Meet Dr. Mehrabi

Dermatology
 

Beauty Articles

 
   

 

 

Grow Your Eyelashes
Get Your Winter Glow
10 Myths About Acne
Facial Rejuvenation
Brown Spots
Acne Scarring
Over-The-Counter Acne Care
Blackheads, Large Pores, and Oily Skin
Eye Care and Dark Circles Treatment
Glycolic and Salicylic Acids
Home Microdermabrasion

 

 


Grow Your Eyelashes

There has been a lot of recent buzz regarding growing eyelashes, making them fuller, and much more noticeable. For years, mascara has been the predominant way of making eyelashes thicker and more prominent. Recently, there has been a flood of new interest in other methods of promoting thicker, fuller lashes. New products have come to market, and interest in cosmetic surgery for eyelash thickening is peaking. Do these new topical treatments work? Is cosmetic surgery the only answer to fuller, healthier lashes? Let's cover what is currently out on the market for those wishing to try things other than mascara for more lustrous lashes.

Topical Treatments

New topical solutions have entered the market in an effort to promote healthier eyelash growth at the follicular base at the eyelid margin. The theory is that by nourishing and stimulating the eyelash follicle, extra growth may occur. Keep in mind that eyelash growth is genetically determined, and like hair on the head, its thickness, color, and distribution is determined by familial genes. However, as Rogaine® is used to chemically stimulate hair growth and thicker hair, new eyelash products attempt to do the same thing. Whereas Rogaine® has been scientifically proven to provide results through years of study, these newer products have not been scientifically proven and no truly predictable conclusions can be made about their effectiveness other than personal use and patient testimonials. The initial reviews have been fantastic and it is a fine idea to try these products to see if they work for you first before considering surgical or more invasive options.

Back to Patient Education Center

 


 

 

 

 

Get Your Winter Glow


As winter approaches, skin care takes on new importance as the cold, dry air may cause some undesirable changes in your skin. While the focus always remains on proper sun protection, even in the winter months, taking some extra steps to make sure that your skin is properly prepared can pay numerous dividends throughout the upcoming season. Here are some tips for you to get and maintain your winter glow:

 

1. Proper sun protection


Even though the air feels cold and you may not be outside as much, the sun is still just as dangerous to your skin as it is in the summer months. UVA and UVB rays are still very much present and will contribute to aging and skin cancer progression. Proper sun protection involves using a sunscreen SPF 15 or higher in the morning, and reapplied at lunch time. There are numerous moisturizing sunscreens on the market, some notable ones being Neutrogena Ultrasheer, Cetaphil Facial Moisturizer with SPF, and Olay Daily Defense, amongst others. These sunscreens have the added benefit of being moisturizing while providing the necessary sun protection.

 

2. Glycolic Acid products


Glycolic Acid products can promote a healthy glow by peeling off the top layer of the skin and leaving a shiny, glowing, and youthful appearance. This may be done with simple use of glycolic acid toners used twice daily, or by weekly glycolic acid peels done at your dermatologist's office. It is essential to use a moisturizer before and after glycolic acid peels in order to minimize dryness and discomfort. Also, use of a moisturizer after glycolic acid toners is also recommended.

 

3. Microdermabrasion


Microdermabrasion uses crystals to abrade the very top layer of the skin surface leaving a clean, glowing, and youthful appearance. This process may be done weekly to maintain the youthful glow, but during the winter months it is essential to use moisturizers before and after doing microdermabrasion in order to prevent drying and cracking. Be careful with use of glycolic acid products immediately after microdermabrasion because of possible stinging, burning, drying, or cracking. For the first 1-2 days after microdermabrasion, use of a gentle cleanser (Cetaphil, Neutrogena) is recommended. Then, resumption of glycolic acid product use may begin. While microdermabrasion has been normally considered an office procedure, numerous over-the-counter home microdermabrasion systems now exist.

 

4. Moisturizing


The dry, cold winter air can make skin appear dry, lusterless, flaky, or cracking. As seen in many of the above recommendations already, moisturizing is absolutely essential thoughout the winter months. Moisturizers do not have to be expensive in order to work well. In fact, some would argue that the best moisturizer is simple, plain Vaseline or petroleum jelly. However, for most of us, using petroleum jelly is too much of a greasy option. Key things to look for in evaluating a potential moisturizer are the thickness, consistency, non-comedogenic properties, and inclusion of sunscreen. Just make sure that the moisturizer you choose is one that you are willing to use several times a day, and one that will not cause you to break out or damage your clothes.
 

Back to Patient Education Center

 


 

 

 

10 Myths About Acne

 

10. Poor hygiene causes acne


While oils, dirt, and other contaminants can clog pores and worsen acne, it is not the primary cause of acne. Acne has numerous causes, the most primary being hormonal factors and to some degree, genetics. For those predisposed to acne, poor hygiene may make acne worse, but will not be the sole cause of acne for most patients.

 

9. Acne lasts forever


While those with acne tend to have their acne for years, most people who get acne in their childhood and teenage years improve in their mid-late twenties without any treatment. This improvement is primarily due to a stabilization in hormone levels during the mid-late twenties that are usually raging and in flux during the teenage years. Some people, however, do continue to have some degree of acne throughout the adult years, and there are even some other people who only develop acne in their adulthood.

 

8. Sexual activity worsens acne


The myth was that testosterone levels and the hormonal milieu associated with increased sexual activity worsened acne, but there is no evidence that sexual activity is at all related to acne.

 

7. Acne can be contagious


Acne is not contagious. If you touch or rub against anyone with acne, you will not get acne from their lesions. Rather, touching or rubbing, in and of itself, can lead to pore blockage and cause acne - an example being those people who breakout on their cheeks and chin from speaking on the telephone for prolonged periods of time.

 

6. Eating fatty foods causes acne


Acne is not caused by eating food. Limited studies have been done to prove whether or not foods cause acne, and while some studies may have suggested an association, there is no evidence to support that acne is related to what you eat. Chocolate or sweets do not cause acne.

 

5. Getting sunlight or tanning improves acne


There is no evidence that tanning or sunlight exposure improves acne. Some people may subjectively appear better after sun exposure, but there is nothing to suggest that regular sun exposure is a good way to treat acne. While sun exposure is known to decrease skin inflammation and, although unproven, certain inflammatory acne would theoretically benefit, this effect is NOT scientifically proven. It is very well-known that sun exposure leads to numerous types of skin cancers and strongly contributes to accelerated skin aging.

 

4. The more you wash your skin, the more improved your acne will be


Facial washing does improve acne, but the effect is limited. For those with very mild acne, washing 2-3 times per day may be all that's needed for improvement. However, for those where simple washing does not fully control acne, further or more aggressive washing/scrubbing will not help and is not advised. In fact, the resulting trauma and dryness may be worse than the actual acne, itself. It would be prudent to have other acne control methods, either topical or oral medications to obtain further improvement.

 

3. Popping pimples is the best thing to do when you see active acne


Popping pimples can immediately relieve the pain and inflammation associated with numerous acne types, however, keep in mind that attempting to pop a pimple may actually worsen your acne greatly. The increased inflammation, trauma, and resulting worsening of acne may lead to not only a larger, more painful lesion, but also the potential for acne scarring.

 

2. Natural makeup's are good for acne


Any makeup can promote acne, natural or otherwise. Makeup occlude pores which subsequently get inflamed and form acne. If you are shopping for a makeup suitable for acne, the best types of makeup to use are those labeled as non-comedogenic (non acne forming). For a list of non-comedogenic compounds, click here.

 

1. Using more medicine on acne makes it better, quicker


Using more medicine on a present acne lesion does not make it better any faster. When an acne lesion is present, it is often helpful to place a benzoyl peroxide or salicylic acid 1.5-2.0% product on the lesion one to three times a day. Doing it any more often may lead to excessive drying and cracking without improving the acne lesion further. To the same token, overusing Retin-A or prescription medications that you already have on a single acne lesion is not recommended.
 

Back to Patient Education Center

 


 

 

 

Facial Rejuvenation


Facial rejuvenation is a term encompassing methods by which to reverse the look of aging through a variety of invasive or non-invasive procedures, and topical treatments. For most people, facial rejuvenation involves treatments meant to eliminate the fine lines and wrinkles on the forehead, around the eyes, or around the mouth; and the reversal of the signs of photoaging. While there are methods by which to reduce even greater signs of aging, such as face lifts, blepharoplasties, and laser resurfacing, this article will mainly discuss some of the non-invasive ways of diminishing photoaging and fine wrinkles.


For the reversal of photoaging (mainly encompassing the appearance of redness and dark spots on the face and neck), IPL / Flash-Lamp Pulsed Dye lasers are and excellent means by which to achieve an even and immediate result. While these laser treatments are not necessarily painless, they require only minimal office time once a month and involve the use of light to destroy the underlying causes of redness and dark spots. Most treatment courses involve 3 to 5 monthly visits with no downtime between treatments. Most people can go to work the very same day without signs of even having had a treatment, except for some slight redness. Major caution must be used to ensure that no burning has occurred, and this risk may be minimized if the laser is being operated by an experienced dermatologist or laser personnel. It is wise to avoid sun exposure 2 weeks before a treatment and for several days after a treatment. As part of the treatment plan, a sunscreen should be used everyday since the damage from the sun is the primary condition being treated. Your physician may also decide to prescribe you a bleaching cream to augment the effects of laser therapy.


For fine lines and wrinkles, a detailed discussion on BOTOX® may be found by clicking here. For deeper lines and furrows, use of fillers such as Restylane®, Captique®, or Radiesse® may be used. An experienced dermatologist or plastic surgeon is the best way to find out if these options are right for you. In addition to laser therapy, the use of fillers may subtract many years from your face, and if done properly, may lead to excellent long lasting results.


For those patients requiring even more aggressive rejuvenation, a consultation with your dermatologist or plastic surgeon regarding face lifts, threading, dermabrasion, or ablative laser resurfacing may be beneficial in finding the perfect treatment for you. In addition to any treatment, a personally tailored topical regimen including a Tretinoin or retinol product, glycolic acid product, and a sunscreen, are essential.
 

Back to Patient Education Center

 


 

 

 

Brown Spots


Brown spots on the face, neck, and arms are among one of the most common cosmetic complaints addressed by dermatologists. Brown spots in these locations may be due to numerous causes, including but not limited to: post-infammatory hyperpigmentation, lentigos, poikiloderma (sun damage), seborrheic keratoses, and even melanoma. The discussion of cosmetic treatment of lentigos and poikiloderma will be addressed here, but it can not be stressed enough that a consultation with your dermatologist to determine the nature of any brown spot present in any location is needed to make absolutely sure that you are not dealing with a melanoma or other malignancy.


For brown spots due to lentigos and poikiloderma, usual treatments include bleaching creams containing hydroquinone, mequinol, or kojic acid in various percentages. For creams or solutions containing hydroquinone or mequinol, there may also be a variety of other ingredients to augment the bleaching effect such as tretinoin, glycolic acid, sunscreen, or a topical steroid. In most cases, bleaching the affected area simply requires using the bleaching cream twice daily in addition to a protective sunscreen. It is wise to know that one day out in the sun may reverse all the effective bleaching that you might have done up to that point. Thus, effective sunscreen use and sun avoidance are essential in preventing recurrence of the brown lesions.


In addition to bleaching creams, liquid nitrogen cryotherapy, laser treatment with a 532nm Q-switched Nd:YAG laser for obvious lentigos, or an IPL / Flash-lamp Pulsed Dye laser for lentigos +/- photodamage may be used to achieve more immediate and even results. Discussion for use of these lasers require a consultation with an experienced dermatologist, and a coordinated treatment plan with either tretinoin products, hydroquinone / mequinol products, or other topical treatments may be the best method by which to achieve the most excellent results.
 

Back to Patient Education Center

 


 

 

Acne Scarring

One of the most common questions confronted in dermatology offices amongst patients with acne is how to get rid of acne scarring. This is such an important question because, as acne has its own problems, occasionally the resulting acne scarring can be as cosmetically disturbing as the original acne. Many advances have been made to alleviate the appearance of acne scarring, but no over-the-counter remedies are currently available. The following discussion and suggestions must be carefully reviewed with your experienced dermatologist.

The first step in the treatment of acne scarring is treating the underlying acne. Without an effective anti-acne regimen, treating acne scarring will be futile as more scars will occur despite treatments.

Your regimen may include simple over-the-counter acne care or prescription topicals such as Retin-A® or Tazorac®. Other treatment options include antibiotics, Blu-Light Photodynamic therapy, and oral isotretinoin therapy. These choices are made between you and your experienced dermatologist.

Acne scarring can be divided into two primary groups: rolling acne scars and ice-pick scars. Rolling scars are best described as hills and valley that are truly accentuated with tangential lighting. Ice-pick scarring is the sharp, deep pitting holes made as if an ice-pick was poked into the skin. The treatment of these two different types of scarring differs in both the methods used and the rate of success.

For rolling scars, there are surgical, ablative, and non-ablative methods to reduce scarring. Surgical methods include subcision treatment where a needle/blade is placed underneath the scar and moved side to side to loosen up the underlying scarred tissue. Another treatment option is using a filler such as Restylane® or medical grade silicone to fill up the scar. Non-ablative therapies include using an infrared laser to heat up and remodel the tissue underlying the scar. Ablative therapies include dermabrasion (manual sanding of the skin) or ablative lasers, such as the Er:YAG or CO2 lasers, to remove the top lasers of the skin and essentially even out the "hill-tops and valleys" of the rolling scars.

For ice-pick scarring, surgical methods include punch excision, where a cookie-cutter circular instrument is used to remove the scar under anesthesia and a stitch may or may not be placed to help with healing. Another new technique involves using 90% Trichloroacetic Acid applied with a toothpick. This serves to damage the skin within the scar and promote scar remodeling. The other treatment methods mentioned above also apply: use of the filler substances, dermabrasion, and laser resurfacing.

In general, non-ablative laser therapy may reasonably lead to 50-70% improvement of rolling acne scars. Subcision and use of fillers are ideally used for limited rolling acne scarring and punch excision treatment may be used if isolated ice-pick scarring is noted. For more extensive scarring of either type, dermabrasion or ablative laser therapy tends to be the best option.

Many of these treatments are skin-type specific and must be determined upon close consultation with your dermatologist. While these treatments are not covered under any insurance, the cosmetic results may be well-worth the price. Make sure to discuss all the possible therapy options and combinations, as well as the reasonably expected results.

Back to Patient Education Center

 


 

 

Over-The-Counter Acne Care

Acne care can be divided into three main groups:

  1. acne requiring only minimal over-the-counter care
  2. acne requiring topical prescription care products
  3. acne requiring topical +/- oral prescription products.

For general purposes, the evaluation of acne also follows division into several main different group types:

1. The most minor type of acne is comedonal acne where blackheads and non-inflamed whiteheads predominate.

2. The second type is inflammatory acne where red, sometimes painful acne bumps are noted along with inflamed whiteheads.

3. The last and most severe type of acne is cystic acne where large inflamed acne nodules are present under the skin.

Knowing your acne type may be very helpful in determining which of the groups of acne treatment may be most successful for you.

While prescription acne care determined by your dermatologist is appropriate for all the types of acne, those of you with the first two types of acne may benefit by first trying an over-the-counter regimen. The general principles of basic and advanced acne skin care regimens are explained in the Learning Center. However, here is a very simple regimen that may be followed using simple over-the-counter products that may be found on this site and / or in your local drugstore.

The first step is always cleansing. The primary cleansing products are generally salicylic acid products (2-6%), benzoyl peroxide products (2-10%), or glycolic acid products (up to 20%). For excellent results, usually a salicylic acid wash is the best first step, especially for those with many blackheads and inflamed whiteheads.

Benzoyl peroxide is helpful for those with inflamed papules, and glycolic acid is helpful for those with both types.

The second step involved the use of a medicated gel, lotion, or cream. Toners and astringents are not any of these and are used for more advanced cleansing. Should that be desired, a toner with glycolic or lactic acid is usually an excellent choice. For a medicated gel, lotion, or cream, using a benzoyl peroxide product over 5% or a glycolic acid lotion should provide excellent relief. These products should stay on the skin and not be washed off for at least 1-2 hours. Thus, the best time for application is both in the morning and in the evening.

In summary, a simple regimen of an over-the-counter salicylic acid wash followed by a benzoyl peroxide or glycolic acid gel or lotion is an excellent starting regimen for mild to moderate acne. This regimen is simple and easy to do twice a day. Should this regimen fail, the next step would be to make a visit to your dermatologist's office for possible addition of topical +/- oral prescriptions.

Back to Patient Education Center

 


 

 

 

Blackheads, Large Pores, and Oily Skin

One of the most common beauty questions repeatedly asked in dermatology offices is how to prevent and treat blackheads, shrink pores, and decrease oily skin. Here are a few suggestions to help your facial skin looking clean, clear, and with time, smooth with smaller pores.

Blackheads, otherwise known as open comedonal acne, are the result of oil duct blockage with sebum (a fatty oil mixture) from the oil glands, and may be due in part to blockage from dead skin cells. The sebum stagnates in the oil duct and leads to a blockage of the opening. With continued exposure to air on the surface of the skin, the sebum contents become oxidized and turn black leading to the appearance of blackheads. Blackhead mostly occur in the oiliest areas of the face such as the nose, cheeks, and chin, but may also occur on the chest and back. Prevention of blackheads naturally centers around keeping the oil ducts clear. This may be accomplished by either decreasing sebum production or dissolving the sebum in the duct and allowing it to drain to the skin rather than causing a blockage.

Prevention of blackheads can be done by several methods: use of Tretinoin products (e.g. Retin-A®), salicylic acid products (peels, lotions, creams), glycolic acid products, and microdermabrasion. Tretinoin products allow normal maturation on skin cells and prevents dead skin cells from contributing to pore blockage. Salicylic and glycolic acid products remove dead skin cells to prevent pore blockage, and salicylic acid works particularly well to dissolve the sebum for easy drainage and unblocking. Microdermabrasion also removes dead skin cells from the skin surface and may physically remove some smaller blackheads.

Treatment of blackheads include the prevention methods above and physical blackhead removal. This primarily includes doing a salicylic acid or glycolic acid peel, or microdermabrasion, followed by the use of force to physically push the occluded pore material out. Commercially available alternatives to physically remove blackheads are also available such as the Biore® Pore Perfect Nose Strips.

In regards to large pores, there are unfortunately no guaranteed method to reduce pore size. It is widely believed that consistent use of tretinoin products, microdermabrasion, and salicylic/glycolic acids all result in the appearance of smaller pores. For more dramatic results, deeper laser treatments and manual dermabrasion destroying the upper layers of the skin may result in smaller pores when full healing occurs.

Oily skin is a product of genetics and is individual to each person. While there is no single best topical treatment to decrease oil production, there are a variety of treatments to minimize the appearance of oily skin. These are mainly benzoyl peroxide, glycolic acid, and salicylic wipes that essentially decrease the skin. Some of these products are only made to be used once a day, while washes are made to be used 2-3 times per day. Decreasing oil production is difficult and really is performed through adjunctive use of isotretinoin therapy for recalcitrant acne. Repeated use of a retinoid product may in theory decrease oil production to some degree.

In summary, the first step to magnificent smooth skin with small pores is to remove the blackheads, either physically or by peels. Then, the use of a salicylic acid, glycolic acid, or benzoyl peroxide wash along with a retinoid is needed to prevent blackhead formations. Regular use of salicylic acid products and retinoids should lead to smaller pore appearance, and regular microdermabrasions may be additively helpful in achieving this goal. Finally, for oily skin, carry some salicylic acid, glycolic acid, or benzoyl peroxide wipes to enjoy clear, dry, and healthy skin.
 

Back to Patient Education Center

 


 

 

 

 

Eye Care and Dark Circles Treatment


The treatment of eye wrinkles and dark eye circles centers around consistent application of a moisturizing compound with firming properties. These compounds primarily produce their effects by tightening the skin and reducing puffiness through moisturization, hydration, and rejuvenation of the dermal skin layer. In addition to the usage of these compounds, it is absolutely essential to apply a moisturizing sunscreen to minimize future possible sun damage and wrinkle formation.
 

Back to Patient Education Center

 


 

 

 

Glycolic and Salicylic Acids

For maintenance of beautiful, smooth, and clean skin, glycolic and salicylic acids are excellent choices for cleansing and exfoliation. Glycolic acid is an alpha-hydroxy acid which serves to loosen the top layers of the skin and promote shedding of the dead skin cells. Used in concentrations of less than 10%, these washes are excellent for daily cleansing and acne prevention as the dead skin cells no longer remain available to plug the pores and promote acne formation. Used in concentrations over 20%, glycolic acid provides more astringent properties for a deeper peeling and skin removal. Glycolic acid products are excellent choices for those who have oily skin, occasional slight blemishes, and those who wish to achieve a shiny, smooth exfoliated appearance.

Salicylic acid is a beta-hydroxy acid which serves to break down skin cells and is particularly useful in loosening material within pores and unclogging pores. Used in concentrations of 2-6%, these products are excellent washes for acne prevention, and may be used as a preliminary wash prior to the application of any prescription medication or acne-fighting medicine. Used in higher concentrations, salicylic acid peels are used for exfoliation and acne treatment. Salicylic acid products are excellent choices for those with oily skin, and those with moderate acne on the face or body.

For added acne-fighting or facial rejuvenation benefit, combine either of these products with retinol products or home microdermabrasion.
 

Back to Patient Education Center

 


 

 

 

Home Microdermabrasion

Having beautiful skin often includes have a healthy glow or shine with minimal pore appearance and blemishes. Achieving this goal may be done in a variety of ways, both at the physician's office or at home, and with solutions or other physical means.

Traditionally, superficial chemical peels are used to remove and exfoliate the very top layer of the skin and create a shining, smooth, and healthy glow. Chemical peels are also often used to even out skin pigmentation and may possibly reduce pore size. The mechanism of action includes the dissolving the glue that holds the top layers of the skin together, allowing them to be removed by gentle wiping. By removing the top layer and dead skin, chemical peels reduce the probability of pore-plugging and acne formation.

Modern microdermabrasion in a physicians offices use aluminum oxide crystals forcefully sent at the skin surface to physically cause microdamage to loosen the top layers of the skin. At the same time, a powerful vacuum immediately withdraws the crystals after skin contact. The skin is left slightly red for a day or two, but this procedure leaves the skin to heal with a radiant and shining glow. Acne formation should decrease, pore size may minimize with chronic use, and superficial wrinkles may be lessened.

Home microdermabrasion kits bring home the ability to use crystals to cause mild exfoliation, leaving the skin refreshed, shining, and glowing. Some kits use a mechanical battery-powered applicator while some kits and creams are sufficiently applied by the user via pads or soft rubbing. Weekly or biweekly use is an excellent method of promoting healthy looking skin and minimizing acne formation. Chronic use is also effective in minimizing pore appearance and may decrease superficial wrinkles around the lower eyelid, mouth, and forehead.

Enjoy the soft, glowing appearance of your skin with home microdermabrasion. Several home microdermabrasion kits are shown below. Obtain extra effectiveness by combining your home microdermabrasion with regular glycolic acid or salicylic acid product use. Concurrent use with retinol products will also provide added anti-aging results.

Back to Patient Education Center

 

 

 

 

 

Home - Appointments - Beauty Articles - Breast Augmentation - Breast  Lift - Breast Reconstruction - Breast Reduction - Botox - Chemical Peels

Contact Us - Directions - Eye Lift - Face Lift - Juvederm / Ultraplus - Laser Treatments - Liposuction - Meet Dr. Mehrabi - Microdermabrasion

Nasal Reconstruction - Our Doctors - Patient Education - Perlane - Photo Gallery - Radiesse - Restylane - Sclerotherapy - Site Map

Skin Care Products - Skin Care Regimens -Skin Conditions - Skin Treatments - Special Offers - Tummy Tuck

Copyright 2008. ©Nexus Beverly Hills. All Rights Reserved.

Web Development by Axcension, Inc