Q: Dear Dr. Berger,
I have acne scars on my face. I had a peel a few years ago thinking it might help the scar become less noticeable. After I had the peel I started to have pigmentation which makes my face dirtier looking.
I have tried all the products on the market. Mederma, Retin A, etc. but the scars and the pigmentation did not fade at all. So I decide to have a Medlite laser for 5 session.
The scar did not go away and neither did the pigmentation.
I heard about the Fraxel. How effective is the Fraxel for removing the scar and pigmentation, and how much approximately is the cost?
I am a keloid former. Can I have a Fraxel treatment even if I have a very sensitive skin?
Dr. Berger: Let’s start at the beginning. First, though some Caucasians form keloids, I assume you’re African-American. There are just some lasers that shouldn’t be used on people of color and, especially keloid formers.
I’d try physician prescribed Hydroquinone, maybe, in experiences hands, Laser Genesis (CUTERA) at high settings to break up the pigmentation... but do not venture into the Fraxel/Pearl/resurfacing world. Even the peel sounds like it was a bit too invasive for your skin-type.
The results could be worse than the initial problem.
Q: I have terrible acne and I would like to know if Neova products are good or should I try stronger medication. Thanks
Dr. Berger: Dear Lilly, it would help to know your age, the amount of time you’ve had acne and what treatments have already been tried.
Everyone has a different definition of "terrible."
I usually start patients off with exceptional cleaning. A Dermalogica Facial a week for a month, while they have 2 Blue Light (OmniLux) sessions a week for 10 weeks.
Generally, that will make any other treatment more effective by removing the offending bacteria and porphyrin by-products, and exfoliating to make the pores more accessable.
Your age is significant because at puberty and menopause… whenever there are big hormone swings… hormone balancing can be VERY helpful, too.
Q: I have been using True Cosmetics essential for the past two months for my acne problem skin. It helps to reduce the acne a lot, but I still have one at least coming out every day. What should I use to stop it permanently? I am 26 years old. Please advise.
Dr. Berger: Dear Nafiza, it would help to know your age, the amount of time you’ve had acne and what treatments have already been tried.
I usually start patients off with exceptional cleaning. A Dermalogica Facial a week for a month, while they have 2 Blue Light (OmniLux) sessions a week for 10 weeks.
Generally, that will make any other treatment more effective by removing the offending bacteria and porphyrin by-products, and exfoliating to make the pores more accessable.
Your age is significant because at puberty and menopause… whenever there are big hormone swings… hormone balancing can be VERY helpful, too.
Q: Dear Dr. Berger,
I am 31 years old and I have never had problems with my skin until 6 months before I got married, when my face started breaking out (clogged pores, huge pimples, etc).
Trust me, it wasn't stress, the doctor gave me Accutane to no avail. 4 months before I got married, I quit my Accutane because I am planning to conceive right away. Since accutane did not help my doctor suspects that it is hormonal. I am pregnant now, and still breaking out.
I still get the occasional big pimples (not as much) and little bumps on my forehead. What kind of products would you recommend for me? Right now, I am using Dermalogica Special Cleansing Gel and Skinceuticals C E Ferulic and a facial once a month.
What kind of skin regimen would you recommend for me?
Thank you doctor!!
Dr. Berger: Dear Mutia, first, congratulations!
A recent marriage.. a baby on the way… and it’s nice to hear that someone’s wedding was not stressful (just kidding).
Your doctors seem to have the right diagnosis, and the fact that it has gotten at least better while pregnant seems to confirm it.
When you’re not trying to conceive, consider Yaz or some other mild contraceptive pills to balance your hormones.
The products you choose are good ones… I use Dermalogica here in the office… and facials are key.
Q: My daughter is 20 years old and has very fair sensitive skin. She breaks out easily, and her skin is recovering from using some harsh acne products (she has redness on her cheeks).
She got a sensitive skin facial at the Red Door Salon and they recommended the B. Kamins line of Rosacea products for her. We purchased the facial cleanser, moisturizer and the Blue Rosacea Treatment.
It has been a week since her facial and since beginning these products. She has about six new pimples (small). Do you think these are from the facial or the B. Kamins products? Do the B. Kamins Rosacea products clog pores?
Red Door also recommended the Phytomer Vegetable Peel, which I notice has vegetable oil in it. We haven't tried that yet, but I am afraid it might clog her pores.
Dr. Berger: Personally, I like B. Kamins products and haven't heard of acne outbreaks from them. That being said, I prefer Dermalogica Acne facials over any other products I've found.
Find a salon that uses Dermalogica and your daughter will see a real difference.
Also, for acne we recommend a facial a week for a month to adequately clean the skin and Blue Light/Red Light LED therapy for the acne, itself.
Your thoughts about vegetable oil are right on target… no place in facials for acne prone patients.
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.
Q: Dear Dr. Berger,
I am 40 years old and still suffer with back acne! The cleansers on the market are too drying & benzol peroxide products bleach my clothes.
Is there anything you can recommend?
Dr. Berger: Dear Karen, first of all, is the problem hormonal? Have you seen a GYN for a hormone analysis and balancing, if necessary?
Find a dermatologist affiliated aesthetician who uses Dermalogica products and get "Back Facials", and a series of Blue Light treatments. That will probably control the problem.
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.
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.
Q: Hello, I'm a 21 year old female who is battling acne around my chin and mouth area. I'm not sure why they appear as I stay away from dairy products and eat a balance healthy diet. I've tried many treatments that only tend to irritate my skin instead of clearing it. I need to know if you can help me relieve these zits around my mouth and chin area all around.
Dr. Berger: Dear Ellen,
Start with a good cosmetic dermatologist who has both an aesthetician and a blue light (Duza or Omnilux).
Have a facial a week... yup, once a week... for a month to really clean out your pores and refresh your skin. Start a series of Blue light treatments, not antibiotics, to kill the bacteria.
Switch to Dermalogica acne products… they’re excellent and effective.
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.
Q: Dear Dr. Berger,
I have stubborn spots that are lingering reminders of a breakout. What would you suggest for fading these spots and preventing future blemishes?
Thanks much and all the best!
Dr. Berger: Dear Nicky,
The best way to prevent future breakouts is to maintain immaculate skin. I recommend monthly Dermalogica facials to my acne prone patients, and switching from whatever expensive products they are using to basic, tested Dermalogica acne products.
Blue Light Therapy on a bi-weekly basis will alleviate immediate problems, without harmful antibiotics, and IPL (Photo Facials) or PDT peels will get rid of the spots.
Q: I have severely dry skin with spots of eczema
along the sides of my face. My skin is very sensitive. Would the atopalm face cream be a good choice for me? I'm 46 and also prone to monthly breakouts due to hormones. I had a hysterectomy when I was 29, but they left my ovaries. I'm very fair, and burn easily. I've spent a fortune on good skin care but nothing seems to help, day or night. Any advice would be appreciated.
Thanks,
Susan
Dr. Berger: Dear Susan,
Good skin care starts with good Aestheticians. Facials (gentle facials, in your case) are the key, and Blue Light Therapy will help, too.
The fact that it is hormonally related means that a week prior to your period every month would be a good time to have two treatments a few days apart. Moisturize with Dermalogica's acne products, and see a GYN about low dose birth control specifically to address hormonally related.
Q: My daughter has very many blackheads on just her nose ... what is the best treatment to be rid of them. I don't want to hurt her feelings.
Dr. Berger: Dear Cheryl,
Blackheads are the result of inadequate cleaning, leaving sebum and dirt in the pores. That being said, most people can not properly clean, exfoliate and express their skin.
That's an Aestheticians job.
Treat your daughter to a professional facial, and get her on the correct products for her skin type. No embarrassment, just results and a bit of pampering.
Q: I have fairly good skin and was wondering what line you recommend for body products, body lotions, etc. My skin type is dry to normal and I am 42 years old.
Also my husband is 45 and has acne on torso.
Dr. Berger: Dear Ellen,
Dermalogica makes products specifically for your type of skin, and ProCyte also has high quality body lotions.
Stick with the basics. No fancy packaging, no fragrances… just good moisturizers. Vibraderm body treatments are a wonderful adjunct to overall body skin health.
Your husband sounds like he needs a consult, possibly a "body facials" and blue light treatments.
Q: My daugther is 12 years old and has mild acne. She is using Dr.Perricone system, but it is causing itching in her face. What can she use to help with the itching that these acne products cause?
Dr. Berger: Dear Lizzette,
Perricone products are extremely high quality, and his acne treatments (and acne diet recommendations, etc) are excellent... but that does not preclude the possibility that your daughter is allergic to one or more of the base ingredient.
In fact, itching is one of the most frequent reactions in skin allergy.
Does the itching stop when she is not using the treatments? Is only one product causing the reaction?
I recommend that your daughter visit a dermatologist for a full acne screening, and avoid products which cause reactions. Acne is frustrating, but there is no need to suffer itching (or any other problem) while trying to treat it.
One size does NOT fit all, no matter how well formulated and manufactured.
Get some hands-on advice.
Sincerely,
Eric Berger MD
Q: At 61 I continue to have 'black heads' on the high part of my cheek bones and on my nose. What product would you suggest to dissolve them. Also, what is H50 Therapy Cream supposed to do. My daughter gave me some samples from her doctor.
Dr. Berger: Dear Linda, I always recommend deep cleansing facials every other month to my patients with a tendency for acneform lesions. I also highly recommend hormone replacement for post-menopausal women with no family history of breast cancer… they can even test for the breast cancer gene! It’s soooo good for your skin (and general quality of life. Ask your GYN.
As for H50, it’s a good, soliud performer for anti-aging, moderately priced and effective. Just be sure to get the appropriate type for your specific skin; dry or oily.
Q: I have Melia underneath my eyes and have had Laser done to take them away. But they are coming back again...What can I do, and is there anything I can use to wash my face with to help keep them away? I know I can’t use anything with Oil.
Dr. Berger: Dear Patricia, Get a good monthly facial with Dermalogica products by a good facialist. Lasers were not indicated for this problem, in my opinion.
Q: What is the best facial care for mild adult acne. I am concerned about the fine lines starting to form so can you help me with a treatment for both? Thanks so much I just turned 50 and never had any break outs as a teenager at all. Kinda wish I could of had them then and not now!
Dr. Berger: Dear Sharon, I see this type of hormonal acne every day. It’s so frustrating. I usually start patients off with exceptional cleaning. A Dermalogica Facial a week for a month, while they have 2 Blue Light (OmniLux) sessions a week for 10 weeks. Generally, that will make any other treatment more effective by removing the offending bacteria and porphyrin by-products, and exfoliating to make the pores more accessable.
Your age is significant because at puberty and menopause… whenever there are big hormone swings… hormone balancing can be VERY helpful, too.
Note: Advice and information presented on this website is of a general nature only and is not intended to constitute or replace professional advice for individual or specific conditions.
