X's Q & A

Q&A: Could a laser procedure remove dome-shaped moles on my face without leaving scars?

Laser mole removal is experimental and doesn't work particularly well. Often the moles reoccur. So, in this case, I can't recommend lasers. Usually in my office we do a technique called a "shave removal". This essentially planes the mole off the surface and although it does involve a scalpel, does not require stitches. 95% of the time, dome shaped moles don't return when removed this way and often heal up very nicely. Of course your dermatologist would need to tell you what technique would be best for each mole, as some just aren't quite right for shave removal. I would get a few opinions on how they would be removed and go with the doctor whose description of the procedure made you feel the most comfortable and who seemed to care about you and your result.

Q&A: Is there a non-surgical option to remove stretch marks?

Stretch marks are notoriously difficult to get rid of. They are almost like a Slinky that has been decoiled, or like a rip in the lining of a pair of pants. The only thing that can be done is to attempt to stimulate the body to make new connective tissue (collagen and elastin) and there are many things which claim to do this, but very few are proven. The most scientifically proven ingredients for new collagen production are retinoids (such as Retin-A) and alpha-hydroxy acids. You could purchase products in these families on the website at (Afirm 2X is a retinol and Soft and Smooth Body Lotion is an alpha-hydroxy acid moisturizer). Expect modest improvements that take a long time (months). Other treatments to consider would be laser and microdermabrasion.

Q&A: What should I do if I have red burning areas on my face after using Tazorak on and then off for acne, Aldera for bumps, and noe Tetinol liquid?

I assume by burns you mean red or brown marks. If you wait long enough they will go away by themselves, as they are the residual of the inflammation that you had. If you want to clear it up faster it might respond to 1% hydrocortisone cream, although using this could worsen or inflame either the acne or the virus. If there are scabs or crusts associated with these burn marks, you should contact your dermatologist as you may need more intervention.

Q&A: What would be the most cost effective way to remove wrinkles and laugh lines on my face?

Mild chemical peels and cosmeceutical creams are the least expensive options and go a long way to improving the texture and tone of sun damaged skin. You can find options that would work well for your skin by visiting and clicking on the skin wizard which will guide you through 3 simple questions and design a skin care program for you. There you can also find my personal favorite around the eye cream called Polyhydroxy Eye Cream. I also like Beta-Lift Peels, which most dermatologists can offer you for a fairly low fee, say around $100 each, but assume you'll need at least 3 of these. Laser resurfacing is one of the most expensive options, costing in the thousands, ditto for dermabrasion. You could try microdermabrasion which might help overall, too, and is less expensive, but adds up since you need so many treatments (often more than 6), I hope this helps!

You would see them now, if you have discontinued it. You would see dilated blood vessels and a certain shininess, or thinness to the skin. This is often reversible and is less common on the face than on areas such as the groin and arms. If these signs aren't there now and you stopped 3 months ago, they will not be present in the future, unless you restart the cortisone and use it for a long period of time.

Q&A: How do I remove body hair from my back and shoulders, what will it cost, and where do I get it done?

By far the easiest and most effective way is via laser hair removal. There are many different laser systems that can achieve this. I would go to the website for the American Society for Laser Medicine and Surgery at and try to find a practitioner in your area. Fees vary widely, so I would suggest having a consultation with an experienced laser surgeon or their laser specialist and find out what is involved and how much it costs. These consultations are often free.

Q&A: What can I use for facial moisturizing and wrinkle-fighting if my skin is very sensitive to lotions and makeup?

You might have rosacea, which, if treated could help to decrease your sensitivity and burning sensations (usual treatments are antibiotic creams and/or oral anitbiotics. For comprehensive info on rosacea, see and click on "skintopics"- under this there is a discussion of rosacea, its causes and treatments). The two least bothersome and irritating creams for sensitive skin that I have encountered and that are also moisturizing and wrinkle-fighting are called Kinerase Cream (a plant extract) and Biohydrating Cream (made from polyhydroxy acids which are gentle to sensitive skin, unlike the stinging that often accompanies alphahydroxy acids, yet with all of the benefits). Both can be found and purchased at under "skinstore", look under moisturizers or anti-aging categories.

Q&A: Will psoriasis be an issue if I want to have a chemical peel, laser skin resurfacing or "N" light treatment?

The only situation I can think of it being a problem is if your psoriasis were in the same area as the area you wanted treated. If so, then the redness of the skin might pull in more energy from the "N-Lite" or other laser and cause an unusual reaction. Similarly, if no psoriasis were there but you wound up with a side effect that caused a skin burn or scabbing of the skin, it is possible that the psoriasis could "spread" into the area that it didn't currently occupy, since psoriasis tends to show up in areas of skin damage. Both of these scenarios are rather unlikely with care and caution, unless you have psoriasis of the face. You should discuss these possibilities with the laser practitioner of your choice. Make sure your doctor is a member of the American Society for Laser Medicine and Surgery, the premier laser surgeon organization (

Q&A: What are my options to remove spider and varicose veins on my legs?

There are 3 main procedures available to you: sclerotherapy (an injection of salt or detergent like solution into the veins), laser, and ambulatory phlebectomy (surgical removal). All work well although general phlebectomy is done for larger vessels or if there is an abnormality of an underlying valve causing the problem. The latter can be diagnosed by an ultrasound. It is difficult to say what type of doctor to go to as dermatologists, phlebologists, and vascular surgeons all do some of these procedures. I would recommend that you try to select a doctor with a known interest in treating leg veins. Some vascular surgeons have absolutely no interest in this, and others have a tremendous amount of interest. If you are interested in laser, find someone who has a 1064 nm laser and specializes or is known for laser. You can find laser surgeons at and phlebologists at

Q&A: Should I consider laser skin resurfacing to remove pitted scars from plucking ingrown hairs on my chin?

Laser resurfacing is a really intensive treatment which I would use only as a last resort. Chemical peels vary by the strength and the chemicals that are used. Mild chemical peels- salicycilic acid 20-30% (Beta-LIft Peel) or glycolic peels 30-40% virtually have no risks and in a series may help you. Another option would be microdermabrasion, which I favor as a treatment for this type of problem, but you will also need multiple treatments, at least 5-6. Finally, you could try to find someone who has a Cool Touch II Laser. These are known to improve acne scars without much risk. Go to the web site to find a laser practitioner in your area.

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