Ask the Doctor

My team and I have created this section to address your questions about your skin’s health, and it’s beauty. The skin’s health is its beauty.

The two are virtually indistinguishable. Dermatologists diagnose mostly by looking at the skin, where any problems are usually evident right there on the surface.

We’re here to help you achieve optimum skin health and optimum skin beauty. Our system of skin care products was developed to give you the technology you need to help maintain and renew your skin on a daily basis. But understanding the skin is also an important element in caring for it, so feel free to Ask the Doctor.

-David A. Colbert, M.D.

A 33-year old woman writes the doctor asking about the appearance of fine lines around the eyes….

Dear Doctor,

I have smile lines around my eyes, I think prematurely, and I wonder if it’s because every summer since I was a teen I’ve spent a lot of time on the water windsurfing and sailing.  I’m now thirty-three, am still a good athlete, but the wrinkles are discouraging!  When do other people begin to get Botox?  Is there a usual age and am I there yet?

 

Thank you doctor, “Sunny”

Dear Sunny,

To a dermatologist, your choice of pseudonym is painful—and a little like waving a red flag in front of a bull.  So before you even think about getting Botox, let’s review your sun protection routine.  With so much exposure over time, especially on the water, I hope you’ve been wearing a top notch SPF 60 and applying it on the hour.  (btw, Waterproof doesn’t always mean waterproof, so research your product carefully via a disinterested party like The Skin Cancer Foundation or Environmental Working Group or ADA—who routinely rate sunscreens.)  Once you get squared away with the proper sunscreen, you’ll need high-level eye protection too—goggles or glasses.  Both of the water sports you mention have gear that’s technologically advanced and attractive, so get shopping.  I applaud your athleticism, but the more skin you can cover while on the beach or the water the better; surfers know this: they wear rash guards with sleeves, and shorts to the knees. That said, any way you cut it, sun will eventually cause more wrinkles than if your skin weren’t exposed. And of course there are greater risks than the cosmetic ones from UV rays; skin cancer is now the most prevalent form of cancer in the U.S.  Make sure to check all your moles regularly and have annual or semi-annual skin cancer screenings with a board certified dermatologist.  As to your question about when to get Botox, here’s how I answered a similar one put to me a while ago Elle Magazine.    The answer’s still the same!

“Since some of us are genetically predisposed to show signs of aging earlier than others, it’s best to go by your ‘beauty age’ instead of your birth date.  Some twentysomethings already have legitimate sagging and wrinkling to contend with and may be candidates for intervention.  On the other hand, if a wrinkle-free 40-year-old demands Botox, [I] will send her home disappointed.”
Dr. Colbert in Elle Magazine (December 2006)

A question about laser skin tightening….

Dear Doctor,

A friend of mine had skin tightening, I think with a laser, a few years ago, and her only comment was never again.  I’m not sure what the name of this torture devise was but is there a way to avoid pain and still get the benefits?  I would like to tighten the skin on my upper arms, and chin. 

 

Sincerely, Sheryl

Dear Sheryl,

It may have been Thermage, which used radio waves, and apparently wasn’t pleasant.  But now we have a more advanced system, the Titan laser, which uses infrared light.  Both for comfort and effectiveness, it’s a big improvement over Thermage.  During the Titan procedure, the handpiece continuously cools the skin’s surface while the laser heat is directed below the dermis.  A cold gel also cools the skin.  So now you can get skin tightening without pain, and without surgery.  And fyi, lasers aren’t the same as they used to be—it’s a whole new generation now. 

A question or for the doctor about instant fat removal …

Dear Doctor,

I remember reading years ago that liposuction was an, unpredictable, even dangerous thing to do.  Is it still as risky and if not, what’s changed? 

Ramona

Dear Ramona,

It’s take people (including doctors) a while to understand that the purpose of lipo is to remove inches, not pounds.  The ideal candidate is in fact at or near ideal body weight, and hopes to get rid of pockets of fat that don’t respond well to diet or exercise.  But liposuction is still surgery and it must be performed by a trained dermatologic or plastic surgeon.  Improved tumescent technique with anti-clotting fluid now reduces risk of bleeding during the procedure.  In our surgery suite, a procedure called ‘Microlipo’ (think less is more) is performed on an outpatient basis under local anesthesia, avoiding any potential complications from general anesthesia.   Again, lipo is safest when you’re thinking in terms of inches, not pounds.   There is no substitute for a healthy diet of whole, fresh, non-processed foods.  These will help you lose weight naturally.  For more information on how to achieve ideal weight naturally, please check out my book on nutrition at www.highschoolreuniondiet.com.