Aging skin can age add ten years to the face with dark spots, spider veins and fine lines and wrinkles. Sunblock, avoiding smoking and tanning beds, good nutrition and skin care maintenance with tretinoin, Vitamin C, alpha hydroxys, Botox and sometimes injectables are very effective in maximizing your assets. Sun exposure increases the enzymes in the skin responsible for the breakdown of collagen and hyaluronic acid, deepening the furrows in the face (and possibly making fillers go away faster). There are some options to make significant changes to the skin, and these procedures can dramatically set back the clock!

1. Microdermabrasion and light chemical peels- administered by an Aesthetician, these treatments can exfoliate the skin and stimulate new collagen formation, minimizing fine lines and evening skin tone and texture. These treatments are usually recommended in a package for best results.
2. IPL (Intense pulsed light) photo-rejuvenation-This no or minimal down-time option provides some benefit with both dark spots and spider veins. Do NOT expect all dark spots or spider veins to go away, and do not expect significant tightening of the skin. The results of photo-rejuvenation are more in line with a “glow” or refreshed look to the skin, with an improvement in tone and texture. The cost for a package is $1500-2500.
3. Dermabrasion- not microdermabrasion! This is an aggressive resurfacing technique that sands down the outer layer of skin to allow new skin to grow- tighter, with fewer wrinkles and dark spots. Down-time is about 7-10 days, pain is minimal and results are impressive, especially for acne scars and deep lines around the mouth. The cost is $500-1500.
4. Ablative Chemical Peel (>30% tri-chloro acetic acid TCA)- A more aggressive peel than glycolics or fruit acid peels administered by an aesthetician- this one should be administered by a physician. Chemical resurfacing allows new skin to grow, eliminating the flaws in the damaged layer (to include pre-cancerous lesions!). Dark spots and fine lines are blasted away. Down-time is about 5-7 days on average, and results are amazing. This is a favorite in our office! The cost is $400-1000.
5. Resurfacing Lasers (like CO2)- An aggressive procedure that yields fantastic results. I do not recommend this on all patients, as the skin may become pale, shiny and thin (and somewhat unnatural-looking) with time and healing. Scarring is possible, and geometric patterns and demarcating lines are common. Down-time is significant (usually months of redness) as is the cost (usually $3000-4000).
6. Fraxel , or fractional resurfacing- A relatively new laser technique that improves the skin in tiny spots, so down-time is lessened. The down-time is a few days, and results are variable. Best results approximate those achieved with a TCA peel. Cost is significant ($2000-3000) and the treatment may need to be repeated to achieve best results.

No matter which modality is selected for improving skin, maintenance is required for best results!