Combination Treatments

Sometimes a skin consultation can be an overwhelming process, especially if it’s your first exposure to current medical skin care. There are so many options and choices available. What do I do first? Can the treatments be done at the same time? How will the treatments and products interact? Which one is best? Then you need to consider your own personal agenda. What skin changes bother me the most? How much time can I commit? Do I have any events coming up? What is my budget? The goal of the consultation is to help you answer these questions and develop a skin maintenance plan.

As a result of the consultation, we often recommend a combination of treatments. The reason for this is that there are multiple changes occurring in the face as we age. Consequently, there are multiple treatments recommended, each addressing different aspects of the maturing face. When we look at the face we are assessing three basic things: 1) Color changes, 2) Fine texture changes, 3) Course contour changes.

I don’t want to go into detail of each treatment, so I will just list a few common treatment combinations here. Color changes are addressed best with lasers (IPL, Fraxel and Laser Genesis) but also helped by using skincare products, microdermabrasions and chemical peels. Fine texture changes are addressed best with Botox, and lasers (Fraxel, Laser Genesis, and Pearl), and also helped with skincare products, microdermabrasions and chemical peels. Finally, course contour changes are helped best with fillers, such as Juvederm and Radiesse, but may also be helped by laser (Fraxel, Titan, Pearl and Genesis). If there is significant sagging or extra skin, then one will need to consider surgical options.

Now that we know our choices, how do we decide? Let me give you some underlying principles. When it comes to collagen stimulation, more is better. You can never have too much collagen. All the treatments listed under fine texture changes, except Botox, work because they stimulate collagen. Long term, collagen loss is the biggest enemy of aging skin. Remember, when it comes to collagen stimulation, some is good, but more is better. Second, none of these procedures work against each other, as they are synergistic in their effects. The third principle is the order in which you do the procedures is not critical. There is the theoretical worry that the heat of a laser can shorten the duration of effect of previously placed Juvaderm or Botox. In our experience, we have not seen this. That being said, I would recommend waiting two weeks after the injectables before a laser procedure is performed. Lastly, everything does not need to be done at once. The expression “Rome was not built in a day” applies here. Factors such as time, budget and “emotional readiness” may dictate that you cannot do everything right away, but that is okay. Do one or two things at a time. You will enjoy the benefits of each step individually and before you know it, everything will be completed and you will love you skin!

If you would like more information, please visit our website at www.dermacaresandiego.com.