Dr. Berger will be available to answer your questions as well as writing quarterly article on Beauty Bridge. His skills are a valued asset in New York, a city where youth and beauty are important trump cards.

Please use the form below to submit your question to Dr. Berger.

Questions & Answers
Q: Have you ever heard of, and can therefore advise on, the skin condition 'ichthyosis'?

Dr. Berger: Ichthyosis is a relatively rare genetic skin disorder. Literally, it means fish skin, since it is characterized by scaly, dry skin. Since it's a genetic mutation, it isn't contagious, there is usually a family history of the disease, which helps your physician diagnose the disorder.
Most types of ichthyosis are present at birth, and are life-long. There are about 25 different types of some so mild that over-the-counter moisturizers control the problem, some so severe that they scaling can be very painful; even restrict the body's range of movement, cause deep cracks or fissures at the joints, etc.
Normal skin sheds (exfoliates) in small flakes, constantly, and the process goes unnoticed. In Icthyosis, however, the shedding flakes are more firmly attached and larger due to clumping.
Treating this disorder is very labor intensive. To force the skin to shed faster and appear more normal, frequent bathing with an exfoliant sponge (like a loofah) and applying moisturizers and emollients several times a day is required.
I hope this answer was useful. There really is no cure only treatment.

Dr. Berger: Yes, there are problems with Hydroquinones. If you have had any Basal Cell activity or significant Actinic Keratosis it is probably best to avoid the higher percentage products. Stick with 2%... or better still, if the spots are generalized, consider IPL laser treatments under the care of a physician.
Usually 4 treatments, spaced a month apart, with a CUTERA 560 will resolve most hyper-pigmentation.

Dr. Berger: There are no real negatives to laser facial hair removal, as long as the correct laser device at the correct settings is used.
I prefer using the CUTERA CoolGlide 1064 YAG laser rather than the 770 Prowave on small areas like the face. This is especially important in darker skinned patients, who risk being burned by flash lamp technology.
Darker and thicker hairs usually get a better result. There are no long term risks to the procedure.

Dr. Berger: There are a wealth of products which treat specific spots (many with various amounts of hydroquinone), and even more "cover-up" products to evenly cover complexion irregularities. But to really TREAT uneven skin tone, there's nothing that comes close to IPL(Intense Pulsed Light) Laser treatments.
Usually a series of four treatments, spaced 4 weeks apart, will erase the unevenness and leave a smooth, even skin tone.
This works best for patients with light to medium complexions, and the results can be dramatic..

Dr. Berger: Dear Meredith,
I am delighted that your health is improving, and would like to add that about 50% of Discoid Lupus cases go into complete remission. Those are really very good odds for any auto-immune disease.
Unfortunately, acne-form lesions are occasionally the FIRST symptom of the disease, and the treatment is often disappointing.
What modalities has your physician tried? Have you tried antibiotics... laser treatments... possibly, Laser Genesis? Deep facial exfoliations with glycolic peels?
There is practically no literature regarding treatment, specifically, of these lesions... any attempt would be classified as an experiment, but the problem is emotionally devastating.
That being said, if you are in the NYC area I'd be pleased to see you and discuss the problem in person and see if I can be of any help.
All the best,
Eric Berger MD

Dr. Berger: Melasma is a very difficult problem... especially when you've unsuccessfully exhausted the topical formulations.
I'd like to know what percentages of hydroquinone you've tried, and how long you used each type.
Treatment today is generally a combination of preparing the skin with progressively stronger amounts of hydroquinone and then attacking the problem with CUTERA Genesis AND IPL lasers.
Let me stress the word "treatment". There is no actual "cure" for Melasma.
Treatment will be ongoing, and it is essential that you avoid sun exposure... use 45-60 SPF even to walk the dog... even when it's cloudy and raining.
If you are in the NY Metro area, I'd be delighted to discuss this problem in person. I understand how frustrating it can be.

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

Dr. Berger: Dear Judy,
What percentage Retin A are you using?
Who prescribed it and have you seen them for follow-up?
I would immediately discontinue use, and plan on visiting a dermatologist who will Rx slowly increasing percentages and frequency of application.
USE SUN SCREEN EVERY DAY, especially while using Retin A; avoid all laser and light treatments; moisturize and rest your skin for a while.
Sincerely,
Eric Berger MD

Dr. Berger: Dear Xen,
I'm not certain I understand the question.
Is your skin still dry and thick, and are you under the care of an MD, or was it a transient problem of infancy?
Any good baby moisturizing lotion should do the trick... and remember, while adults "shed" a layer of skin every 30-60 days, your baby is renewing her skin every 10 days!
Talk to your pediatrician, but moisturize, moisturize, moisturize!
Sincerely,
Eric Berger MD

Dr. Berger: Dear Dawn,
Though your description was pretty good for a non-dermatologist, there are any number of problems which present in this way.
Among them are melia, seborrheic hyperplasia and even pre-cancerous actinic keratotic lesions.
I highly recommend that you make an appointment with a dermatologist in your area for a more accurate disgnosis and treatment.
Not a spa... a physician.
Best regards,
Eric Berger MD
Medical Director

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

Dr. Berger: Dear Nelly (Deer Nelly?),
The thin skin is being extra protected by circulation and that's why you get the Rudolph-nose.
Don't IPL... IPL is for hyper-pigmentation, not transient, temperature related changes.
The best thing to do is keep your nose warm... a ski mask, for example, and HIGHLY protected with Chapstick/Vaseline-like substances to prevent chapping and cracking.
I've never been to Norway, and this would be an excellent excuse, so if you need me to make a housecall...
Best regards,
Eric Berger MD

Dr. Berger: Dear Mary,
Many metallic substances can dye the skin however, the amount in facial products is minimal and not even the type of silver compound that will cause these problems.
More important is the fact that laser treatments can react with metal to change skin tone… if you plan on having any of the wonderful, rejuvenating treatments like laser Genesis, Photo Facials, etc, discontinue these products for a month beforehand and tell your physician so that they can perform a facial and remove all the product which may be hiding in your pores.

Dr. Berger: Dear Belinda,
This is a very interesting problem, indeed. You actually want to remove the remaining pigment.
First step is to try Hydroquinones… but that would be only a temporary fix. Interestingly enough, during tattoo removal patients often lose their natural pigment. While it would be a stretch to assume that all the natural pigment could be intentionally removed, in the right hands it would be worth the try. No harm done, even if the results are less than perfect, and possibly a real; solution to your problem.

Dr. Berger: Dear Julie,
There are about a million creams that purport to fix stretch marks… and none of them work.
I have had some success with the Titan Laser combined with Genesis to re-align collagen. If you're in the New York area, give my office a call.

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.

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.

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.

Dr. Berger: Dear Carolyn,
In the midst of New York winter, I envy you being in South Carolina… need a house call? LOL Actually, Jane Iredale makeup is an excellent product line.
They boast that their products contain no oil to clog or enlarge pores and no talc, which can dry the skin, and there is no perfume, alcohol, chemical additives or artificial dyes.
That's huge in the cosmetic marketplace. Good choice.

Dr. Berger: Dear Gilda,
Keloids are an excess of collagen growth at a scar site. The collagen forms lumps and clumps instead of smooth layers and a flat matrix.
Injection of steroidal compounds like Kenalog can decrease the formation and Laser Genesis, at high levels with topical anesthetic can help smooth the appearance. Usually about 10+ treatments are necessary 3-4 weeks apart.

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.

Dr. Berger: Dear Nici,
I'd have to evaluate the problem first hand, but if this is a result of capillary overgrowth, lasers are the answer.
Unfortunately, the problem is considered cosmetic… a letter from a psychologist describing your social reluctance and anguish over the problem might help, but insurers are tough. Find a specialist with a Cutera Xeo, who has a LOT of experience with vascular lesions.

Dr. Berger: Dear Beth,
A combination of Vibraderm™ Microdermabrasion and laser genesis might help. It sounds, however, like the lines are pretty deep.
BOTOX® is NOT indicated in this area, so don't worry.
Get a good evaluation by a cosmetic dermatologist and think "Titan™".

Dr. Berger: Dear Heather,
Feel free to call the office… 212-838-6900. Tell my office manager you contacted me through Beauty Bridge.

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.

Dr. Berger: Dear Beth… STOP!
Retin-A can, in and of itself, dry and irritate the skin and should always be discontinued a few weeks before laser treatment of any type… especially IPL.
Your Aesthetician may be a good facialist, but I must question her judgment in this case.
And IPL will NOT treat rosacea.
I recommend arranging a consultation with a physician cosmetic skincare specialist before proceeding.

Dr. Berger: Dear Deborah,
Find a physician with a Cutera LimeLight. It treats redness and sun damage and spots… not just spots. That is far and away your best choice.

Dr. Berger: Dear Kay,
There should be an expiration date on the package, or you can call the company with a lot number and get more information.
After years of using a specific product, you might have developed a sensitivity… in any event, wasting a few dollars is better than harming your face.
Discontinue use and switch to a mild product for a while. If the problem persists, consult a dermatologist.

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.

Dr. Berger: Dear Becky,
I have done hundreds of Titan treatments, without a single burn or problem.
Certainly, in the wrong hands, lasers are dangerous. Too many offices have semi-trained laser techs performing the procedures and a physician who "oversees" the process.
In some states (New Jersey, for example) only the MD can use the lasers.
Find a physician who does his own work and don't take chances with your face… but Titans are safe AND effective in most cases.

Dr. Berger: Dear Sue,
Bad news… stop the Retinol. Moisturizing will cover up the damage, but if you are one of the unlucky patients who have been sensitized to the product, discontinue use.
There are more than one ways to attack wrinkles. Consult a good facialist and a cosmetic skin care MD.

Dr. Berger: Dear Shirley,
Grenz rays are a form of black light produced at low voltages, giving them a very low penetration power. They do not penetrate beneath the skin.
Due to its very limited level of penetration, Grenz rays are classified as ultrasoft radiation. They do not carry the risks of other forms of radiation.
Your basal cell problem is most probably due to excessive sun exposure and not the Grenz Treatments.
I have basal cell carcinoma, myself, from working as a lifeguard in my pre-sunscreen youth. Every year I have a full body check up and every year they find new lesions. I guess we're both, as you put it, "doomed". Buy hats!

Dr. Berger: Dear Marcie, those of us with pasty white skin have always envied the olive-skinned. I guess there is a down side, after all. (Greener grass, and all that!).
There are many good bleaching creams with Hydroquinone available, but be VERY careful not to get then into the eye, itself. Also, use it sparingly or you might get the reverse effect and be too light around the eyes.

Dr. Berger: Dear Victoria,
So that's Victoria's secret! Too many creams. Actually, 7% Hydroquinone is very strong and I would recommend using those products serially, rather than simultaneously. It's better to err on the side of caution… always.

Dr. Berger: Dear Tona,
Not having seen your skin or knowing how sensitive it is makes this a difficult question.
Stay with basic product lines, and their dry skin formulae. Try Procyte’s excellent Copper Peptide creams. They are really great and excellent value for quality.

Dr. Berger: Dear Gretchen,
It's rare enough that light skinned red heads develop keloids at all. I would go to someone with a Cutera Xeo, use topical anesthetic cream and get about 10 treatments at relatively high settings. That might blanch out the small blood vessels which are actually causing the redness. Make certain the physician is no stranger to this problem. The last thing you need in that sensitive area is a burn!

Dr. Berger: Frankly, Alice, I have no experience with Solage. I read up on it and it seems fine, but I tend to favor the old standards like Hydroquinone.
If it works for you… It is, after all, a lightening cream, though it's specifically recommended for sun spots and age spots. May work, probably can't hurt.

Dr. Berger: Dear Deb,
There is no average as it may not work on deep wrinkles at all. I've never been particularly impressed, but that's just one man's opinion. Are you seeing any results? How long is "recently"?
Give it a month and if you're not impressed, consider a Titan series.

Dr. Berger: Dear Tom,
Got gloves? All kidding aside, a good pair of ski gloves will help a lot, and simply using ProCyte Copper Peptide cream will help the healing a lot.
Buy a few pair of inexpensive cotton gloves, smear your hands in ProCyte and sleep in the gloves. Your hands will be smooth and your significant other will be grateful.

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

Dr. Berger: Dear Rhonda,
The treatment of choice is 4 sessions of IPL pulsed light or, in advanced cases (like you seem to describe) PDT with Levulin™. That will certainly do the trick.

Dr. Berger: Dear Rhonda,
The treatment of choice is 4 sessions of IPL pulsed light or, in advanced cases (like you seem to describe) PDT with Levulin™. That will certainly do the trick.

Dr. Berger: Dear Patsy,
I prefer to treat AKs with Levulin and Blue light. It’s definitive and better than any topical product.
You can use Jane Iredale over most anything. Its an excellent product line.
They boast that their products contain no oil to clog or enlarge pores and no talc, which can dry the skin, and there is no perfume, alcohol, chemical additives or artificial dyes. Good choice.

Dr. Berger: Dear Nina,
As I wrote to Marcie, There are many good bleaching creams with Hydroquinone available, but be VERY careful not to get then into the eye, itself. Also, use it sparingly or you might get the reverse effect and be too light around the eyes.

Dr. Berger: I'm sorry, call me stupid, but I can not imagine soap for $100 a bar. It would have to sing and dance in the soap dish to entertain me each morning while I brushed my teeth!
Any good cleanser… for $25-40 a large bottle… will do just as well. Let's all take a deep breath and think of the fun you'll have drinking Vodka and Lime with the other $60 (in moderation and with a designated driver).

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.

Dr. Berger: Dear Skyla (GREAT name… lovely!),
Try hydroquinones under dermatologist supervision and, if that doesn't do the trick, consider IPL treatments.

Dr. Berger: Dear Ariel,
Strivectin is an ordinary moisturizer and potentially quite irritating. It’s basic components are the emollients sesame oil and alkyl benzoate.
Organic, high quality sesame oil costs $14 a quart at banyanbotanicals.com!
See for yourself.
In my considered opinion, there are no ingredients in Strivectin which could possibly justify its unconscionably high price.
It is neither an effective treatment for stretch marks and, as regards the claim "better than BOTOX®", whom do they think they're fooling?
Nothing is better than BOTOX®. Its main "active" ingredient is a peptide molecule too large to penetrate the skin and even reach the dermis, where stretch marks and wrinkles are formed.

Dr. Berger: Dear Dona,
Have you tried Dermalogica's Ultracalming Cleanser? It's a great choice for sensitive skin and contains neither.

Dr. Berger: Dear Rebekah,
I've actually heard the "pit viper look" is hot this season!
Seriously, though, I assume you're referring to the smokers' lines radiating around the lip margin. They are a fairly easy problem to address.
First, CUTERA Laser Genesis,directly stimulates superficial collagen formation. This is Upper Dermis collagen, the loss of which causes those nasty lines to form in the first place.
A series of 4 or 5 Genesis treatments should do the trick. I prefer to do this particular area with topical anesthetic cream... like EMLA... so I can work at higher power and get better results.
Full Face Genesis Package (3 treatments) is between $900-1,100, so the whole series of treatment of the lip area only should be about $600-... it won't break the bank.
Find a physician with CUTERA Lasers www.cutera.com and get rid of those lines!
Eric S Berger MD

Dr. Berger: Dear Ala,
There are several excellent "bleaching creams" on the market... most consisting of Hydroquinones with/without Glycolic Acid.
Hydroquinone decreases the formation of melanin in the skin. They work pretty well, though not nearly as well as a series of IPL (Intense Pulsed Light) Treatments, which will cause the pigmented lesions to flake off entirely.
Be careful using these products in Winter. Hydroquinone can further irritate dry, chapped skin. Use Extra moisturizer! In either case, Hydroquinone or Laser IPL, they are not recommended for use during pregnancy OR while breast feeding.
There is no direct evidence linking Hydroquinone or IPL (or any laser treatment) with birth defects or illness in breast-feeding infants, but it is definitely not worth the risk.
Wishing you and your baby all the best,
Eric Berger MD

Dr. Berger: Dear Shaheen,
Hyperpigmentation may be due to trauma (acne, infection, etc.), medications, sun damage... do you use sun screen and a host of other reasons. How long has the hyperpigmentation been there?
Certainly, Hydroquinones have a place in treatment, and depending on your natural skin tone, IPL Lasers might help. If you are light skinned, IPL can even tone in a series of 4 treatments. Then, too, series of glycolic peels, Vibradermabrasion or Microdermabrasion might work. So you see, it's a complex problem. You really need to be seen by someone VERY good, who can select the option that's best for you.
All the best,
Eric Berger MD

Dr. Berger: Dear Susan,
There is no contraindication to the use of retinoids with Neova products… especially the Copper Peptides.
I recommend Neova Night Therapy. Cleanse carefully and apply nightly. You'll be very pleased with the results.

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.

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.

Dr. Berger: BOTOX® is the answer to a lot of questions. Someday there will be a religion where BOTOX® will be a sacrament. It will prevent the scrunching and wrinkling that leads to furrows, and prevent the lines from worsening. Be religious in it's application. Every 4 months.
Go to a cosmetic laser/plastic/derm specialist… please don't let your dentist, GYN or podiatrist play with your pretty face.
As for existing lines, I REALLY like the Pearl treatment from CUTERA, or Laser genesis. I really do NOT like Fraxel.

Dr. Berger: If they are big, blue varicosities, go to a vascular surgeon. If they are spider veins no More than 3/16" in diameter, find someone with a CoolGlide Cutera Laser and start treatment. 3 treatments per area of veins usually does the trick.

Dr. Berger: As you certainly already know, RSD (Reflex Sympathetic Dystrophy) believed to be the result of dysfunction in the central or peripheral nervous systems. Other theories suggest that RSD follows an injury and is caused by triggering an immune response. In either case,
Treatment may include: Physical therapy and exercise, Psychotherapy to relieve stress, anxiety, and depression, Spinal cord stimulation and,
Medications including: Topical analgesics, Anti-seizure drugs, Antidepressants (Pain CAN make one very depressed), Corticosteroids and even Opioids for severe pain.
Ask your internist to recommend a well thought of pain specialist. Start with combinations of topicals such as BLT or EMLA, and work from there.
All the best.
Eric Berger MD

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.

Dr. Berger: Great question! Thanks, Sonya.
TT is a eubacterium. That means it’s a bacteria, not a mold, and that it has thick, rigid cell walls (rather than flexible) and a flagella (tail) so it can move. There's a lot of research going on about TT… it was isolated in a deep, hot water ocean vent off Japan, and prefers to live in VERY hot (65ºC, 150ºF) environments. It also can exist in hot water heaters. To the best of my knowledge, and all the scientific data I could find, it currently has no human application except to separate you from your money.

Dr. Berger: Great question! Thanks, Sonya.
TT is a eubacterium. That means it's a bacteria, not a mold, and that it has thick, rigid cell walls (rather than flexible) and a flagella (tail) so it can move. There's a lot of research going on about TT… it was isolated in a deep, hot water ocean vent off Japan, and prefers to live in VERY hot (65ºC, 150ºF) environments. It also can exist in hot water heaters. To the best of my knowledge, and all the scientific data I could find, it currently has no human application except to separate you from your money.

Dr. Berger: Dear Joan,
Titan can help with the laxity of the facial skin... but no one, anywhere... despite claims to the contrary... has developed a laser that replaces eye lid surgery for hooding.
The risk of laser damage to the eye is just too great.
Find a competent plastic surgeon who specializes in facial work and bite the bullet... you'll be glad you did. The risks are minimal (he'll explain everything) and the results are real.

Dr. Berger: Dear Sacha, your dermatologist is a good man.
Some things are just plain surgical, and this is one of them. The surgery is relatively simple and routine... don't look for cures that will disappoint. Go to the ophthalmologist, as recommended.

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.

Dr. Berger: Simply put, tanning beds suck. I don't believe I just wrote that, but I refuse to change it! You still get harmful UV rays no matter what the scoundrels who run the place say, and yes, they can affect your keloids, cause skin cancer and more. Get a nice, effective self tanner (like Clarins) and call it a day.

Dr. Berger: You’re in luck, Penny. Jane Iredale products are a complete line of natural, wonderful makeup and cosmeceutical. Give then a try and let me know what you think.

Dr. Berger: Dear Nelly, (I love the name Nelly… not common and evoking the pioneer spirit!)
SkinCeuticals is a pretty good product, and not too pricy. They fill a good market niche. Their normal skin Cleansing Cream, Revitalizing Toner and Daily Moisture are a good place to start.

Dr. Berger: Wow, Jasmine! That’s some letter. Ever think of getting a job at the FDA? The best idea for your problem is KEEP IT SIMPLE.
Switch to natural mineral products… stop all the stuff with additives. Buy Jane Iredale products are a complete line of natural, wonderful makeup and cosmeceuticals.

Dr. Berger: I do not... REPEAT: DO NOT... recommend using any adult product on an infant with out Pediatric supervision!
Babies skin is totally different than ours. Beware.

Dr. Berger: Well, Colleen, I am currently working on a cellulite cream of my own… if you’re in the NY area, you’re welcome to try it out.
But for significant cellulite therapy, with some proven success, mesotherapy with thigh cream, not thigh cream alone, is the treatment of choice. Meso is applied by injection every 2 weeks for several months. There will be some bruising, so begin treatment soon so the effects will start before summer.

Dr. Berger: Sarah, congrats on the new baby! Juvaderm is just Hyaluronic acid… it’s the same across every mammalian species. In fact, they could put HA from my schnauzer puppy into me and I’d be fine. No problem recorded with this product as far as I know.
If your post baby tummy loses the weight, but not the loose skin, consider abdominal Titans… they really are wonderful.

Dr. Berger: There are several viable approaches here, John. Laser genesis can effectively fade scars, but you might want to try a cream containing Hydroquinone as a first line. A 4% preparation is a good place to start. Good luck.

Dr. Berger: Dear Sgt Blanchard,
Time is NEVER short when it comes to those in uniform. They are usually the most unlikely to ask for help and yet the most deserving.
First, wash or soak your beard in hot water for several minutes before shaving. This softens the hair for easier cutting. Second, don't shave against the grain, ever. This cuts the hairs too short and allows then to ingrow more easily. Third, no alcohol based after shaves. They dry and irritate the skin. Fourth, Retin-A type products are helpful.
Finally, if you're ever in the NY area we can laser off the hair where you usually get the bumps. That's a permanent solution and it would be a pleasure to help you out.
God bless and safe tour.

Dr. Berger: To be quite frank, I have never encountered this problem, but I was surprised to find that the internet is full of blogs and discussion groups about it. I searched the literature and found no products for decreasing color on the lips, and I believe that Hydroquinone is just too irritating for use on the lip.

Dr. Berger: If you're a smoker... quit. Try to eat a balanced diet and take a multi-vitamin. Home remedies include tea bags and cucumber slices, but a good quality nighttime eye cream with Vitamin K is the best treatment. I recommend PETER THOMAS ROTH - Ceramide Eye Complex. It's not a perfect solution, but it's definitely the best out there.

Dr. Berger: Have you spoken to your surgeon? I bet he's seen this alot. Usually, post rhinoplasty discoloration will fade after 5-6 months… that's a longer than expected time, but it happens.
If not, ask him for his advice. That's why he makes the big bucks. ;-)
He might recommend a fading cream... maybe a Rx formulation with 7% Hydroquinone.

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.

Dr. Berger: Find a good laser dermatologist in your area. There are several possible solutions depending on your natural skin tone and the darkness and extent of the damage. It’s impossible to diagnose by e-mail.

Dr. Berger: Dear Donna, the Strivectin folks specifically state on the warning label: “Not for use by pregnant or nursing women.” I believe them… so should you. Also, a strong warning for everyone out there: Don’t put anything, ever, on your face or body without reading the packaging and warnings!!!!!

Dr. Berger: Find a good laser dermatologist in your area. There are several possible solutions depending on your natural skin tone and the darkness and extent of the damage. It’s impossible to diagnose by e-mail.

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.

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.

Dr. Berger: Dear Trish, fear not!
Find a laser specialist with a Cutera LimeLight laser.
He might pre-condition your skin with Hydroquinone and, after several weeks off of that product to decrease irritation, will probably begin a series of IPL treatments designed to eliminate the spots.
Let me know what happens.