X's Q & A

Q&A: Would chemical peel be recommended to remove my patches of red acne scars?

You call them red scar patches. Does this mean they are mainly red, or red and indented. The redness makes me think you may be a candidate for a procedure called photorejuvenation, a new treatment for rosacea and sun damage. If there is red in the scar this procedure will help to remove it, plus stimulate the skin underneath to grow new collagen. Find a practitioner in your area or more about this at or or at Microdermabrasion can help smooth out superficial scars (indents) but needs to be performed multiple times. Similarly, mild chemical peels would need to be done in a series. Neither peels nor microdermabrasion will help with redness.

Q&A: How long does adult onset acne typically last?

Unfortunately, it is usually a chronic condition, meaning it can last for many years. However, I have yet to meet a woman in her 60's that has active acne, small comfort that that is, unless she has acne rosacea.

Q&A: What does it mean to be Stage 1 / Level 4 and 0.8 for melanoma?

The most important piece of information is that the melanoma is 0.8. This is relatively good news, since the tumor was not that deep. Depending on which scales you go by, less than .76 is the best, .76-1.5 is next best, 1.5-4 is third and over 4 is worst. Some, though make the first cutoff at 1.0 and your husband would be below this. The next most important information will come when they do the sentinel lymph node (dye in his back). If negative, this would be the best news and his risk of it having spread would be very small, since it would have spread to this lymph node first. If positive, one has to assume then that the melanoma has spread, and he would need some type of further treatment to kill off the cancer cells, such as chemotherapy, usually with a drug called interferon. Stage 1 means no clinical evidence of disease spread (can't feel lymph nodes), level 4 means that although the tumor was relatively thin, is went down fairly deep into the skin. I find this odd however because if the melanoma is on his back where the skin is thick then 0.8 and level 4 don't go together. It would be great for your husband to quit smoking, although it would be a difficult thing to do right now. But it would make him feel like he was doing something positive for his health. Try to distract him and give him things he likes, take him to movies or watch sports with him and try to be strong yourself and reassuring, even if you don't feel that way. It is very frightening to be diagnosed with cancer, but most people with melanoma survive and he has a very good chance, too! The surgery itself is not difficult. It sounds like his surgeon is doing all the right things.

I am so sorry that so far the outcome isn't what we were hoping for. Until you have the final pathology we don't really know. If the lymph nodes are positive for cancer, the treatment usually given is interferon, an injectable medicine (he will be given the medicine to inject superficially into the thigh). Once you have the results, however, I want you to call the National Institutes of Health. They have many ongoing studies on the treatment of melanoma. There is a Dr. Rosenberg who has been very involved in research on melanoma that has spread and who has had some really good results. You can call 800-411-1222 to find out if your husband is a candidate or email I would specifically ask for Dr. Rosenberg' s studies. They will tell you what is involved but the treatments are usually "free", that is the study grants pay for the medications and the evaluations. Of course, you have to travel there to get it, which isn't ideal (The NIH is in Bethesda, Maryland). For more information go to and click on clinical trials and search on melanoma. There you will see the trials available to you. Also there is medline plus which gives you info on melanoma. Be strong. Be positive. It is going to be hard but he really needs you.

Q&A: What should I do if I have tried everything to remove my facial hair and I do not think I can afford laser hair removal?

There aren't any quick fixes to this problem. Ideally, if the hair is darker than the skin you would have laser. In many places the prices for laser hair removal have dropped due to increased competition. Have you considered electrolysis? This might be effective but will also probably leave you with breakouts. I would consider seeing your doctor or an endocrinologist. Sometimes facial hair is either due to a hormonal imbalance, or, even if the hormone blood tests are normal, hair follicles that are overly sensitive to hormonal stimulation. In this case, a combination of treatment with birth control pills and a medication called spironolactone (which decreases androgenic-male type hormones) can not only decrease hair growth but also reduce acne.

Q&A: What should I do if I am detection a fluid pocket in my chin?

Without seeing it it is tough for me to say.. I am going to assume it is there because you say it is. I would make an appointment with a dermatologist(you can alays cancel it), but you could always also try some over the counter stuff like benzoyl peroxide, to see if it would go down with some treatment. Try not to play with it as this does make it worse and can lead to infection or scarring. You could try some acne stuff at my website, where there is something called the complete anti-acne treatment and if you gave it a few weeks (the time it will take you to get in to see a dermatologist) you'd know if it were going to respond to something topical.

The best thing you can do is to reassure everyone and leave your husband alone. This is the way he is dealing with it- you are dealing with it by trying to understand, but he wants to forget, so give him some space. I wouldn't involve your children much at all, only to tell them concrete things like Dad is having surgery but he'll be fine. Then be strong! He is not a stage 2. This is the only thing that matters ultimately, that the cancer hasn't spread. Breathe a huge sigh of relief when the lymph node is negative. Write me back when you have the surgical results. PS Glad I could help.

Q&A: What procedure can be used to lighten the color of skin?

You can lighten the skin with various bleaching agents, the most utilized was hydroquinone in a 4% formulation (need a prescription) or over the counter in a 2% formulation. Much higher percentages can be utilized for more permanent results and there is speculation that this is what Michael Jackson used but I have no confirmed information about his treatments. Kojic acid is another chemical that may help lighten the skin. Other treatments would include laser treatments or chemical peels. There are tattoo artists skilled in hiding scars with flesh colored tattoos, but I am not sure how this would work if a large surface area were involved.

Q&A: What is the procedure for skin peeling and the health affects?

There are many types of skin peeling, but the two most superficial are with glycolic acid and salicylic acid in a 20-30% concentration. These superficial peels (sometimes called "lunchtime peels", since you could have them on your lunch break and nobody would know you had it done when you went back to work. These smooth the skin, clean and tone pores, reduce pigmentation abnormalities such as sun freckles or melasma and help reduce acne. If done multiple times, they may help reduce fine lines.

Q&A: How can I get rid of two dark spots on my cheeks that came from the use of an acne medicine called Dernovat?

I am not familiar with the cream you name. Assuming that you had a reaction to them and developed some type of hyperpigmentation, I would attempt to use a hydroquinone containing cream (preferably a 4% hydroquinone prescription cream such as Lustra) or an OTC version (such as Bleaching cream or gel on the website) as well as a retinol containing cream (again such as Afirm on the website) and even consider some mild chemical peels or microdermabrasion. Even though they have been there for a long time, interventions such as these may help. If these do not help, find an experienced laser surgeon who may be able to help you by going to and searching for a practitioner in your area.

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