Top Skin Care Questions Answered by Local Renowned Board-Certified Dermatologist

Skin Care Awareness Month is fast approaching, a month helping patients understand how to achieve their skin care goals. Adam Wallach, M.D. answers questions about popular cosmetic dermatology treatments and skin care ingredients. 

Q: Some patients are wary of fillers for fear of looking unnatural. What do you recommend for avoiding this? 

A: The key to a natural result is using fillers with a restorative mindset rather than an augmenting one. Find a practitioner whose aim is to create a natural appearance and look in a mirror together to determine what you would like to correct. Start slow, and if you like it, you can do more.

Q: How long do the effects of fillers last?

A: Fillers can last anywhere from as little as six months up to 24 months. That said, there is some variability of duration among patients. Also, facial fillers tend to last longer in some areas than others.

Dr. Adam Wallach (Photo courtesy of Skin Cancer and Dermatology Institute)
Dr. Adam Wallach (Photo courtesy of Skin Cancer and Dermatology Institute)

Q: What does laser therapy treat? Is there downtime after a laser treatment?

A: Lasers can be used to treat many different conditions, including sunspots, facial blood vessels, excess hair, wrinkles, and scars. The downtime depends on the laser used and the strength of the treatment. Some laser procedures target specific problem areas alone, consequently they can have minimal downtime. Other procedures where the entire face is treated often have more wounding due to the affected surface area, but there are lighter versions of these.

Q: How does microdermabrasion work and how many treatments does it typically take to see results?  

A: Microdermabrasion enhances exfoliation by both the mechanical removal of the most superficial skin combined with suction that then removes those skin cells. For the best results, this treatment is performed in a series of 4-6 treatments every 2-4 weeks. 

Q. Talk to us about chemical peels.

A: Chemical peels come in many varieties (salicylic acid, glycol acid, mandelic acid) and multiple strengths, with some of the strongest peels performed only by medical providers. In addition to brightening the surface of the skin, peels help topical creams such as antioxidants, retinoids, and stem cell products to penetrate more efficiently.

Q: Hyaluronic acid is an ingredient often touted with skin care benefits. What is it exactly and how does it work?

A: Hyaluronic acid is a standard dermal component of skin that holds onto water when used topically or in injectables like JUVÉDERM®, which helps plump the skin. Generally, it is incredibly safe and non-irritating as a topical and rarely causes problems as an injectable filler.

Q: Retinol – prescription or over the counter – which is better and why? What skin concerns does retinol help treat? At what age should retinol be incorporated into our skin care routine? 

A: Retinoids are a group of products derived from vitamin A which have been studied for years and whose skin care benefits have been scientifically confirmed. Tretinoin (also known as retinoid acid or Retin A) is the best-studied and best-known product in this group. It has been used for over 20 years for its effectiveness in diminishing fine wrinkling, lessening skin darkening, and generally improving the skin’s tone. Tretinoin is a differentiating factor, which means it normalizes the way cells develop as they are affected by aging or oxidative damage. In theory, tretinoin is returning proper signaling to the skin so that it matures properly. Related molecules to tretinoin are retinaldehyde and retinol that are not quite as potent as tretinoin but still exert their effects with a bit less of the downsides of sun sensitivity and dryness. If you are new to this product category, start with one of these less potent molecules, and you can always transition to tretinoin later as your skin become used to it. Nighttime is the perfect time to use retinoids.

About Our Dermatology Providers

In private practice since 1997, Dr. Wallach treats patients at Skin Cancer & Dermatology Institute’s Truckee location. He diagnoses a full range of dermatologic problems for both adults and children, specializes in medical and cosmetic dermatology, and is well known for treating many types of skin cancer. He is a strong proponent of patient education in his practice and is a contributing author to the upcoming book, The 21st Century Man. Dr. Wallach and his family live in the North Tahoe area. Get to know Dr. Wallach and book an appointment online here.  

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