effect as the products are absorbed, we use liposomal technolgy to push the products through the skin. It is a feeling off dryness but is actually not drying to the skin at all. I am afaid that the matrix cream does not help with the freckling or brow spots, for that you need another cream and we did not include that ingredient as it will, by its nature, irritate the skin and we were trying to avoid that. You can get some hydroquinone 4% cream from your local doctor for the spots. All the best. JG 3.3.10

Question:

HI-first, thank you for answering a ? I asked re: juvederm injections I had in my tear troughs. Second, a question regarding your products. I was born looking tired. I don`t really have bags or wrinkles-I am 42. Should I use your dark circle cream or serum-what are the ingredients? Do they help when the circles are inherited? Thank You!!

Answer:

they will help with the inherited dark circles too, although injections also can help, the main ingredient in the dark circle cream is haloxyl, but there are other chelating agents in it also. JG 3.2.10

Question:

Hello, I have a large painful pimple between my eyebrows toward the right side. It has made my right eye noticeably swollen in the inside corner. Should I worry - could this be an infection rather than an ordinary pimple? Isn`t it odd that it has made my eye swollen? Would ice or a hot pack be helpful? Thank you.

Answer:

well, I do think it might be worthwhile to see your primary care doctor and get some antibiotics to get it to settle down faster due to its location. It is actually common for the eyelid to get swollen as gravity pulls the swelling into that direction. A warm pack would be better at this point to get the infection to hopefully open and drain on its own. JG 3.2.10

Question:

Hello, I am wondering if IPL can cause breakouts? I had make-up on during the IPL session - I asked the technician if I needed to re