Question:

Do both Niacin And Niacinamide  interact negitivly with vitamin C If combined in creams and serums??

Thank you for your time, I appreciate your opinions.

Answer:

The question of mixing these creams together and having the side effect of weakening both is not true with niacinamide and Vit C. They are both good products and can be mixed together if desired. I will say that when mixed, they turn to a yellow color but they still work well. Mixing niacin with Vit C can cause some redness, a rash appearance, and flushing so most people avoid it.

Question:

For example, if the wound is closed is there any need to apply vaseline to promote healing? Thank you

Answer:

There is no advantage to applying Neosporin or Vaseline to a closed would. It can, depending on the location of the cut, cause plugged pores.

Question:
Answer:

The skin on the nose is fairly sturdy and does heal well compared to thinner skin like eyelids. I would anticipate a few months of looking pink but should all fade in time if superficial

Question:

The ingredient Albumen is in a product a friend swears by, but I can't for the life of me see this as better than AHA  or Retin-A or even a Peptide. Is there something I'm missing? She says she knows it works because she can feel it tighten her skin? Thank you for you time and input

Answer:

Your friend can swear all she wants, Albumin placed on the skin will 'tighten' the skin but as soon as your face moves the protein will crack and flake off, a process you might not see. They have been using albumin for almost a centruy and someone is always trying to make it sound new. The common source of topical albumin is from raw eggs, taking the faint clear material and applying it to your face. Save your money

Question:

Hi Dr. Garcia.  Can you recommend a topical treatment to reduce dark pigmentation around the eyes?  Something that can be used on eyelids as well as undereye.

Answer:

If it is a brownish discoloration from sun exposure, then a mixture of hydroquinone and Retin-A will help. If it a blueish or just a darker color of the skin then the topical creams will not work. Fillers will fill a depression that may be darker but will not remove any darker bluish discoloration. I am afraid lasers will also not help. It is a genetic issue in an area with very thin skin and the bluish color comes from the blood vessels just underneath the skin. I wish I had a solution for you but I do not.

Question:

If you ride on a plane after scar revision, whether you still have stitches in or if the stitches were recently removed, will the air pressure stretch out your scar (if you have  probem with scar stretching out after scar revision)?

Answer:

There should not be any problem with you flying after a scar revision. There would be minimal air beneath the skin that would expand enough to cause any excess stretching of the new repair. Fly without a concern

Question:

Questions regarding SkinMedica TNS Essential Serum for repair of collagen and elastic fibers?

Answer:

It helps many, but not all. It does help collagen formation but I have not seen an elastin recreated by that product.

Question:

Tiny red dots on skin

Answer:

you likely have some small capillary hemangiomas. Common with the passing years.Your plastic surgeon can easily hyfercate them in the office for you. You will likely get more with time though.

Question:

What is your opinion of Plexaderm, which claims to tighten the skin to reduce the appearance of herniated orbital fat and facial wrinkles? Thank you.

Answer:

It will tighten and make the puffyness and the small wrinkles get better as the material dries, kind of like shrink wrap. It might last a few hours but less if your face gets wet or you sweat. It is not a long term fix. Makeup applied over it may not stick very well.

Question:

I know you're a fan of Olay products. What do you think of the Strivectin line ? I used to use their main product (a moisturizer) when it first came out about 14 years ago, and I liked it very much. For some reason, I stopped, and in the meantime, they have launched many more items in their line. Thanks for your opinion and for all the help you give us!

Answer:

Over-priced, outrageous claims, but other wise are OK, no better than many others out there at a fraction of the cost

Question:

What is your opinion of the product Crepe Erase, a topical cream usedto reduce the appearance of crepiness in aging skin? Worth the cost?  Better than other moisturizers? If you do not think it is worth the price, what other moisturizers or combinations of them would you recommend to achieve the same results as this product promotes? Thanks for your help! 

Answer:

I have not seen any advantage with Crepe Erase over most other over-the-counter moisturizers.  Aveeno, Lubriderm and Nivea are good.  I use just coconut oil on mine and it absorbs faster with no smell and works well

Question:

Hi Dr. G.,

I have dark skin. I used small bandages to cover up the site of my mole removal. I have worn bandaids on and off throughout the past few months but gradually I decreased this. Now I don't wear them and the hyperpigmentation has faded slightly but it's still there. Can I do anything about this or will it fade in time? Thank you

Answer:

It will fade on its own with time, but using products like hydroquinone and Retin-A will help, your physician should be able to write the prescriptions for you. Of course, continue to use unblock and not sunscreen when outside or under florescent lights

Question:

Hi Dr. G.,

Can the light from a normal flashlight cause hyperpigmentation?

Answer:

A normal flashlight does not emit the wavelengths nor strength to cause hyperpigmentaion

Question:

Thanks very much for the answer about the at-home LED devices.  Any difference at all between the one I sent you in the link (a model that sits above the skin) and the mask-variety (that sits directly on the skin) ? And what about the ones that are medical-grade and available in a dermatologist's office? Are those any good at all or just as useless/harmless as the at-home devices?  Thanks again for your generosity in sharing your opinions with all of us, Dr. Garcia.

Answer:

I do not think the mask will work any better than the one that does not come into contact wit the skin. I think the ones in a doctor's office will be stronger but it still will not be a dramatic effect. Both will be harmless though. Thanks for posting the questions

Question:
Answer:

In my personal opinion, I cannot say that the home device will help the skin any more than the body's own healing capabilities, although I do not think it will hurt in any way

Question:

Hi Dr. G.,

I'm the guy who keeps talking about the radio-frequency mole removal. Things are looking better. If I do have a scar, it's likely on tilting towards the normal side of things. It's mostly aligned with the rest of my surrounding normal skin (in terms of level). It blends in mostly well.

But I do have a ring of hyperpigmentation. Is it safe to use hydroquinone on this surrounding hyperpigmented skin? Will hydroquinone adversely impact the normal (or hypertrophic) scar?

 

Answer:

Hydroquinone will help the surrounding hyperpigmentation but if it gets on the scar it will irritate the skin and make the healing take longer

Question:

Hi Dr. G,

Can post-inflammatory erythema from ablation of some kind subside on it's own? I have it and it's of a pink hue, 2 months post-op. Ty

Answer:

The erythema can fade in time as long as nothing irritating is done to it. The fading process can take months though.

Question:

Thank you Dr. G for patiently answering all my questions about my radio-frequency mole removal.

I think it looks like a normal scar. Flat and mostly blended in. I imagine it could improve with time or maybe with some other treatments (such as resurfacing).

However, I have brown skin. Do I have any options for lightly resurfacing this area? Would it make matters worse?

Answer:

In your case, I think the best thing is to let the body do what it can without anything invasive being done for one year and then re-evaluate at that time

Question:

Hi Dr. G.,

Can a 'normal' scar have texture resembling healthy skin? After a period of months, this hypothetical 'normal scar' can blend in totally?

Answer:

although in some cases the scar will fade and it might be hard to discern, but there is ALWAYS a scar, it will never be totally the same as the surrounding area, sorry

Question:

Hi Dr. G,

Aside from silicone gel sheets, is there anything I should be doing post-radio-frequency mole removal? I'm 2 months post-op. I am using an AHA cleanser. No other creams or lotions. Just the silicone gel sheeting. Ty

Answer:

That is about all you can do I am afraid. 

Question:

Hi Dr. G.,

 

Out of curiousity, is it possible that following ablation of any kind that the skin may appear shiny for months on end and is not necessarily scarring but taking awhile to return to normal?

Answer:

It is possible, but since heat was involved, the possibility still exists that the deeper structures required for normal healing have been damaged, so there is no way to tell except waiting it out

Question:

Hi Dr. G,

I am the person who had radio-frequency mole removal. I am 2 months post-op, and have been using silicone gel sheeting for the past week or so. Things have improved but I know I'll have to use the sheets for 3-6 months. 

I was wondering if Retin-A is safe to use on the scar? TY

Answer:

I see no reason to use Retin-A on your scar.It might even thin the skin out further.

Question:

Hi Dr. G,

I hope you had a fun New Years. 

I've been asking about my post-op radio-frequency mole removal wound healing. In our last correspondence you said it was an atrophic scar that would need to 'fill in' (based on my own descriptions). However, as I see it now, the site where the mole was removed is now slightly elevated, pink/reddish and smooth. It's been 1.5 months. This elevated area is very tightly demarcated. You can tell that this is where the mole was removed. It's also a bit shiny.

What I was getting at in my last question is whether this is a clear sign of hypertrophic scarring OR in your experience, is it possible that the wound is still remodeling? In other words, can this raised skin come down with time? I read somewhere that as the skin heals from ablation, it needs to go through cycles of natural exfoliation (taking months). In other words, as you've been telling me already - I need to wait this out?

Answer:

the remodeling of the area will take 6-12 months, although most of it should occur in the first 6. Yes, unfortunately, it is  a matter of waiting at this point.

Question:

What do you think of Profound (formerly ePrime)? I have a friend who did it and whose skin snapped back up and developed volume in three months' time. She looks fantastic (after 3 weeks of truly hideous downtime from bruising and swelling). But I see you don't think much of any skin tightening technologies.

Answer:

I think the results are unpredictable and you cannot count on you having the same success your friend did. You also have to understand that any benefit will likely not last very long.

Question:

After radiofrequency ablation, will the ablated skin plump up somewhat? Even if it's a little? Or will it stay depressed. I also had lidocaine injected prior to the ablation (to treat a DPN). So the surrounding of the wound-site is slightly (very slightly) raised. This may exaggerated the depressed look of the post-treatment site.

Answer:

There is normally a ridge at the edge of the wound that is created by the cells trying to bridge the wound closed. There is usually a depression though from the radiofrequency heat which can leave a small depression depending on the energy used. It is a mixture of skin injury as well as subcutaneous fat loss. That can be permanent.

Question:

Facial scar

Answer:

I suggest using either ScarGuard or Mederma for the scar, once the sutures are removed, it can be applied

Question:

What do you think of hyaluronic acid dietary supplements? Do they improve skin quality and texture?

Answer:

taking hyaluronic acid supplements orally will never improve you skin. It is a scam trying to capitalize on the name of the product and get you to buy it. The hyaluronic acid will be totally digested in your stomach and intestinal tract and will never reach you skin. Sorry.

Question:

What are the BEST two ingredients to look for in diminishing/removing age spots. Thank you for your valuable time!

Answer:

many people use retinol, an OTC product, but the effects are very mild. I prefer to use Retin-A and Hydroquinone but they are prescription medications that are mixed for the best option to fade brown spots with a cream.

Question:
Answer:

I think the products from Omni Bioceuticals are excellent, but sold only in doctors' offices. For OTC, at a lower price and still quite effective, I like Olay Regenerist skin care products. They are available at most department stores and pharmacies

Question:

hi , i would like to ask , is it ok to wipe 70% Isopropyl alcohol onto the skin prior to applying topical antibiotic cream , Fucidin Cream ( Fusidic Acid ) .. or would doing so would make the antibiotic cream useless or less potent   ..... also , would applying a topical antibiotic ointment, Fucidin Ointment  ( Sodium Fusidate ) instead of its cream version ( Fucidin Cream Fusidic Acid ) make a diffrence .. i mean when you want to wipe isopropyl alcohol prior to the antibiotic ..thanks

Answer:

As long as you allow the alcohol to dry it will not cause a problem. You can use either the cream or the ointment with the alcohol wipe prior, not a problem.

Question:

Do you like Bio Oil to improve the appearance of scars and for general overal evenness of skin tone?  And what do you think of the line of products known as "Meaningful Beauty," owned by Cindy Crawford? Thank you.

Answer:

I have not had any patients use Bio Oil so I cannot endorse it. As to Cindy Crawford's products, in general, I am always a little suspicious about celebrity endorsed products as to their 'superiority' over others

Question:

Good news Dr. Garcia, I am the one who had laser on the nose which caused severe vessel matting. One month later and the redness has reduced a good 40%. I have some leftover momesetone steroid ointment leftover from a long time ago. I apply it every few days or so but I'm not sure. Will this help or hinder my healing?

Answer:

I would avoid the steroid cream as it can thin the skin and actually make blood vessels be more easily seen. I am so glad it is slowly getting better. Just let nature take over and avoid the cream.

Question:

I have very sensitive type I skin. Might microdermabrasions cause capillaries to rupture?

Answer:

That all depends on the strength to which the microdermabrasion machine is turned up to. Keeping the suction on lower settings makes it safer, possibly a little less effective, but safer.

Question:

Is there any benifit to Cryotherapy? I could get my whole body done, but if there is no benifit, why bother and waste money! I'm 53 years old if that matters. Thank you for your time!

Answer:

I believe cryotherapy has some benefits as to recovery from a hard training session. It does help reduce inflammation and gets you back to strenuous working out with less aches and pain. As to cellulite, fat loss and general well-being, not so much.

Question:

My palms are wrinkled and finger tips are shriveled. My right one is worse than the left one and the skin between my thumb and index finger is thin and looks stretched out. bub

Answer:

The most common reason for that is exposure to some type of irritant that your hands are coming into contact with or sweating while working with rubber gloves. In rare instances it can be a sign of dehydration, but that is unusual to show up on your palms. Take  a look at anything new you might have exposed your hands to and eliminate it to see what happens.

Question:

What is the best way to brighten dull skin besides exfoliating scrubs and alot of water?  thank you!!

Answer:

I think improvements can be achieved with microdermabrasions, light chemical peels, as well as platelet rich plasma in conjunction with microneedling and additional growth factors.

Question:
Answer:

I think the effective part of skin hydration comes after the Hydrafacial, in terms of your skin getting the needed products it requires. Coconut oil or squalene oil are great skin moisturizers. I also think the higher end Oil of Olay line is quite good and affordable. More expensive products do not always work better than the lesser expensive ones.

Question:

Hello Dr.  How good is hydrofacial to help hydrate dehydrated skin?  Or are there any other skin care products in the drugstores that you would recommend to bring moisture to the face. I am currently on fish oils , using coconut oil, and oil of olay moisture serum.

Answer:

The Hydrafacial is likely not going to add much over what you are doing at the present time. I do think some type of exfoliation such as microdermabrasion when your skin is dehydrated aids the penetration of your skin care regimen.

Question:
Answer:

I am not a believer in Hydrafacial. They make lots of claims and I do not see how much of what they claim will happen actually producing an effect seen visually.

Answer:

I see no ingredient in it that will make it any better than the myriad of other products claiming the same, they just use different celebrity "users" who get paid to endorse it

Question:

Will Lactoferrin help with moderate cyctic acne?? Thank you for your time

Answer:

Scientific studies do show that lactoferrin taken orally does help with acne, it works through an anti-inflammatory effect

Question:

Silly question, but I can't get a straight answer from aesthetiticians who have a vested interest in selling their product. Wouldn't individual eyelash extensiions pull out one's own eyelashes, since they are attached to the native lash with glue? All the aestheticians say no, but I'm skeptical. I have very thin, sparse lashes and after just one round with these things, they look even thinner. My aestheticians says it's just because I forget how thin they were before the application, but I don't think so. Sorry to bother you with a non-medical question!

Answer:

If the eyelash extension does pull out the native eyelash along with the follicle bulb, the natural eyelash will be permanently gone. Does that happen all the time, no. Does it happen sometimes, yes. Hope that helps, I agree with your skepticism.

Question:

What do you think of this product, Dr. Garcia? http://www.highya.com/beverly-hills-md-crepe-correcting-body-complex-reviews Valuable? Useless? I'm not sure that there's a lot to be done about crepey skin, especially on the arms, leg, and throat. I've tried ThermiTight and various lasers, and they've helped a little bit, but I'm looking for something additional. Thank you for your opinion.

Answer:

I think you have already utilized more powerful things than the cream you mention, I would save your money

Question:

I have been hearing a lot about DNA testing for skin care.  Do you offer that at your office?

Answer:

ID DNA is a revolutionary product line recently released in the US. How it works is the potential patient has a DNA test done with a swab inside the mouth, just like we see on TV. It is simple and the patient does it themselves. The sample iis then sent off to get your own DNA results. What they look for are the genes that affect aging skin.  A large report with the resutls of your DNA are sent to the office for review with me.The company then formulates a unique set of creams and oral vitamin supplements to improve your skin. The patient will use an intensified formualtion for a while until the skin improves and they then go on a maintenance regimen. The creams and supplements are made for each individual so one's sister or brother would get different creams as their DNA is different. It is a revolutionary concept that will make buying expensive creams on a trial and erorr basis obsolete. I am very excited ot be one of the initial offices in the US to offer this new technology.

Question:

Thanks for your answer. I forgot to tell you that I use Retin-A already. What do you think of micro-needling on the arms?

Answer:

personally I have be unimpressed by the results while the claims are pretty over-exagerrated once the swelling goes away

Question:

I'm 56 and have begun to have that terrible crepey skin on my forearms. I've had several Fraxel treatments and one ThermiTight, but that hasn't seemed to do much.  (I use sunblock every day, exfoliate several times each week, and moisturize constantly.) Are there any topicals that might improve the texture and tone of this skin? I saw recently that you told another questioner that you think the new  ZO items are very good. Anything in that product line that might help? Probably nothing, but I thought I should ask.  I wish I had laminated myself at 20! Thank you, Dr. Garcia.

Answer:

About the only thing I can suggest for you is Retin-A, might give you some improvement.

Question:

I had a minor scar revision recently and was put on cephalexin for 4 days. On the fourth day, my mild rosacea flared up in a way I have never seen. I've been managed the very mild flushing with a gentle salicylic acid face wash and Metrogel for the past 18 months, but now I am covered in flat red papules and horrible blotchiness. Could the cephalexin have caused this? The Metrogel isn't doing a thing. What would you recommend? Doxycycline? Peels? IPL? I look just terrible. Thank you for your kind help, Dr. Garcia.

Answer:

The cephalexin can cause that in about 0.07% of patients, the effects of the cephalexin should wear off in a week or so, and then with your normal routine it should settle down. I do not think peels are good right now, might suggest Bactrim or Doxycycline as an oral pill to take,

Question:

My gf has suffered a pretty bad case of ance induced pih on her chest, face and back for several years. Creams do not seem to help much and aggravate her skin further causing more acne. She does not have that much active acne though, more red and brown skin discolorations hanging around and accumulating. She is olive complexion and 27. What are the best lasers to handle this problem?

Answer:

I would suggest an Nd:YAG laser for her issues. I wish you the best.

Question:

What is this Peptide
Syn-ake peptide

Answer:

it is  a peptide reportedly made form snake venom that promises to work like Botox by paralyzing the muscles under the skin. If it were true, it would be a prescription drug and not sold OTC. I would not suggest you buy it.

Question:
Answer:

it is a peptide reportedly made from snake venom that claims it works like Botox in that is paralyzes the muscles to decrease wrinkle. In my personal opinion, IF that were true, it would be a prescription drug and not sold over the counter. I think they are using very little science to convince people to buy something that is likely just a moisturizer. I would save your money.

Question:
Answer:

I have no personal experience with the technology, all the pictures on their website appear to be 6 months or so after the treatment. The issue with RF is getting the tissue to the correct temperature for a described amount of time. If you cannot maintain that temperature, the results will not be very dramatic. I would wait until there are some longer term results to look at for now.

Question:

Thanks for your answer the other day about my chemical burns. I forgot to ask: I know that burns heal from the bottom up, but do they heal from the outer perimeter towards the center or from the center to the outer perimeter? Thank you. My burns look just terrible. So eager for them to heal!

Answer:

They only heal form the deep to the superficial but there is a process called contracture that pulls the intact skin on the edges into the center. Hang in there, it will get better.

Question:
Answer:

Short of a light laser, there is nothing topical that will really help, sorry. The laser will likely give you 6-18 months improvement at most before it needs to be repeated

Question:

Of any benefit at all? Worth the relatively low investment of $150?

Answer:

In my opinion, none. Sorry.

Question:

Shiny flat, slightly discolored spots on my forearms and hands. Actinic keratoses? I've had multiple chemical peels (maybe 35-40 in the past 5 years) and many, many laser procedures (Q-switched YAG, Alex, short-pulsed YAG, 12 Fraxel ReStore treatments, etc.) Anything else you recommend? I am now 50 and have had zero sun exposure since sunblock was invented (I use full spectrum SPF 50 6-8 x/day 365 days/year, always wear layers and layers of clothing and never go out between 8 AM and 7 PM. Ever, because I work very long hours and commute before dawn and after dusk. No fluorescent lighting either. But  I had absolutely  no sun protection in infancy and childhood. I know that's the culprit.)

Answer:

it does not sounds like actinic keratosis. Might want to see a dermatologist in person but they might be molluscums. Might be able to treat them with cryotherapy

Question:

Any thoughts about this line of products? https://www.genucel.com/?utm_source=Google&utm_medium=cpc&utm_campaign=G...  I've heard good things but always want to separate hype from reality. Thank you!

Answer:

pretty similar to lots of other products out there that have Matrixyl in it. There is some reality, mild, by what their clinical trial  show in pictures, but like most skin care products, there is also a lot of hype in the marketing.Plant stem cell products do not necessarily transfer effects to humans and one needs to also realize that there are no live stem cells in the product either.

Question:

I have two prominent instances of this one my face -- glabella and nose! My dermatologist has tried DCA to no effect. What do you recommend next? Shave excision? Cryotherapy? Something else? Thank you.

Answer:

I usually hyfercate those with a cautery unit, byt cryotherapy has also been used.

Question:

Dr. Garcia,
 I large light brownish/reddish spot that looks dry and as if something is eating my skin. A dermatologist told me I had rosacea on my cheeks, it has been more than a year and it is getting worse. Is there another product you recommend for this?
Thank you, 
Ariceli

Answer:

I use topical antibiotics, starting with cleocin and I also recommend doing IPL photo-facial sessions or a light Nd:YAG laser to help control it. It gets worse in the summer with the at though

Question:

Hi Dr., in reference to acne, and acne scarring, does "needling" really help? The process sounds a bit barbaric, and wonder if down the road (only being 26) it would actually cause skin thinning, or other problems. Would you suggest just using squalene oil, or another not so harsh product?

Answer:

squalene is a great moisturizer but by itself will not do anything for acne scars. As to the long term consequences of needling, it is more likely to cause slight scarring and stiffening of the skin more than any thinning effect.

Question:

What do you think of it?

Answer:

In general, although I think the Vit C ester and the DMAE are good skin care products, it is pretty pricey and when you compare it to other, non-celebrity sold products that have the same ingredients, it is still a bit pricey. I am not saying it is not a good product, its just that you can likely get the same at a fraction of the cost is all.

Question:

Any thoughts about this cream (enriched C+E)? Both my PS and dermatologist--and I've noticed some others too of late--but as ever, I'm skeptical of the real benefit of any topical. Thanks for your constantly candid opinions, saving us money or helping us to invest it wisely.

Answer:

should do well for fine lines and such, but I hate when they use terms like firming the skin because it all depends on how you define that. I always think of firmer skin as more snug or tighter, something more than a texture change. I do not think it will snug or tighten you skin but it likely will help the texture and feel of the skin and help the fine little lines, but not any deep ones you might have. No cream can do that because if it did, it would be considered a drug and not a cosmetic.

Question:

I am confused about skin bleaching creams. After brown pigment diminishes, will the same brown pigment in same spot come back if you are exposed the sun (wearing sheer top, etc)? Or is the brown spot removed so the same brown spot will not come back meaning if brown comes back in that area, it will be new spot? I have brown hyperpigmentation or brown lines on my skin from laser damage, not sun damage. So. I was wondering if the sun might make these brown lines come back after a skin bleaching cream removed it? And do skin bleaching creams work on this type of hyperpigmentation?

Answer:

The melanin cells in the skin have memory and in time with sun exposure it will return. Many people think that clothing provides a sun protection and it does to a small extent, maybe a SP of 15 or so in terms of t-shirts and items like that.There is nothing you can do to permanently remove the brown spot I am afraid. The bleaching creams do help but it is temporary.

Question:

I am confused about skin bleaching creams. After brown pigment diminishes, will the same brown pigment in same spot come back if you are exposed the sun (wearing sheer top, etc)? Or is the brown spot removed so the same brown spot will not come back meaning if brown comes back in that area, it will be new spot? I have brown hyperpigmentation or brown lines on my skin from laser damage, not sun damage. So. I was wondering if the sun might make these brown lines come back after a skin bleaching cream removed it? And do skin bleaching creams work on this type of hyperpigmentation?

Answer:

The melanin cells in the skin have memory and in time with sun exposure it will return. Many people think that clothing provides a sun protection and it does to a small extent, maybe a SP of 15 or so in terms of t-shirts and items like that.There is nothing you can do to permanently remove the brown spot I am afraid. The bleaching creams do help but it is temporary.

Question:

I am going to be in a very how climate for 3 months  and due to the nature of my job. I will be in the ocean for hours a day. I'm wondering if at this time it would be a determent or help to continue using retinal/retin a type products at night like I usually do and also sunscreen during the day? Wondering if the retin a at night may make me worse off by making skin more vulnerable during the day even with sunscreen.

Answer:

The Retin-A can sensitize your skin to the sun and may make it more susceptible to burns as the sunblock does not stay on well in the ocean

Question:

 Hello Dr. Garcia. I am pleased with the results obtained (for melasma) from using 4% hydroquinone morning and night. Now that the melasma is faded, what can be used to prolong the results? Vit C, HQ less frequently, antioxidants, etc.? I am already using a good zinc oxide/titanium dioxide sunblock religiously. I just want to know what more can be done to maintain these results and prevent relapse of melasma for as long as possible. 

Answer:

HQ and sunblock is all you need for the prevention or slowing down of the return. for that specific issue you do not need anything else, although you can use them for skin quality at the same time.

Question:

Happy Holidays Dr. G,
 
I have previously had LHR in the summer of 2013. I feel it did not work at all and left me with induced growth.
 
I was also left with PIH which has persisted until the present. I used Obagi for a time (but ran out of toner early on). I then began to use the Retin A infrequently.
 
I felt there was some improvement but ultimately things seemed to return back to normal. 
 
The PIH-spot in-question is about the size of a dime. Is it possible that this is permanent? Should I try Obagi again? Or could this be something completely different?
 
Some days this spot looks fainter than usual and other days it looks red! Today, it looks very irritated. I put concealer on it yesterday so I assume that may be why.

Answer:

Look for  a dermatologist or plastic surgeon that has an Nd:YAG laser and have them treat the spot with that, much more effective than the Obagi at this point. Stop the creams for now until you see them

Question:

Any time I've had microdermabrasion, I've been left with hundreds of broken capillaries which I then need to address with multiple laser and/or IPL treatments. What other methods of effective exfoliation do you recommend for such sensitive skin as mine? Microplaning? Hydrafacials? Something else? Thank you!

Answer:

I would try microplaning next but it might happen with that too. Otherwise it will need to be light hydroxy-acid peels

Question:

Hi, Dr. Garcia. What is your estimate of the NuGene line of skin care products? I am especially interested in knowing if you think that their NuCell serum is good. It's quite pricey, and I don't want to waste my money. Two friends who are aestheticians use their products and love them. Thanks for your advice.

Answer:

it is hype, there is no possibility of a stem cell placed on the skin doing anything, the stem cells will not survive in the product nor on your skin. Sorry

Question:

Hi, Dr. Garcia. What is your estimate of the NuGene line of skin care products? I am especially interested in knowing if you think that their NuCell serum is good. It's quite pricey, and I don't want to waste my money. Two friends who are aestheticians use their products and love them. Thanks for your advice.

Answer:

For clarification, the company does not place any live stem cells on the skin, they use products derived from fat cells where cytokines and growth factors exist and then the surround them in a nano-some carrier to deliver it to the area. What would be hype is companies claiming to use stem cells directly on the skin. The scientific evidence they show appears to be conducted by the company and they post no links to peer-reviewed scientific articles. I personally have not used the skin care products but have heard from a couple of users  that they did not see much difference compared to other things they had tried, but they do post testimonials on their website. More than that, you will have to make up your own mind on whether to try it.

Question:

I've been reading this blog for the past couple of days and see that you've made a distinction between collagen and elastin, which, if I understand it correctly, is a protein fiber in the skin. What, if anything, can be done to improve elastin and the skin's elasticity? Might diet and supplements help if dermatologists have nothing to offer? Or is this something  that simply deteriorates with age, with nothing to be done about it...like so many other parts of aging? Sigh....

Answer:

I am afraid that I know of nothing at the present time that can increase elastin. Companies commonly clump collagen and elastin together, but they are different molecules with different roles.It does deteriorate with age and things like sun exposure and smoking accelerate it but at the present time there is nothing that can increase production or slow the breakdown of it. Sorry

Question:
Answer:

I think fillers last very short periods of time and can get lumpy. As to IPL, i think it is safe but the more ablative lasers, even the fractional ones either do too little if done at low energies or can result in scars if done at stronger settings.

Question:

I use Retin A but may need something with more moisture to it. I have used your peptide cream in the past and seems to work good. Thanks

Answer:

the gold standard is Retin-A and if your skin gets too dry from it you can apply it, wait 15 minutes and then layer a moisturizer over it. Glad you liked my cream too.

Question:

Looking for something to help with fine lines and wrinkles. Also to firm skin under my eyes.

Answer:

I have not been impressed by the effects and do not use it in my office.

Question:

I had a Visia analysis of my skin done last week. Wow! What a mess under there! I had extensive daily exposure to the sun for the first 20 years of my life, including countless burns. Since the invention of sunblock, I've used it religiously and stayed out of the sun, but the damage was done.  It's like coating rotten stairs with new paint every morning. I'm now 53 and embody full employment security for a small army of dermatologists and aestheticians. I have a fractional resurfacing every two years, punctuated in between with non-ablative resurfacings, IPL's, and Genesis. I use Retin-A 10 months/year and hydroquinone intermittently prn.  I use CE Ferulic acid every day and glycolic acid cream in the mornings. I have mild acid peels every 8 weeks and medical facials monthly. I've tried every kind of heat-delivery system there is: RF, ultrasound, long-pulsed YAG, infrared, etc. And then, after ALL that, I discover a mine field of sun damage just beneath my epidermis waiting  to erupt! Here's my question: the aesthetician who did the Visia photography for me assured me that all that damage will indeed "rise to the surface" and will inevitably become visible in time. Is that true, or will this regimen I've got going on--and the retinue of people I've employed to help me do it--prevent that damage from "rising" to the surface? And what exactly does "rising to the surface" mean? Do these cells migrate upward with each exfoliation? I expect that this damage is not only dyschromia but, of course, compromised collagen that will eventuate in wrinkles.  Do you have one of those UV cameras in your own practice? Seems like it would create a lot of revenue from freaked out clients like me who then try even more treatments to fix their skin. What a money-maker! 

Answer:

She is correct, all in time will surface, but it may not be visible to the naked eye even if it does as you will not be looking at your skin under a UV light. That damage is deep as those deeper levels of damage will eventually come to a more superficial layer as you skin sloughs over on its own over time. The discoloration seen is only dyschromia, but the effects of the sun will also affect the collagen, although that is not measured by the technology. We have a similar technology and use it not to scare patients but to show them what can happen when they go out in the sun unprotected, so they see the before first and then go out in the sun without protection and we can show them the increased spots. In that way we can help motivate them to protect their skin. But I never tell them that anything can help remove the old damage, as you have seen, it is there pretty much no matter what you do.

Question:

 
Dr. Garcia,
I am debating as to whether I should spend $1,200 for the Erbium laser treatment or whether I should go for a series of microdermabrasions. I want to have a more refined skin texture and reduce small wrinkles. I was told that the Erbiium laser would not help the wrinkles above my lips. What is your suggestion. Also, is it dangerous to have fillers like radiesse or juvederm in the forehead area to fill wrinkles. I don't like Botox as it give me a "Dr. Spoke" appearance.
Thank you.
 
 

Answer:

I think the Erbium will be more effective for the wrinkles or fine lines on your face than the microdermabrasion. I use Juvederm into forehead wrinkles, but Radiesse not as much for fear of lumps from the granules in the product.

Question:

I know you like the Olay line of products. They have just released a new version of their Total Effects 7-in-1 cream, which now included a broad spectrum 30 SPF.  I have never trusted the sunblock that are mixed into cosmetic products and have opted always for sunblocks like SkinCeuticals Physical Defense. But that layering of products on my face is cosmetically terrible. If I'm just going to work (travel before sunrise and after sunset, no UV lights in the office, no windows at the office), do you think it's OK to use this new Olay product? If I'm out for a run or a bike ride or otherwise not at work, I would of course revert to the use of a strong sunblock-only product. Thanks for your advice.  I hope you're having an enjoyable holiday weekend with your family, Dr. Garcia!

Answer:

with what you are describing light exposure wise I think the new Olay of Olay 7-in-1 should do well for you.

Question:

I know you like the Olay line of products. They have just released a new version of their Total Effects 7-in-1 cream, which now included a broad spectrum 30 SPF.  I have never trusted the sunblock that are mixed into cosmetic products and have opted always for sunblocks like SkinCeuticals Physical Defense. But that layering of products on my face is cosmetically terrible. If I'm just going to work (travel before sunrise and after sunset, no UV lights in the office, no windows at the office), do you think it's OK to use this new Olay product? If I'm out for a run or a bike ride or otherwise not at work, I would of course revert to the use of a strong sunblock-only product. Thanks for your advice.  I hope you're having an enjoyable holiday weekend with your family, Dr. Garcia!

Answer:

I think it is a good compromise for your needs and should more than enough for the sun exposure you are speaking of.

Question:

My aesthetician seems to be making a crazy claim. She is telling me that after I finish peeling from a SkinMedica peel, my skin will "continue to improve." Nonsense, no? Thank you

Answer:

well, if it caused any inflammation, it might cause some small amount of collagen to be formed, but likely not visibly seen

Question:

Thanks for your answer about the marks on my legs. I'm confused by your advice to remove the compression stockings. I was told to wear them for four-six weeks following the procedure. Can you clarify what you meant?  Thanks ever so much!

Answer:

I think you should stop the additional compression stockings that you added and call their office and see if you can remove the compression stockings they recommended at least at night.

Question:

This is a minor question but I'm a bit stumped by it and hope you can help. Two weeks ago, I had sclerotherapy to my lower legs and have worn the appropriate compression stockings ever since. For good measure for the first three days, I had also worn compression knee garments (Tommie Copper knee sleeves) to give a bit of support to my lower thighs and knees as well. When I removed those knee sleeves, I was left with bright red marks at the sight of the end-points of the garments, on my mid-thighs. They are not painful or irritated, just bright red. It looks like I drew lines around my lower thighs with a red marker. (I had no injections above my knees, by the way.)  I'm a bit concerned that they haven't faded at all yet. What do you think is going on? Any suggestions? Thank you!

Answer:

most likely just a skin response to the compression with blood vessel dilation, it can take a while to go away but should not be permanent. I would just refrain form wearing the compression garments if at all possible. If you cannot, then at least remove them at night

Question:

Hi Dr. G,
 
I have several ingrown hairs, as a result of electrolysis. These hairs are on my arms. I am a skin type IV; brown skin.
I've been having electrolysis treatments for 8 months now. Now, I currently do not have regular treatments. My last treatment was several weeks ago and the aftermath of a particular treated area is:
http://img.photobucket.com/albums/v450/NSix/2014-09-13061044_zps86d79436...
http://img.photobucket.com/albums/v450/NSix/IMG_1356_zps4c1af4ed.jpg
 
I used to have laser hair removal on my face but stopped it when I began getting PIH that wouldn't resolve. I have gotten PIH from electrolysis that has persisted (but lessened) for the past 8 months.
 
Is there simply no viable options for ingrown hair removal? Should I try laser again for the ingrowns on my arms? Thank you

Answer:

I think a laser is an option but in darker skin the risk of PIH is there. It can be treated with a YAG laser to fade it though if the PIH occurs.

Question:
Answer:

the effects of skin improvement with Retin A are achieved in 12 months, everything after that is at best maintaining the improvements that occurred, but there is no further reversal. It is common for patients that have used Retin A for long periods of time to not go through that initial irritation phases as their skin is not as damaged as it was originally. As to any effect from the 0.025%, it will not irritate your skin and the amount of benefit will be much less. Sorry.

Question:
Answer:

IT would moisturize the skin  but the effects are really\y very short lived. Your skin will feel smoother for a couple fo days though.

Question:

What do you think of the Clarisonic Opal, the small device that aims to massage topical products into skin with ultrasonic pulses? Are topical serums better absorbed with the assistance of this device in your opinion and experience? Thank you.

Answer:

in my opinion it does not assist in the absorption of any product as all it does is vibrate the skin. If the skin is intact, as it should be unless you have taken the top layer off,which this machine does not do, the ability of products to penetrate is not changed.

Question:
Answer:

yes, we still have my formula peptide and as to the Neova for use during the day under makeup I suggest DNA Barrier Accelerator and Refining Eye Lift for the eye region

Question:

Do you recommend IPL to control acne? Thank you

Answer:

I do not think that IPL alone will control acne, it may help decrease the amount of bacteria on your skin so the help will be mild and very temporary. It will help fade the redness faster though

Question:

Hi Dr. G,
 
I just asked the question about possible ingrown hairs from electrolysis. 
 
I have no scarring from the ingrowns. They're just bumps currently. 
 
If I were to do nothing to these hairs, would the pigmentation worsen? Would the bumps get bigger?
 
I have read conflicting things about electrolysis and ingrown hairs, but superficially speaking, it seems like electrolysis would kill the hair and thus the underlying problem.
 
What I'm wondering is whether these bumps are simply the result of the fact that more than one hair was close to the site of the electrolysis. So what I'm seeing is maybe just another hair.

Answer:

the scarring is inside the hole where the hair comes out and cannot be seen. You might need someone with magnifying glasses to see if there is still a pore that can be opened and pull the hair out, it is the curled up hair that might be causing the bump in some cases. Also as you said, it might be a hair that was next to the one treated that has become ingrown. Only tiem will tell I am afraid

Question:

Hi Dr. Garcia,
I had electrolysis several weeks ago on my forearm. Just a test spot. I was wondering if it's possible for electrolysis to cause ingrown hairs if done improperly?
If so, what are the circumstances? Just improper insertion technique?
I've got a lot of hair. I'm of Indian descent with type IV, brown skin. 

Answer:

I have not heard of it happening but I guess if the hair follicle is not killed by the electrolysis and it causes some scarring that does not allow the hair to grow though, I suppose it might happen.

Question:
Answer:

I think it is a good skin care line but I would not use the Creme daily, just after sun burn or extended sun exposure or after skin treatments like microdermabrasion or peels.

Question:

My lips are malligned with fordyce spots giving them a very uneven appearance in color. I tried a tca peel but it further damaged my lips by triggering a mild case of exfoliative cheilitis that still remains.
I have heard of some people getting medical tatooing as a last resort successly camouflaging the problem. I am male though and don't want it to apear as lipstick. Do you think this is a valid path?

Answer:

in experienced hands it should work well, but understand that every 3-5 years you will likely need touch ups.

Question:

Hi Dr. Garcia,
I have PIH from electrolysis. http://img.photobucket.com/albums/v450/NSix/photo_zps50af0be7.jpg
It looks much better now, because much of the color has faded, but it's still there.
It's been almost 7 months.
After using Retin A in conjunction with HQ, I was left with red irritated skin that has also since faded. But it's left a vast area of slightly darker skin.
I think this was due to the inflammation caused by the topicals. I think I have an allergy to these only when I apply it to sensitive areas.
I use Retin A on my face and do not get this reaction...

Answer:

any irritant can cause some degree of PIH, and both Retin-A and Hyrdoquinone are irritants. Usually the hydroquinone will avoid the creation of PIH and can help to some degree in the treatment. It is very unusual to be allergic in one area and not another, so it more likely is that the area where the hair was treated is just more sensitive. Typically the face is the most sensitive areas  to those products. Might consider treating the PIH with a Q-switched YAG laser.

Question:
Answer:

I must say that I think it is unlikely the injections caused the tinnitus or sore neck. As to why to do the nerve blocks, it is to lessen the discomfort from the peel as it can feeling like an intense burn. No big reason to do the inside the jaw though, not sure what they thought needed that approach versus just through the skin. Sorry to hear about the tinnitus. Seeing an Ear Nose and Throat specialist might isolate the cause for you.

Question:

hi Dr. G,
 
I made the absolutely dumb decision to shave my arms a year ago. I think i was then left with ingrown hairs on my elbows. these look like small bumps
 
i picked at one of them, and now it's basically a hyperpigmented mark and will probably be permanent
i was wondering: if i never have these ingrown hair/bumps treated with something like perhaps, electrolysis - would they get worse?
can electrolysis make them worse or cause ingrown hairs anew? ty

Answer:

electrolysis will not make the ingrown hairs worse and is effective in hair removal. In very rare instances there can be some pigment changes after the electrolysis or form picking at it. In those case I suggest trying Retin-A mixed with hydroquinone first and if that does not work then we use a Nd:YAG laser to fade them. They will likely not fade away on their own I am afraid.

Question:
Answer:

topical application is of no use, it cannot be absorbed through the skin so it just lays there, feels smooth, but does nothing

Question:
Answer:

wheat products are pro-inflammatory and can increase the oxidative stress that accelerates the aging process in the body, yes. Stick with healthy meats, fish, fresh colorful vegetables and decrease your wheat intake for better health. Certainly no problem to eat wheat in lesser amounts but it should not be the main staple of your diet, as it is in many Americans.

Question:

Can nuface/microcurrent technology be used on the face (far from the uterus) during pregnancy?  It says no on the packaging but how can those mild currents do anything that far away?  

Answer:

They say not to use it because it has not been tested on pregnant females, so they are being safe and do not want a lawyer to sue them if something were to happen to the baby while using the technology.

Question:

I know you are a believer in the Olay line of products. They have just rolled out a new version of their all-purpose Total Effects (7-in-1) cream, which includes a broad spectrum sunblock, SPF 30. I never trust the sunblock additives in cosmetic products and use a separate zinc oxide sunblock. But I'm sick of looking like Casper the Friendly Ghost. Do you think that this version of Total Effects would be enough to use on my face while I keep using the other zinc oxide on the rest of my body? 

Answer:

I have not had anyone use the new product so I cannot say. I understand the desire to lose the Casper face, and there are many sunblocks that avoid that. I like the sunblock from Fallene.I tell my patients to put the sunblock on first, wait ten minutes, then apply the make up, I have found that lessens any whitish effect that might be there. Look for sunblocks with either Helioplex or AvoTriplex for complete protection.

Question:

I use Retin A .1 %. The cream is very thick and difficult to rub easily into my skin. Will I still get its full effects if I blend it into my skin using a less viscous --but still strong -- retinol cream like Environ's or Skin Medica's?  That is, will the addition of the retinol dilute the Retin A, making it less effective, or will it increase its potency because it will actually absorb into my skin better because I'm using the more liquid retinol as a "carrier"?  I appreciate your help!

Answer:

It will be a little weaker but the better absorption might help the efficacy and yield better result sin your case. Might want to have some microdermabrasion treatments once a month to remove the waxy layer on your skin and that will also aid penetration as well as make your pores open so they can shrink after letting their oil out

Question:
Answer:

Progesterone's main effects are on the breast and uterus but there are receptors for progesterone in the brain and also bone. It helps in proper bone health and helps re-establish more normal sleeping patterns which are affected in post-menopausal women, and that allows the body to heal at night. I do think even without a uterus there are many health benefits to it.

Question:

Hello - Hope you are well. Do you think a women that takes 1mg of estrace also needs progesterone ? I have an impressive (ugh) amount of sagging skin even though I have always been thin. But then I am 58 y/o and other women my age do not look as bad. Thank as always !!!!!!!!!

Answer:

I do think using progesterone along with the estrace is better to avoid imbalances that can affect many things in your body but the additive effect of the progesterone will not significantly or visibly affect your skin changes that have already occurred. Sounds like you have lost some facial fullness leading to the sagging skin, so fillers might help for a while. I wish you the best.

Question:

Hi Dr. Garcia, I got vbeam four days ago. While the rest of my face has settled down, the tip of my nose is still pink. It didn`t bruise, but is simply pinker than it was before. Is it possible that it burned my skin, or is it just taking longer to heal? I`ve gotten vbeam before and my nose has always been resilient, so it has me a little scared that it`s permanent. Thanks

Answer:

That can happen but I do not think it will scar, just give it a little more time.

Question:

I`ve been using a Retin A cream (0.1) every other day for about 2 months. My skin has no flakiness, but feels dry and very tight. I`ve tried many moisturizers including a very expensive Argan oil, but nothing seems to help. My face looks normal, it`s just the feeling of tightness that is driving me nuts. Anything you can suggest?

Answer:

I am afraid that is how Retin-A works, you might want to try some squalene oil from the health food store, I find that to be a great moisturizer.

Question:

Hi Dr. Garcia, I had sexual intercourse six days ago, and the following day, around one square inch of the base of my penis was red with several painful bumps and the skin was burning. I`m not concerned about an STD as both my girlfriend and I have been tested in the past. I thought it was a friction burn, but it`s five days later, there`s less redness, but still several (albeit smaller) painful bumps and the skin is flaky. Can friction burns take this long to heal, (and result in flaky skin?) Or could it possibly a bacterial or fungal infection? Thanks

Answer:

the burn can take a week or more to heal in that area, keep some Neosporin on it and it should get better soon.

Question:

Is this a good sunblock for the face? http://www.cerave.com/our-products/sunscreen/sunscreen-for-face-spf-50 I have difficulty with white film from all other zinc-based sunblocks on my face, even SkinCeuticals` and SkinMedica`s versions. This product doesn`t leave a film and has no oil (I have oily skin that breaks out regularly), so I`d like to use this if you think it`s safe. Thank you.

Answer:

looks like a good product.

Question:

I meant to type, just as good OR better below. Sorry.

Answer:

not as good as what you are using now. 

Question:

Hi Dr. G, I had a quick question about hyperpigmentation (again). I had some hyperpigmentation from electrolysis about 5 weeks ago. Here is a pic: http://imageshack.com/a/img691/1048/41ef.jpg do you think this is just the usual PIH or something worse? ty

Answer:

Looks like just PIH which is good.

Question:

What kind of diet or supplements do you recommend for older (60) skin that`s starting to thin and loose elasticity? Anything to generally avoid other than smoking? Thank you.

Answer:

Salmon twice per week, omega 3 fish oils 2,000 mg per day, Vit c 1000mg per day. CoQ 10 400mg day, sun block all the time and 6 8oz glasses of filtered water per day.

Question:

Hi Dr. G, I had 2 quick questions for ya. I am east indian with brown skin. I had LHR done with a laser not meant for my skin type, 10 years ago. Then 6 years ago i had 1 fraxel tx. All these yrs later I have a strip of skin on my face that is distinctly hyperpigmented. It`s very noticeable because the adjacent skin is unaffected. Could this be dermal hyperpigmentation or is it possible that I simply have not treated it with the proper regime all these yrs? I am currently using Retin-A nightly. Generally speaking, can LHR and/or Fraxel cause dermal hyperpigmentation? Thank you.

Answer:

It certainly can cause hyperpigmentation. Might need a series of light Nd:YAG laser to fade it. I do not think the Retin A and hydroquinone alone will help. But I would use the HQ after the laser sessions to avoid any problems. I wish you the best.

Question:

I understand that Pelleve has a new handpiece to treat telangiectasia. From the description, it sounds like a form of cautery: a percutaneous treatment in which a needle is inserted and RF energy is used to heat and close the vessel. What do you think? Thanks so much!

Answer:

it will work, they will likely still come back near the area and it can leave a pale white spot at times.

Question:

Is CE Ferulic most effective if applied in the morning (under sunblock of course), applied in the evening, or applied both morning and evening/

Answer:

in the morning after cleansing and toning.

Question:

Hi Dr. Garcia. MyI face was sunburned when we went to the beach, but it`s painless at all. Can I use a facial mask over it? Thanks.

Answer:

I would give it a week or so before the mask to avoid possible problems.

Question:

Hi Dr. G. I had a question about hyperpigmentation. I had LHR in the summer. I was left with hyperpigmentation in one circular spot on my face. Its been like this since the summer. I have begun once again using Obagi. Is it possible to get rid of this? I am Indian with brown skin.

Answer:

might need a YAG laser to speed it along but Retin-A and hydroquinone should help.

Question:

hi Dr. Garcia , does triamcinolone injections get rid of trapped oil on the skin without any inflammation .. so just purely a collection of oil on the skin ... not acne .. i mean will the trapped oil be gone after the triamcinolone injection .. the trapped oil has already persisted for like a month already .. thank you for your time Dr. Garcia

Answer:

Sorry but it will not reduce skin oil production.

Question:

Hi Dr. G, I had 2 quick questions about hyperpigmentation. 1. Should hydroquinone only be used for 1-3 months at a time? If we discontinue it`s use after the maximum continuous time recommended, can we resume tx in say, 6 months for another round? 2. Can a regimen of just retin-a (applied nightly) without hydroquinone be effective in treating hyperpigmentation?

Answer:

we use it until the pigment is gone, if by three months that has not happened then we use chemical peels or a laser. We use it continuously in people who will not refrain form sun exposure, but we do have them take a 2-3 month break in the winter months. If the pigmentation is recent, the Retin-A alone will take care of it. Understand that hydroquinone is really meant for prevention and not treatment so we always use it with Retin-A.

Question:

I know that baths are particularly unhelpful for dry skin, as the hot water strips the skin`s natural oil. But I am wondering if some baths can actually help dry skin. Particularly, I wonder if tepid water with baking soda, oatmeal, and bath oil might have a therapeutic effect. Thank you for your help.

Answer:

Good for rashes and skin irritations but not for normal skin, sorry.

Question:

Hi Dr. Garcia, I had a question about general complexion. As an Indian male (29) with brown, combination skin - I have noticed that my skin color is not completely uniform in areas. Do you think sleeping enough/changing diet to less processed or fried food and using night-creams would have any meaningful effect? I don`t really moisture my face for fear of making it oily. Would lotions be able to help the texture?

Answer:

I think all those things help as part of a regimen but you will likely need some other skin products such as Retin-A and Hydroquinone to assist you. Even some lighter chemical peels could be introduced to speed the process along and then of course sunblock whenever you are outside needs to become an everyday habit.

Question:

Is there any proof DMAE taken orally (between 100 and 300mg) a day will - improving/preserving skin elasticity - reducing lipofuscin deposits/preventing them?? If so what should the correct dose be?? Thank You for your time

Answer:

none for orally injected DMAE that I know of. One can expect no more than 15% of the injected amount to get to the skin, so the dose, if it were to work, would likley need to be quite large. 

Question:

Hi, Dr. Garcia! What do you think of this product? Any good? http://www.dermstore.com/product_Skinovage+PX+Vita+Balance+Lipid+Intense... It feels quite rich and leaves my skin supple, but I`m not sure if it`s actually improving my skin or is just pleasant to use. Happy February! Hope that the drought breaks out in your part of the world -- or else YOU`LL be needing to buy this expensive cream!

Answer:

very temporary feeling of moisture, but not really creating anything except the feel as it has lots of glycerin and wax in it. I think as yo say, it is pleasant on your skin. Thanks for the best wishes and stay wrinkle free!

Question:

For everyday use on the skin, which would you prefer, Argan oil or Squalene

Answer:

I prefer squalene.

Question:

hi , what is the minimum concentration of triamcinolone ( mg/ml ) that is used for acne injections that produces an effect on acne

Answer:

I never use anything more than 1mg for fear of tissue damage.

Question:

It looks like you`re a fan of squalene oil. Do you recommend it as a daily moisturizer or just for healing after abrasive procedures?

Answer:

Both!

Question:

What is the difference between squalane and squalene oil? Do you recommend both?

Answer:

I recommend the oil for skin issues.

Question:

Hi Dr. Garcia, Hello, About two weeks ago, I had sex with my girlfriend and, due to friction, I ended up getting a bruise/sore on my penis. Not too big. It`s the kind of thing that would have healed in a week, but I made the mistake of having sex with her every three to four days for the past two weeks, thus reaggravating the bruise before it completely healed. Suffice it to say, I`m going to abstain from sex for the next couple weeks to let it heal completely. I`m a little worried that, since I didn`t allow the sore to heal completely and reinjured it every few days for the past couple weeks, that I somehow made it more vulnerable to bruising/tearing in the future. Is this a rational fear, or do you imagine that if I let it heal completely for the next couple weeks, that the skin will be as strong as was originally?

Answer:

the tissue there is quite resilient and should heal well in time. You might need to use lubrication in the future, even if there is  `adequate amount` normally so it will allow a smoother passage and less likelihood of friction tearing any skin. In time the skin should return to essentially the normal strength with little long term effect, as long as the problem does not continue to occur repeatedly.

Question:

Sorry about the wrong link I sent. Here it is - L`Oreal`s Age Perfect Glow Renewal Facial Oil http://www.lorealparisusa.com/en/products/skin-care/treatments/age-perfe... By luminosity, I think that they mean an improvement in the dullness of aging skin.

Answer:

It is a moisturizer that if you apply it onto your skin will give it a shine so to speak, but any of that will disappear as soon as you apply any make up. Some of the oil will be absorbed into the skin but only a small fraction so the shine or luminosity will need repeated application to maintain, there will be no long lasting effects or reversal of any dryness on a longer term basis. In a small percentage of patients there may be some plugged pores from the oils.

Question:

What do you think of this product? http://www.oscarcountdown.com/2009/07/film-news-nicole-kidman-in-little-... It claims to restore luminosity to aging skin. True? Snake oil? Thanks for sharing your honest assessment.

Answer:

I am sorry but that link is not working. I also need to know what you or the company implies with the term luminosity as it relates to skin, as it is a term only used by product manufacturers and really does not apply to human skin.

Question:

I am writing to ask why, despite doing all the right things (exfoliating weekly, professional pore cleansing regularly, occasional professional peels, using the right OTC and Rx products), I seem to have 5 pores that regularly clog and develop deep whiteheads. I`m in my 50`s, so I no longer suffer from acne -- as I did until I was 35, following two rounds of Accutane, at long last), but I have three pores in my forehead and two in my cheeks that are the sites of breakouts whenever I have them. Is this common? Is there something I can ask my dermatologist to do to those five pores to kill the sebaceous glands adjacent to them? Thank you!

Answer:

the dermatologist can either try to lance them to open the pore and let it empty, or they can be removed with a punch biopsy and closed with a single stitch.

Question:

Hi Dr Garcia, I really don`t enjoy using prescription HQ cream (thick and sticky) but I resort to using it for a while at least every couple of years to bring my pigment issues under control. I am now 3 weeks into using it again and I am seeing results. here is my question: Would a series of PCA chemical peels (while I continue to use the HQ cream)speed up this process so that I can get my usual results in less time?

Answer:

certainly worth doing.

Question:

My squalene oil has vit e in it. Is that ok?

Answer:

yes, its OK.