Ask Dr Elaine 
Click on the desired topic to view. Click Topic Headline again to close.
Q. What causes dark circles and bags under the eyes?
A: Dark circles may be hereditary pigment causing the darkness and is more common in those of Middle
Eastern, Mediterranean, East Indian ancestry. Thinning of the skin and collagen loss from aging, sun damage,
smoking and lack of estrogen make the skin more translucent and saggy. Increased number of veins or increased
visibility of veins from thinning skin also contributes to dark circles. In some people allergies and chronic
rubbing of itchy, watery eyes darken the skin. Finally there is shadowing-- when the infra orbital fat pad (the
fatty layer just under the eye and above the cheek bone) drops or thins and leaves a dark shadow.
Under eye bags are often from the gravity effect on infra orbital fat pads causing the pad to drop and become a
“bag”. Also thinning skin from aging, sun damage, smoking and lack of estrogen cause the skin to be loose and lets
the fat pad descend. Allergies may cause puffiness.
Q. How do you treat dark circles and bags under the eyes?
You can camouflage bluish dark circles with yellow based concealers. Eye products with light reflective
particles bounce light to optically soften the area.
Surface treatment creams for dark circles and under eye bags involve a combination of therapies.
Antioxidants help stimulate dermal fibroblast activity helping firm and tone the region. Vitamin C thickens skin to
decrease visibility of underlying tissue and may lighten pigment.
Retinoids such as Retinol, Renova®, and Retin A ®increase collagen to tighten the skin holding the
bag and also help reduce pigment.
Peptides are amino acid messengers which tell fibroblast cells to increase collagen production
thickening the skin and tighten the area to form a “girdle” for the bag. Useful peptides for under eye bags and dark
circles are Matrixyl™ 3000 (Palmitoyl-Oligopeptide and Palmitoyl Tetrapeptide-7), Matrixyl® (Palmitoyl
pentapeptide 3 also called Pal kttks), Argirilene® (Acetyl Hexapeptide-3). Eyeseryl® (Acetyl
Tetrapeptide-5) has been developed specifically for under eye bags.
Hydroquinone or kojic acid skin bleaches at times are helpful but the eye is a delicate area and
bleach often causes irritation. Bearberry is a natural botanical that contains
Arbutin a glycosylated benzoquinone which inhibits tyrosinase and prevents the formation of melanin
pigment and is well tolerated.
Oral antihistamines such as Benadryl or Claritin and are helpful if allergies are a culprit.
Non surgical treatments include:
Eyes by Thermage®
radiofrequency tissue tightening specifically for the eye area.
Fraxel® Eyes fractional laser resurfacing for the
eye area to reduce lines and tighten skin.
Juvederm™
hyaluronic acid filler injections soften hollowing under the eyes.
GentleWaves®
non invasive LED treatment to increase collagen and soften fine lines.
Surgical treatment, Blepharoplasty, involves surgical removal and tightening of excess skin and
fat.
For emergency home treatment after a late or sleepless night a cold gel eyelid mask kept in
refrigerator and applied in the morning will help reduce swelling. Cold Black Tea bags contain
tannins which reduce swelling by decreasing inflammation and caffeine draws water from the skin helping deflate
puffiness.
A traditional spa treatment, chilled sliced cucumbers contain enzymes that reduce tissue
inflammation but may cause irritation and rash.
Urban legend treatment with Preparation H® applied for 15 minutes has a temporary vasoconstrictor
(constricts tiny blood vessels) effect but also can cause irritation.
We have developed Dr Elaine´s Advanced Skin Treatment
Total Eye Renewal specifically for dark circles and under eye
bags. Professional eye treatment with Eyeseryl®(Acetyl Tetrapeptide-5) to correct puffiness,
Melfade®-J (Magnesium Ascorbyl Phosphate and Bearberry Extract) to brighten dark circles and
Matrixyl™ 3000 (Palmitoyl-Oligopeptide and Palmitoyl Tetrapeptide-7) to reduce fine lines. Ginseng
and light reflective particles give a young rested look.
Q. What is the best treatment for acne scars?
A: Acne scars when the acne or surrounding inflammation is deep enough in the skin to cause a scar. They
also occur after aggressive picking at acne. Scars are a function of the healing process and can be raised,
depressed, or at skin level.
Pigment changes after the inflammation of acne may be either darker or lighter spots and are a result of increased
or decreased melanin (the pigment that gives your skin color) or iron from red blood cells. Post inflammatory
redness occurs from red blood cells in the skin, or dilated blood vessels. These are not true scars and often
disappear without treatment over a period of months or years. Various bleaches, and other surface creams as well as
Intense Pulsed Light (IPL) treatment can help resolve the discoloration.
Clear Skin Treatment, Perfecting Lotion 10 and Oil Free Moisturizer are helpful to both prevent acne and
reduce redness and pigmentation.
True acne scars are more difficult to treat. For the mildest cases we use a combination of the medication
tazarotene (Tazorac® cream) with a treatment series of Silk Peel®. The most effective treatment is Fraxel® Laser and is our preferred choice of
treatment for acne scars. Juvederm™Juvederm™ may
also be injected into depressed scars, and steroids injected into some raised scars.
Because treating acne scars is a challenge, it is important to treat acne early and effectively.
Q: I’ve read that diet may really affect acne after all,
what’s the truth?
A: Although Dermatologists have long maintained that diet does not play a significant role in acne, some
new evidence indicates that diet may worsen acne in certain patients who are genetically
predisposed to having acne.
Caffeine containing foods/drinks such as coffee, colas, and chocolate, have long been associated with worsening of
acne in some individuals. Now the question has been raised as to whether milk products, or a diet high in processed
foods, may worsen acne. Although there is little scientific evidence for this at present, some investigators are
studying this possibility.
Most patients who restrict their diet find little or no improvement, however some do see an improvement, and of
course we can all benefit from more healthful eating habits.
Q: Doesn’t laser treatment give better results without pain
for spider veins on the leg?
A: Physicians who are experienced in the treatment of spider veins of the leg most often use Sclerotherapy (injection of a solution into the
vein) as it usually the most effective with the least number of treatments, and with the least discomfort. Although
laser treatment can be effective for treatment of spider veins on the leg, it is more painful and less effective
than sclerotherapy.
Q: How do you treat spider veins on the face?
Intense Pulsed Light® (IPL®) uses a pulse of
light to heat up and seal off small veins on the face. It also reduces overall redness, flushing and rosacea.
Q: Do Birth Control Pills really help acne?
A: Acnein women often has a strong hormonal
influence. Oral contraceptives, or birth control pills, are often helpful. However BCP’s alone may not completely
control acne. Ortho Tri-Cyclen® and Estrostep® are FDA approved for the treatment
of acne. I think that Yasmin® is the most effective, and has the added benefit that women usually
do not gain weight. Yaz® seems to work for some women. The risks of certain medical conditions such
as stroke are higher in oral contraceptive users so discuss it with your Gynecologist or Family Physician.
Q: It seems as though everyone I know has rosacea. Is it
really that common?
A: Rosacea is usually correctly diagnosed
by experienced dermatologists. The characteristic findings include redness, dilated blood vessels, bumps, pustules,
skin thickening, and oil gland growths. Patients with sun induced dilated blood vessels, acne, perioral dermatitis,
sensitive skin, and lupus may sometimes be incorrectly diagnosed with rosacea.
Q: What is a “mineral foundation”?
A: Mineral makeup is increasingly popular, particularly among women with sensitive or acne prone skin. It’s
made from minerals taken from the earth, such as titanium dioxide and iron and zinc oxides, rather than synthetic
ingredients. The advantages: no artificial colors, fragrances, or ingredients; plus, mineral products have a natural
SPF. The downside, however, is that they’re intensely pigmented, which may make them harder to apply. Pat on lightly
with a sponge rather than rub. The brushes used to apply some products can cause irritation to sensitive skin or to
those using “active” skin care products which is why our mineral powder is used with a sponge.
Q: Is it safe to put self-tanner all over the body or are
there areas you should stay away from?
A: Self-tanning lotions are safe to use in all areas but tend to cause an exaggerated darkening in the
areas of thickened skin such as elbows, knees, calves, and heels. Exfoliate those areas prior to treatment with a
physical exfoliant or lotion containing glycolic and/or lactic acid, such as Perfecting Hand and Body Moisturizer. Applying
lotion before application also reduces the darkening in these areas. When applying self-tanners the face may be
treated avoiding application into eyes or mouth. Individuals who apply these lotions via a spray should avoid
breathing in the aerosol.
Q: I have a reunion in 2 weeks and want a quick pick me up.
What do you suggest?
A: Two procedures that offer rapid improvement with minimal downtime are BOTOX® Cosmetic and Juvederm™.
If you have movement related wrinkles in between your eyes, forehead, or crow’s feet, or are seeking a nonsurgical
brow lift, BOTOX® Cosmetic is the treatment of
choice.
Alternatively, if you have moderate wrinkling around the lips, smile lines, or at the corners of the mouth, or would
like increased lip or cheek volume, Juvederm™ is
appropriate.
Utilizing both BOTOX® Cosmetic in the upper face and Juvederm™ in the lower face offers complete rejuvenation.
Results of both are complete by 2 weeks after treatment.
Q: Is there a topical product that can be applied to the skin
to get rid of small broken capillaries?
A: If it sounds too good to be true, it often is. While there are many surface cream treatments that lessen
skin redness, there is no cream that decreases small broken capillaries, called telangiectasia. Fortunately,
however, facial telangiectasia responds well to Intense
Pulsed Light® (IPL®) treatment.
Q: I heard that the FDA is banning hydroquinone containing
skin bleaching creams because they cause cancer. What is the story?
A: Hydroquinone has been used effectively for many years, both in over the counter (OTC)
products with a strength of 2% or less, and higher strength by prescription. Recently questions have been raised
regarding the safety of hydroquinone based solely on rodent studies. Currently there is no evidence that
hydroquinone is carcinogenic in humans.
There is also the rare condition, called onchronosis; in which skin darkens if a high concentration of hydroquinone
is used for a prolonged period of time.
The FDA is considering restricting the sale of hydroquinone containing skin bleaching
products for prescription sale only. It is likely that the FDA will require that OTC hydroquinone manufacturers
conduct formal safety studies, as is currently required for all prescription medications.
Bleaching creams tend to lose effectiveness if used continuously for many months at a time. Therefore both to
monitor progress and reduce the risk of side effects we evaluate patients on a regular basis and prescribe
intermittent rest periods from treatment.
Q: What are these rough bumps on the outside of my arms? It
doesn’t matter how much lotion I put on.
A: Those are usually keratosis pilaris (KP), hard cores of shed skin cells that plug the hair follicles.
They are most commonly found on the outside of the upper arms, on the front of the thighs, and on the lower cheeks.
Often rough, they sometimes become red inflamed bumps or pustules.
Keratosis Pilaris is very common, often inherited and worse in childhood, adolescence and early adulthood.
Treatment is daily use of a moisturizer containing glycolic or lactic acid, such as our Perfecting Hand and Body Moisturizer, which
dissolves the plugs and prevent them from reforming.
|
|
|
