Skin Care

Cleansers - Cetaphil lotion is an excellent over-the-counter cleanser for most skin types. It is gentle, greaseless, and inexpensive. Use it in place of regular soap as a makeup remover and cleanser. You can purchase Cetaphil lotion at most pharmacies and super markets.

We also offer excellent cleansers from AcuteDerm. Pro C Antioxidant Cleanser has a nice fragrance and contains antioxidants to help prevent aging of the skin. We also carry their Non-Drying Skin Cleanser. Ask about the AcuteDerm “Core Pack” for general skin reconditioning.

Retin-A (Renova) - One of the most valuable treatments for skin maintenance and rejuvenation is Retin-A.  This vitamin A compound should be used at night after cleansing the skin and removing all makeup.  We recommend 1/2 of a pea-size amount (0.05% Cream/Blue tube) applied to moist skin.  The package insert says to apply the Retin-A to dry skin but we have obtained more even spreading by applying the cream to skin that is wet or moist.  This also makes it easier to use less to cover the entire face.  This process avoids over exposure and burning or irritating the skin by using too much cream.

Some patients will need to use even less than the 1/2 of a pea-size amount due to their sensitive skin.  It will take some experimentation to find the best combination for your skin type. Retin-A will still work if you skip a few nights, use less than the 1/2 pea size amount, mix the Retin-A with a moisturizer before applying it to your face, or even putting moisturizer on immediately after the Retin-A.  After applying Retin-A to your face, you may use other skin treatments, moisturizers, masks, or makeup on your skin. You should be gentle and cautious until you figure out how best to use Retin-A for the rejuvenation of your skin.

Scientific studies show that results from Retin-A are best if used for approximately 4 months straight.  Most patients need 3-6 weeks to build up to every night use.  Some patients are unable to use the Retin-A this intensively, but they still can improve their skin by less frequent use.  For the first 3-6 weeks most patients will have some peeling, scaling, & irritation of the skin, especially around the nose and mouth. Retin-A can make acne worse during this introductory period. Your skin becomes hyperactive as it begins to renew itself. You can adjust the frequency of application or use a moisturizer to decrease these side effects. Almost everyone, in 3-6 weeks, can adjust to a routine that will fit their skin type and tolerance.

After 4 months of nightly use, most patients can decrease the frequency of Retin-A application. Fair skinned patients can use it 1-2 nights per week. Normal skin responds well to 3-4 nights per week. Oily skin can get the best benefits by using the product 4-7 nights per week.  These regimens will maintain the improvement you have achieved.

Since Retin-A will cause some healthful thinning of the skin, it is essential that sun block be used if you are going to be in the sun. Any type of sun block with a sun protection factor (SPF) of greater than 30 will be adequate.  Many patients use Retin-A from Sunday through Thursday, and then avoid weekend use when they will have greater sun exposure. We still recommend a sun block and a wide brimmed hat whenever you will have sun exposure.

Glycolic Acid - While Retin-A rejuvenates the deepskin, or dermis, Glycolic Acid works best on the superficial skin (epidermis).  It should be used in the morning, 4 to 7 mornings per week.  We recommend 5 - 10% Glycolic Acid for sensitive skin and 10 - 20% for normal to oily skin. It is also available in cream, lotion, or gel so that the correct combination for your skin can be used. Glycolic Acid will enhance the effects and benefits of Retin-A. We recommend the application of a small amount of Glycolic Acid to moist, clean skin in the morning prior to makeup or moisturizer. You can put sun block, moisturizer, and/or makeup over the Glycolic Acid without difficulty.  Most patients benefit from the combination of Retin-A and Glycolic Acid use. Occasionally, patients with sensitive skin use Retin-A a few nights per week and Glycolic Acid on the nights that they do not use the Retin-A. They may or may not use Glycolic Acid in the mornings depending on the response of their skin. It is important to remember that everyone has different skin care needs and a little experimentation will find what works best for you.

Besides the regular use of Retin-A & Glycolic Acid at home, even stronger concentrations of Glycolic Acid can be used in the office to hasten the rejuvenation of the skin. These "lunch time peels" can be obtained with 30, 40, 50, 60 or 70% Glycolic Acid. Very light freshening peels can be performed by an aesthetician during a facial at a salon. Stronger peels are done in our office by a physician or Physician Assistant. The recovery time for these non-painful freshening peels is minimal and patients usually are able to go about their business the same day. It is amazing how much smoother the skin becomes. For more severely damaged skin, a medium peel (TCA), deep peel (phenol), or laser resurfacing can be considered. These procedures are done only in the office and require longer recovery times. Information will be supplied to those who are interested.

Sunscreen - We recommend that you use a sunscreen daily. Use a PABA free, non-comedogenic (greaseless so it won’t block pores) product that protects against UVA and UVB light. An SPF of 15-20 should be used for regular daily protection and a stronger SPF of 30 or more should be used with prolonged sun exposure. AcuteDerm makes an excellent sunscreen that absorbs well under makeup and meets the above criteria for daily use.

Esthetics - Read about the services that are offered by an esthetician in rejuvenating your skin.