Dear Dr. Scott, Is there any way to look 10 to 15 years younger by Valentine’s Day? I have a really hot date with someone I met on the Internet and am terrified he will run for the hills when he sees me. I am working out like crazy but don’t know what to do with the lines and wrinkles on my face. I really don’t want surgery and can’t afford a lot of downtime as I do have a job. Please help, I really want this to work out. Signed, “Looking hot by Valentine’s Day”
Dear “Looking Hot,” The answer to your question is, yes, you can look 10 to 15 years younger by Valentine’s Day. Significant medical advancements have made it possible to look younger without going under the knife, using minimally invasive cosmetic procedures. We call BotoxCosmetic® and nonablative cosmetic laser treatments “lunchtime” procedures because there is no downtime associated with them. You can have a procedure performed on your lunch hour and return to work without anyone knowing that you have had anything done. You simply look better. Injectable dermal fillers, such as Restylane, Perlane and Juvederm, typically cause some mild redness and swelling for one to three days. Clients typically have the procedure performed on a Friday and are ready to return to work on Monday without any co-workers being the wiser. The nice thing about these procedures is that they give a very natural appearance. The typical comments/questions a post-procedure client hears include, “You look more rested.” “Your skin looks great. What did you do?” “Did you get some rest?” “What kind of skin care are you using? I want to buy the same product you are using.” For you, he’ll just think you look hot.
Dear Dr. Scott, I am interested in having the lines on my forehead treated, and I was told that Botox would be the best procedure to treat my problem. I’ve seen television actors who have had Botox and their face looks “paralyzed” or “frozen.” I am afraid that my face will look like this if I had the procedure done. Will this happen to me? Signed, “Paralyzed with Fear”
Dear “Paralyzed with Fear,” BotoxCosmetic® gives the most dramatic improvement in forehead lines and wrinkles. It is very effective and has been shown to be even safer than aspirin at the doses used for cosmetic procedures. When the procedure is performed by a provider certified in the medical use of Botox, the results are very natural in appearance and the muscles of facial expression can still be used. Yes, you can still raise your eyebrows. The lines are simply softened. The actors who have that “paralyzed” or “frozen” look have been over-treated, either going for too much, too fast or going to the wrong provider. Make sure you let the treating provider know that you want to start at a lower dose to see how you like the results. More can always be added at the follow-up appointment if you choose to do so. The other nice thing about BotoxCosmetic® is that if you decide you don’t like it, you do not have to continue with any further treatments; the results wear off in approximately two to four months, and you simply go back to looking the way you did before the procedure was performed.
Dear Dr. Scott, I started a diet to lose weight, but I get very hungry between meals and end up “cheating.” What can I do to help decrease this feeling and stick to my diet better? Signed, Hungry Dieter
Dear Hungry Dieter, “Hunger pains” are signaled by a drop in blood sugar following a meal. After a person eats a typical meal, the blood sugar rises in the blood stream, and insulin is released by the pancreas to process it. This leads to a fall in the blood sugar level, turning the hunger signal on. Eating foods that stabilize the blood sugar and keep it in the blood stream longer will help you feel less hungry for a longer period of time. One way to do this is to eat carbohydrates that are complex rather than simple. Examples of complex carbohydrates are whole-grain breads, brown rice and whole-grain pasta. It is important to look for the word “whole grain” and not “whole wheat flour” as the first listed ingredient. Avoid simple carbohydrates that lead to rapid fluctuations in blood sugar levels. An easy way to think about simple sugars is that they are foods that have been “touched or processed by man” such as white breads, white rice or white pasta. You can stabilize the blood sugar level even further by adding a protein to what you are eating. Add peanut butter or a slice of cheese to your toast rather than butter. Use a meat sauce on your pasta rather than a marinara sauce. The protein will act like a “sponge” and hold the blood sugar in the blood stream longer. Other options that will help decrease those hunger pains are eating five or six smaller meals rather than three regular meals, or you may want to speak to your doctor to see if you are a candidate for prescription appetite suppressants.
Dear Dr. Scott, I am growing hair on my upper lip and chin and want to know if laser hair removal can be used to get rid of this permanently. Signed, The Bearded Woman
Dear Bearded Woman, Facial hair growth is a common problem for women. Laser hair reduction is a great option for anyone who wants permanent hair removal Hair can be removed not only from the face but from anywhere on the body. Treatments for facial hair reduction are usually performed once a month and require five to eight treatments. Multiple treatments are needed because the hair must be in an active growth cycle to work. Only a small portion of the hair is actively growing at any one time, and there is no way to tell which hairs are in the growth phase just by looking at them. The entire affected area is treated, and hair that is in the growth phase will not return following a treatment. Treatments work best in brown to black hair. The darker the hair is, the better the results. Laser hair reduction does not work on blond, gray or red hair. In between treatments, the hair can be cut or shaved down to the skin surface, but it should not be plucked or waxed because that removes the laser’s target, or “chromophore,” making treatments unsuccessful. Laser treatments for hair reduction can be performed in patients of all skin tones, but caution must be used in darker skin tones, i.e. Latino or African American. If your skin has a darker tone, it is very important to make sure that the laser being used is FDA approved for all skin types. Otherwise, you risk having the natural color removed from your skin, leaving behind permanent light discolorations.
Dear Dr. Scott, I had a face-lift done several years ago, which helped with my saggy jaw line, but I still have “smoker’s lines” around my mouth. Are there any new cosmetic procedures that would help smooth out these lines? Signed, “Smokin Sue”
Dear “Smokin Sue,” Face-lifts are helpful for improving excessive drooping of skin and muscles over the cheek and jowl area, but they do not help much in the center part of the face, i.e. around the mouth, the lines that run between the nose and mouth, and the lines between the eye brows. For the area around the mouth, the best treatment is a combination of BotoxCosmetic® and a dermal filler (a plumping substance that is similar to the consistency of Jello). The dermal filler instantly fills in the fine lines, and the BotoxCosmetic® relaxes the muscles, so the lines are softened. By relaxing the muscles, the results of the treatment will last significantly longer. Another option is to use cosmetic laser treatments around the mouth. There are a variety of different lasers that can help treat this problem, but overall, the results are usually not as dramatic as with the Botox/dermal filler combination.
Dear Dr. Scott, I’m always hiding my hands, because I have numerous “age spots” on them. I seem to be getting more as time goes by. What is the best way to treat these and to prevent new ones from appearing? Signed, “Spotted Hands”
Dear “Spotted Hands,” What patients commonly call “age spots” are usually solar lentigos or seborrheic keratoses. Both of these conditions are benign (not medically concerning) but are cosmetically bothersome. Solar lentigos are usually the result of excessive sun exposure. It is unclear why seborrheic keratoses form. Before presuming that your “spots” are benign, I recommend having a doctor examine them to make sure that none of it is cancer. The best way to treat these spots depends on if they are flat brown spots or if they are slightly raised. Flat brown spots can be treated with topical creams, cosmetic laser or liquid nitrogen freezing. If they are slightly raised, liquid nitrogen freezing works best. Use caution when undergoing treatment to make sure the provider explains to you which treatment would be best for your situation. The goal is to remove the “brown spot” without taking out too much color and leaving a white spot behind that is lighter than the surrounding skin. To prevent the return of solar lentigos, sun block is highly recommended.
Dear Dr. Scott, I went to see my medical doctor to have my varicose veins “stripped.” I was told that I didn’t have varicose veins, I had “spider veins” and that mine could not be “stripped.” I was also told that my medical insurance would not pay to have them removed because it was considered an elective procedure. I know it is not medically necessary to have them removed, but they are ugly and prevent me from wearing shorts. What is the best way to have these removed? Signed, Jill
Dear Jill, Let me first explain the difference between varicose veins and “spider veins.” Varicose veins and spider veins both typically occur on the legs, but varicose veins are larger. They are the thick, ropey, bulging veins that protrude above the skin’s surface. Spider veins, also called telangectasias, are smaller in diameter. They tend to have a branching pattern, and can cover a small area or extend up to several centimeters. They are usually red to purple in color. Spider veins can be treated using sclerotherapy (inserting a needle into the vein and injecting a substance that damages that blood vessel) or by laser vein treatment (placing a laser hand piece against the skin that delivers a wavelength of light energy that heats and damages the blood vessel). Laser vein treatments are preferred for removing the smaller spider veins because it is difficult to get a needle into the smaller diameter vessels to inject them. Varicose veins are treated using either sclerotherapy, vein ligation/stripping (cutting and removing the damaged vein), or by radiofrequency endovenous ablation (inserting a catheter probe inside the blood vessel and using radiofrequency to heat and destroy the vein).
Dear Dr. Scott, I have facial hair that I want to have permanently removed, but I was told that because it was gray, it would be difficult to treat. Is there any way to get rid of my gray facial hair? Signed, Mary
Dear Mary, Permanent methods of removing unwanted facial hair include electrolysis and laser hair reduction. Up until recently, the only effective way to permanently remove gray, blond or red hair was by using electrolysis. Electrolysis is still effective at removing lighter colored hairs, but it is time consuming and painful. It is practical only when used to treat small areas needing hair removal. Until recently, laser hair reduction has been ineffective at removing lighter colored hair (it works best on dark brown to black hair). But, with the introduction of a recently FDA approved product called Meladine™, clients with lighter colored hair can now have effective laser hair reduction results. Meladine™ is a liquid that is sprayed onto the skin and is absorbed directly into the hair follicle. The hair below the skin surface absorbs the melanin and becomes darker, but no change is seen above the skin surface. The hair follicle now contains the necessary melanin that is required for the laser treatment to be effective. The laser releases a wavelength of light that targets the melanin within the hair follicle, heating it and destroying it to prevent hair re-growth.
*Disclaimer: The material in this column is in no way intended to replace professional medical care or attention by a qualified physician and is intended for educational purposes only. Dr. Scott is not making a diagnosis of your condition or a recommendation about the course of treatment for your particular circumstances. You should never delay seeking medical advice because of what you have read in this column. If you have, or suspect you have, a health problem, you should consult your physician.
