I have been going to the dermatologist since I can remember. My grandmother and mother always stressed the importance of taking care of your skin, and began taking both myself and my sister to the dermatologist from a young age to get our yearly skin check-ups. I tend to listen to any advice my mother and grandmother give, as they both look beyond amazing for their ages, and seem to know what they’re talking about. I got into a cadence of going to see a dermatologist at least once a year to ensure my skin was not only healthy today, but informed on how to stay healthy and looking my best tomorrow.
Since I became so diligent about seeing the dermatologist and my skincare routine, I was determined to find one I loved and could ask my millions of questions to. It was also important for me to find someone who not only practiced medical dermatology, but also cosmetic since I am now beginning to care about anti-aging, as I enter my thirties. I found Dr. Jennifer Hermann, whom I have grown to love and whom has become not only my doctor, but a friend I can ask basically anything to.
Dr. Herrman practices at MFC Dermatology (Moy-Fincher-Chipps) in Beverly Hills, right on Rodeo Drive. MFC Dermatology is made up a select group of world-renowned dermatologists that specialize in not only medical dermatology but also pre-juvenating dermatology including cosmetic treatments like lasers, Botox, fillers and facials.
What I like about Dr. Herrmann is the fact that she is focused on not only the health of the skin, but wanting her patients to look and feel their best.
On a recent visit, the numerous laser machines (about 30 of them) at MFC piqued my interest, so I sat down with Dr. Herrmann to find out more. I plan to do a “Skincare 101” series with Dr. Herrmann since I think we all probably have the same and/or similar questions about our skin! This is what I found out last week.
Q: What are cosmetic lasers?
A: Cosmetic lasers are devices that use specific beams of light energy to cause certain reactions in the skin. Lasers have 3 main targets: pigment (think brown spots and discoloration), blood vessels (think redness and tiny nose veins), and water (think wrinkles and sagging). When a laser’s energy is directed at one of these targets, light energy is turned into heat and the target is eliminated or the laser-target interaction causes skin tightening/smoothing. Because lasers can be very precisely controlled, they are safe and predictable.
Q: Who is a candidate?
A: Because there are so many types of lasers, almost everyone can be a candidate for a laser treatment if he/she is looking to eliminate red spots, brown spots, or wrinkles (especially around the eyes and mouth), or improve skin luminosity/texture/tone. Certain skin types are more suitable for certain lasers, and certain lasers are inappropriate for some conditions, so asking your dermatologist about those that are best for you is important.
Q: At what age should one start looking into laser treatments?
A: This is a very personal decision, but if a patient is bothered by poor skin tone, acne scars, or brown spots, cosmetic lasers can be appropriate as early as in the 20s. And even in babies with certain birthmarks, we often use lasers to fade out red or purple skin “stains” very early in life.
Q: How many different types of cosmetic lasers are there?
A: There are numerous (100s) brands and types of cosmetic lasers, but all lasers are devised to react with one of three skin targets: pigment, blood vessels, or water.
Q: What do lasers target? How do they work?
A: Lasers have 3 skin targets: blood vessels, pigment, and water. How does each work? For blood vessels, laser light energy is aimed at hemoglobin, a protein in red blood cells. When hemoglobin absorbs the light energy, it’s converted to heat, which collaterally damages the surrounding blood vessel walls. This causes the blood vessels to close down and then unwanted redness fades from the skin (good-bye nose vessels!). For pigment, like that in a regrettable tattoo, laser light energy targets and reacts with pigment particles so quickly that it shatters them apart. This causes some immediate elimination of the pigment, and allows your body to more efficiently remove the smaller pigment pieces internally. And for lasers that target water? Because the majority of the skin is water, these lasers absorb shallowly and tend to vaporize the skin in their path. Often, these lasers are aimed at a fraction of the skin at one time, causing a field of micro-injuries (think of a perforated lawn). These micro-injuries then trigger a wound-healing response that stimulates collagen production, leading to smoother skin and fewer wrinkles.
Q: Which laser treatments are the most popular at your office?
A: Because we have over 30 devices, I most often use a combination of lasers to address each patient’s individual needs. For my younger patients, eliminating brown spots, red blood vessels and acne scars are most popular. For patients in their 50s and 60s, the ablative fractionated devices (CO2) that target facial wrinkles are most popular because they do a beautiful job of smoothing the skin without it looking over-filled or too tightly pulled. Again, because these lasers stimulate your body to create more collagen, results are extraordinarily natural looking.
Q: How do you know which laser is right for you?
A: I never expect my patients to come in knowing what laser is his or her best option. Rather, if a patient knows what bothers him/her, we can work together to devise the most specific and efficacious treatment plan.
Q: How many laser treatments does one need to see results?
A: This depends on what is being treated. Even with the newest picosecond lasers, for example, tattoos can be exceptionally stubborn and require more than 10 treatments to fully fade. On the other hand, zapping an isolated blood vessel may require just one treatment. Because some lasers offer increased skin brightness and radiance, I often recommend a series or maintenance regimen to keep skin glowing with these devices.
Q: Are there any side effects and/or down time?
A: This also depends on the laser. Some of our lightest lasers, such as the Clear + Brilliant laser, leaves patients red for a few hours but then back to make-up the following day. In contrast, some of the more powerful devices like the fractionated CO2 laser can leave the skin red and crusted, requiring 7-10 days of downtime before make-up can be worn. When lasers are used incorrectly, side effects can occur, such as burning, scarring, pigmentation changes, or prolonged healing/redness.
Q: What are the most common cosmetic issues clients would like to fix? (i.e. stretch marks, acne scars, uneven skin tone, etc.)
A: 20s: Skin dullness, acne scars, acne, 30s: Brown spots, red spots, skin dullness, acne scars, 40s: Brown spots, red spots, skin dullness/texture changes, fine lines, 50s/60s: Brown spots, red spots, skin dullness/texture changes, fine and deeper lines, especially around the eyes and mouth.
Q: Which laser do you recommend for acne, for sun/dark/age spots, for wrinkles, for sagging skin, for dull skin?
A: Acne: Active red lesions: topical medications and PDL lasers; scars: Fractionated Erbium or CO2 Lasers, Sun spots/pigment problems: Piqo4 Pigment Laser, Fractionated Erbium, Clear + Brilliant, 585/1064 duplex, IPL,Wrinkles: Fractionated CO2 or Erbium Laser, Sagging:, Fractionated CO2 (+/- Radiofrequency skin tightening devices or lifting procedures), Dull skin: Clear + Brilliant Laser or Fractionated Erbium.
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