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Laser Skin Resurfacing - Rejuvenation (Pearl, Fraxel, etc.)

Q: I woul like to know whats the best care for my redness in my face.

Esthetician: You should try Neocutis Peche Redness Control.

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Q: I'm 63 yrs old. And I tried all the remedies to lighten or get reed of my liver spot on my cheeks. I tried laser, lancome(Blanc expert) Avon (Luminosity) & more other product. But nothing could solve my problem. I had been using Demablend for 16 years but if I could get rid the age spot on my face, that would be fantastic. Could you please advice me what's the bets rememdy to lighten or get rid of my age spot? Thank you.

Esthetician: We have many products for you to choose from including Murad's Age Spot & Pigment Lightening Gel or Nuxe's Nuxuriance Anti-Aging Re-Densifying Concentrated Serum.

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Q: Hi Dr.Berger iam trying to find out which line would be the best for my skin at age of 47!I have used jane irredale but i found out that it did not give me the best coverage for out this way and found it very drying to the skin!I know it has to do with more than the top layer it goes to more under the dermis that could cause of my dryness!and too under the eyes it looks cakey and not young looking!I sometimes do break out with my hormones too in which i find too when a woman has her periods!i do have a little pigmentation to showing up from years of laying in the sun!I want to look fresh and healthy and young looking!I dont know if what i said has helped in the asking part!Could you please tell me which one or is there one better than these two available!marsha

Esthetician: You should try G.M. Collin's Anti-aging duo, it helps with both aging and dry skin.

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Q: I had the Pearl about three months ago and today I went back for a follow up visit with my doctor. She told me I look great but suggested that in order for me to maintain my results I should consider four laser Genisis treatments and one Limelight treatment. I thought perhaps she was just trying to "sell" me more treatments? Or is this perhaps a good idea because I love the results of my Pearl and don't want to loose this look. I'm also on the Obagi system through them.

Esthetician: I don't know much about the treatments she is talking about but I do know about the product you are using and if you keep using this brand you will not loose the results and wont need and treatments.

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Q: G.M COLLIN Stretch Mark and Keloid Smoother could possibly help for removal of keloid. I have a Keloid in between my breast itchy and become bigger. I would like to remove. Advise please.
Thanks

Esthetician: The only way to completely remove a keloid is sugery but if you use this smothing cream and it flatens out you can try using scarguard and it can possibly disappear.

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Q: I have moderate sun damage mostly along my jaw-line, and some acne scarring. I am 53 and have been advised by a physician at Dermacare to have a combo Cutera Pearl/Titan at the same visit.
I know the results may vary, but could you give me an idea of the outcome of one combo treatment? I really cannot afford more than one treatment at this time.
The fee for this is $2225.Is this a fair price? How long will this treatment last if I wear sunscreen or will the old spots come back? Do you know of any negative results from this these treatments, since they are fairly new? Thank You

Dr. Berger: Dear Julie,
I prefer Pearls and Titans at separate occasions. Both procedures heat the skin and why risk being burned?
Also, is the MD actually doing the Pearl, or a technician? Be careful.
The outcome, unfortunately, would be impossible for me to predict. I haven’t seen the extent of the spotting and scarring. But the combination is excellent, in the right hands.
From the problem you described, I think 2 Pearls would serve you better… but again, I haven’t seen you.
As for the price, there is no “correct” price. In my office a single Pearl + Lower Face Titan is about $2,000, so your doctor is pretty right on.

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Q: What skin care line do you recommend for premature aging and hyperpigmentation? I have a medium colored complexion and I have slight acne scars with acne prone skin? I was thinking Kinerase?

Dr. Berger: No doubt about it, Kinerase makes a good line. So does Dermalogica, for that matter. Still, get the advise of a licensed skincare professional (aesthetician) as to which specific products are for your skin type.
The mild acne scars can now be treated wonderfully with the PEARL laser from Cutera. It is mildly ablative, heals in 4-5 days and is truly amazing.

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Q: Acne Scars…I have acne scars on face. Can I treat it with a laser.

Dr. Berger: Dear Balil,
I haven't seen the depth of the scars, but relatively shallow scarring is perfect for the Pearl Laser treatment. Start with a few micro-dermabrasions to prepare the skin, and expect 2 Pearl treatments will minimize the problem.

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Q: How do I get rid of black heads and acne scars?

Dr. Berger: Dear Rose,
it sounds like you still have acne-prone skin. You need to have a good, deep facial at LEAST every other month by a trained aesthetician who uses Dermalogica products. These facials need to include exfoliations to untap your pores and extractions of the blackheads.
Change your cleanser to specific ance cleansers.
As for the scars, you can either find someone who will perform laser Genesis with a Cutera CoolGlide™ laser, usually 10 treatments at high settings with topical anesthetic or, even better, a doctor who uses the new Cutera Pearl resurfacing laser. 2-3 treatments, a month apart with double passes over the worst areas should yield a great result.
DO NOT let a laser tech treat this problem... stick with a Cutera trained physician.

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Q: What does this involve and what are the costs? I have facial lines and skin sagging but think it is too early to do a face lift but have looked into the mini face lift. What are your thoughts on this? I am 43 years old and have indulged in the sun too much in my life. Thank you.

Dr. Berger: Ahhh, Shannon… too much sun.
That’s the mantra of an entire generation of us who were brainwashed to think being tan is cool.
It’s as sad as thinking smoking is cool.
First of all, STOP sunning or whatever we do for you will just return.
Get a good Neova 45 sunscreen and use it EVERY day.
I recommend a combination approach to your problem.
1) 2 Titan Treatments to stimulate collagen and,
2) 2 Pearl treatments to further tighten and also resurface your face. This will remove a substantial amount of existing damage and give your skin a fighting chance. Cost of all four procedures, as a package, should range from $5,000.
A face lift will start at $20,000 by the right surgeon, and you’re not ready for that procedure, anyway.

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Q: Dear Dr. Berger,
What is the best way to help skin that seems to get congested from time to time? Also, I have very, very, light, small acne scars (not bad at all, but I see them) what would the best way to fill them in, or erase them? I'm about to buy a $479.00 16ounce jar of pure Hyaluronic acid. (The only ingredient in it is Hyaluronic acid, so it's pure...) will that help to plump out the little tiny old acne scars? Also would copper-peptides work too?

Dr. Berger: As for the congestion, treat yourself to a facial every 2 months. For the acne scars, forget the creams and potions. Nothing in a jar… for $400 or $4000... will fill in acne scars.
Save your money for laser treatment for acne scars. Applying topical Hyaluronic acid is irrelevant. Laser Genesis or Pearl is the correct answer.

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Q: I'm a man 34 yrs old. Since the age of 12 I had severe acne problems and my dermatologists had to prescribe Roacutane 80mg capsules for me to use as I had acne problems to the 3rd degree as he said. Since then I have no acne at all. Thanks God. But what is left is not beautiful to see. I have many deep acne scars on both on my cheeks with spots in them. What would you suggest in order to treat the deep holes left by the acne. My skin is an oily type. I live in Mauritius, but now I'm in Europe (Ireland). I look forward to hearing from you soon. Thanks

Dr. Berger: Acne scarring is a difficult problem… often more worrisome (socially) than acne, itself.
You can either find someone who will perform laser Genesis with a Cutera CoolGlide™ laser, usually 10 treatments at high settings with topical anesthetic or, even better, a doctor who uses the new Cutera Pearl resurfacing laser. 2-3 treatments, a month apart with double passes over the worst areas, should yield a great result.
DO NOT let a laser tech treat this problem... stick with a Cutera trained physician.

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Q: I had laser skin resurfacing 2yrs ago. I have large pores around my nose and cheeks. What can I do? I am 64 yrs old and I use MD Forte products, level 3. I also have developed Sebaceous Hyperplasia on my forehead and cheeks. I have had most of the places taken off with a Diode laser, but the Dr.(Plastic Surgeon) said they will come back. Is there anything else I can do?

Dr. Berger: Dear Carol, Sebaceous Hyperplasia is a recurring problem... you can treat it, but not cure it. I suggest a resurfacing with the brand new Pearl laser from Cutera. You'll find it has much less down time than previous laser resurfacing technology and will tighten your pores significantly in most cases.

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Q: I am 44 and have lines above my upper lip from sun damage. What can I do to soften or eliminate them?

Dr. Berger: Dear Patty, Ahhh, another former (I HOPE, former) sun-worshipper. I'd eliminate "smokers lip" (or sun damage lip, in your case) by resurfacing with the new Pearl laser from Cutera. Virtually no real down time, and great results in most cases.

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Q: What is the difference between laser resurfacing and photo rejuvenation?

Dr. Berger: Dear Lynn,
Laser resurfacing (Pearl, by Cutera, for example) consists of the destruction of the Epidermis and regrowth of new cell layers. It is highly effective and requires about 5 days of recovery. The results are, indeed, dramatic. Photo Rejuvenation is a combination of IPLs (Intense Pulsed Light) to even tone and 1064 Yag Laser Genesis to even texture. It requires no down time, is generally less expensive, and is excellent for skin that is only moderately damaged.

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Q: I'm considering this procedure could you tell me if this is the way to go as I have huge pores and loads of white heads.

Dr. Berger: Dear Diane,
Huge pores are the result of porphyrins and other oxidizing compounds destroying collagen and prematurely aging your face. As the support structure for the pores weakens, they widen.
The best treatment is a combination of Laser Genesis to stimulate new collagen formation and deep cleansing facials, with the correct cosmeceuticals and exfoliants for your skin type.

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Q: I have extremely large pores, bigger then I’ve ever seen on anyone, lasers never helped, they just seem to grow more and more into each other by the day I also have tons of capillaries, also happening seemingly by the day my nose looks like a wino, I’ve had 10 v-beam treatments, I’ve had 5 for iraderm for melasma, and YAG laser, too. None of this has helped me. My skin is totally flawed and my veins don't respond.
I think I need someone to cauterize or inject them with saline. Do you or anyone you know do that? Seems hopeless.
Will anything help with the pores? I didn't used to have them and no one else in my family does, it ruins my life, and I can't fix it, and my makeup looks terrible in an hour, and I am very oily and shiny. Do any primers or makeup actually work for this type of skin. I need heavy, heavy coverage. I also have some brown spots.
I am only 32 thanks, Michele

Dr. Berger: Dear Michele,
I feel your pain. This type of global skin problem is frustrating and seems forever… but it can be treated.
I would treat the capillaries first with a 1046 YAG laser… 3 treatments, probably.
Then we’ address the issue of the brown spots with IPL, and finally attack the enlarged pores with Vibraderm, Facials and Genesis.
Next, we’d specifically select products for your skin type.
It’s a process… a carefully orchestrated process, and not to be done by other than qualified PHYSICIANS.
There is hope, but you have to look in the right place.
All the best,
Eric Berger MD

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Q: My skin is developing large pores and starting to sag...ugh! What products are helpful for this skin condition?

Dr. Berger: Dear Athena,
As I wrote to Diane, huge pores are the result of porphyrins and other oxidizing compounds destroying collagen and prematurely aging your face. As the support structure for the pores weakens, they widen. The best treatment is a combination of Laser Genesis to stimulate new collagen formation and deep cleansing facials, with the correct cosmeceuticals and exfoliants for your skin type.

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Q: How can I get rid of melia on my face?

Dr. Berger: Dear Mickey,
Melia are actually trapped beneath the outermost layer of dead, keratinized skin.
The best solution is simply to exfoliate regularly. There are several different types of exfoliation, but generally mechanical exfoliations such as Vibraderm, which gently vibrates away dead cells and refreshes the skin, or chemical peels (Glycolic acid, for example) will do the trick.
Find a qualified aesthetician near you and treat yourself to a Vibraderm or peel once a month.
Your melia will be gone and your skin will look wonderful. Sincerely,
Eric Berger MD

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Q: I am brown in complexion, and I have dark spot all over my body due to prior injuries and also from my pores. Is any laser for brown skin?

Dr. Berger:Dear Leona,
unfortunately, no. Resurfacing darker skinned people is a real problem... it can lead to serious scarring, dark spots that are worse and even de-pigmentation in blotches. Try lightening creams and see what works for you.