Frequently Asked Questions
Q. Why do I have more wrinkles on the left side of my face?
A. Everyone’s face is asymmetric. It is extremely rare for a person to have a perfectly proportioned face. The underlying action of the muscles may be stronger on one side of the face than the other. We also tend to express ourselves on one side of the face more than on the other. Most importantly, when you drive, both ultraviolet A and B rays attack the left side of the face more than the right. UVA can penetrate through glass and clothing, and is even present indoors!
Q: Why do I have large pores?
A: Some people have genetically enlarged pores. In general, though, as we age, we are exposed to a variety of toxins, first-hand cigarette smoke (which contains more than 4,000 toxins), secondhand smoke, pollution, ultraviolet A and B rays and toxins we ingest. All these environmental influences affect the enlargement of pore size.
Q. Why do I still break out with acne as an adult?
A. Due to exposure to unfriendly, environmental influences, the pores on our face enlarge. In addition, as we get older, our skin cell turnover cycle lengthens. It takes longer for a skin cell to live, to die and then wear off of our face. This is a perfect set-up for adult break-outs. The dead skin cells end up staying on your enlarged-pore face for a longer period of time, resulting in adult-onset acne.
Q. How does Botox® work?
A. Botox works by temporarily paralyzing the underlying muscles that create wrinkles. Botox comes from the toxin Botulinum toxin A, which is produced by the bacteria, Clostridium botulinum--the cause of tetanus and lockjaw, both life-threatening conditions. The amount of Botox injected to achieve cosmetically desirable results is very little, compared to the toxic dose that can cause death.
Q. I have a mole I’m concerned about. How can I tell if it is skin cancer?
A. If you have a mole you are concerned about, you should definitely have it checked out. Start with your primary care physician. Some tell-tale signs of possible malignancy or cancer include:
- A change in color --any change in the color of the mole.
- A change in size --for example, if a flat mole becomes raised or a small mole starts spreading and getting larger.
- Any sign of itchiness or irritation.
- Any sign ofulceration or bleeding. If you have any of these signs or if you think a mole just doesn’t look “right,” contact your primary care physician immediately.
Q. Why do wrinkles form?
A. There are basically two types of wrinkles: dynamic wrinkles and static wrinkles. Dynamic wrinkles include crow’s feet, bunny lines at the top of the nose and lip lines that are made worse when you pucker up. Dynamic wrinkles are produced by facial expressions created by the muscles underneath the skin and soft tissue. Static wrinkles are stationary wrinkles that are formed by deeper attachments from the upper layers of the skin to the deeper layers. We had those attachments when we were 10 years old, but as we age, there is just no stopping gravity. Since the attachments stay stationary and the skin and soft tissue move downward, these static wrinkles become apparent as we age.
Q. Why do the corners of my mouth go downward?
A. This is one of the classic signs of facial aging. There is a static attachment present down deep underneath the skin at the corners of the mouth. Unfortunately, as we age, and gravity sets in, some soft tissue drapes downward and can create the downward look at the corners of your mouth. Make sure you clean off all toothpaste and extra saliva from these areas. If you don’t, cheilitis or corner-of-the-mouth irritation can result.
Q. Why can’t I use Accutane® to treat my acne if I’m trying to get pregnant?
A. Accutane is a very potent prescription-strength medication that is used in nonresponsive cases of cystic acne. This medication has been associated with birth defects. In addition, Accutane is so potent, that you should not plan on any elective, non-emergency, surgery for approximately nine months to one year after stopping Accutane, because it can negatively affect wound healing.
Q. If I don’t wash off my makeup before going to bed, how do I always wake up with pimples the next day?
A. As we age, our pores enlarge secondary to exposure by negative environmental influences. Also, dead skin cells tend to stay on our face for a longer period of time and fill in the enlarged pores. This situation is made even worse when applied makeup is allowed to overfill the pores even further, especially when left on overnight.
Q.Why do the back of my hands look so old? It used to be that I couldn’t see the veins or white strands on the back of my hands.
A. As we age, we tend to lose fat in a few areas, including our face and the back of our hands. When you lose fat (otherwise known as fat atrophy), the veins and tendons (white strands) that control the movement of your fingers become more obvious or apparent. Special ingredients contained only in unique moisturizing creams can draw moisture into the skin and help fill in the area by plumping up the skin. Hydration of the skin and soft tissue with these advanced moisturizers can give the hands a more youthful appearance.
Q. Do I really need to use toner?
A. Consider toner as a second step in your cleansing routine after the first step of using a cleanser. Toner also helps balance the pH of your skin since pH can vary in different parts of the face. Equalizing the pH helps other corrective products work better after the toner’s application.
Q. I shaved off my eyebrows about a year ago because I wanted to reshape my brows. The problem is, my eyebrows haven’t grown back. What can I do?
A. Unfortunately, eyebrow hair is very specialized hair. It grows at a very slow rate and at a variety of angles. Sometimes, eyebrow hair doesn’t grow back after it is shaved off. That is why we are always taught in medical school to never shave the eyebrows, even if a cut goes right through the eyebrows themselves. Be patient, and be sure that your nutrition and vitamin intake are optimal. All you can do is hope that the eyebrows will grow back. There is no ready-made cure.
Q. I tend to flush red when I drink alcohol and break out with whiteheads on my nose that appear redder than the other parts of my face. What’s wrong with me?
A. You may have a skin condition known as rosacea. With this condition, certain events can trigger a flushing episode, including pollution, smoke (first-hand or second-hand) and alcohol, to name a few. I would consult with a board-certified dermatologist. In a majority of cases, rosacea can be controlled with oral and topical medications.
Q. I have been told never to use tissue or toilet paper when I apply astringent or toner. Why is this?
A. When applying any fluid, including a toner or astringent, the small fibers from them can break off and stay on your face. Instead, use a cotton ball or cotton pad to apply toner. The fibers are longer and inter-woven, and therefore are much less likely to break off and remain on your skin.
Q. I had acrylic nails taken off with a drill a few months ago, which burned my thumbnail at the time. Now, whenever my nail grows, there is a crack in it and it splits at the tip. What can I do?
A. It sounds like you are suffering from a bad case of a split nail. The nail is formed from the base of the nail--an area called the nail bed. If you remember feeling a burning sensation with the acrylic nail removal, chances are the nail bed was damaged. This could be either temporary or permanent damage. Try to cut the split nail area short and evenly to prevent it from getting snagged on clothing and other objects. If the condition continues for a full year after it occurs consider seeing a hand surgeon who can address possible nail bed reconstruction.
Q. As I have aged, it appears as if my lips have “disappeared.” What can I do about this?
A. It is not uncommon to lose fat in your face and lip areas as you age. The distance between the bottom part of the nose and the upper lip also appears to lengthen. You can temporarily fix this problem by increasing the blood flow to the lip area with lip plumpers that help vasodilate the lips (increase the size of the blood vessels located in the lip). Lip plumpers are a great way to achieve a younger-looking mouth without surgery.
Q. Why do I have brown spots on my face? I look so old.
A. Brown spots can occur in anyone, but they appear to be more common in women. Brown spots can become more prevalent during various hormonal changes in one’s life, including pregnancy and menopause. Synthetic hormonal influences, including birth control pills and hormones taken after menopause, can also increase the occurrence of brown spots. Exposure to UV rays can also increase their frequency.
Q. Why do my lower eyelids get puffy when I have a sinus infection?
A. There is a small tear duct in the lower eyelid area (toward your nose) that is connected to the sinus passages located beneath the cheek areas closest to the nose. When you have sinusitis, there is inflammation and/or infection in the sinuses. This inflammation can track upward through the small duct and cause swelling in the lower eyelid area.
Q. Why do crow’s feet form? I try not to squint and wear sunglasses all the time because I hate them.
A. Crow’s feet are formed by the dynamic muscle action of the orbicularis oculi, a circular muscle located around the eye area. Even though you may try not to squint, you still may smile or otherwise express yourself with your eyes. Some actions are voluntary and others are involuntary. How boring would it be if you had no facial expressions at all! Some special skin ingredients can draw moisture into the skin and plump out fine lines instantaneously.
Q. If I were able to do only one thing to look younger, for example, a tummy tuck, breast augmentation or skin treatments, what would you suggest?
A. Being an aging woman myself, I can completely relate to your situation. This is how I look at it: I consider the face and therefore the skin--the largest organ of the body--to be the first thing most people see. That is why I consider making your skin look as good as you can to be more important than undergoing changes that can only be accomplished with a scalpel.
