During a recent webinar, cosmetic dermatologist Monica Boen, MD answered some of the following dermatologic questions.

Do eye creams really work?

The skin under your eyes is very delicate and thin, and it is prone to a lot of motion and direct UV light and that is why it is one of the first places to show signs of aging, such as wrinkling. For this reason, you do need special creams to treat this area. 

However, there is no “magic in a bottle” and special eye cream isn’t going to remove all the wrinkles, swelling, or dark circles under your eye. What these eye creams will do it strengthen the collagen and elastin fibers that are the backbone of your skin, prevent free radical damage from sunlight and pollution, and hydrate the area. Using these eye creams consistently can lead to healthier looking under eyes. 

In an ideal eye cream, I look for antioxidants such as Vitamin C, or plant botanicals, peptides to activate collagen production, moisturizers such as hyaluronic acid, and low concentrations of retinol if you have deeper undereye wrinkles to strengthen the epidermal layers. 

Some of my favorite eye creams are: Neocutis Lumiere Bio-Restorative Eye Cream (hyaluronic acid, growth factors, caffeine, vitamin d) which is good for sensitive skin, SkinCeuticals A.G.E. (clinically tested and has herbal antioxidants, peptides). Value: Neutrogena Hydroboost is great for hydrating the under-eye area.


What helps with stretch marks?

Stretch marks are similar to scars. When you take a biopsy of stretch marks and examine it under the microscope you will see a loss of elastic fibers and changes in the collagen structure in the dermal layer. The goal in the treatment of stretchmarks is to normalize the structure and integrity of these collagen and elastin fibers. The earlier you treat stretch marks, the better. 

For stretch marks, I will usually use the Fraxel ReStore laser to try to normalize the elastin and collagen fibers. This laser is able to reach the dermal layer of the stretch marks to help with this remodeling. If the stretch marks are red, I will combine them with a pulse dye laser called Vbeam. Usually, several treatments are needed and can help minimize the appearance of the scars. Topically, retinols and retinoids can help, but their effects are minimal.


After I get acne, I have brown spots. Anything to help with this?

First, it’s important to make sure we have the acne under control with a good topical regimen and sometimes other medical treatments are needed. Second, I would always be wearing a good mineral-based sunscreen with SPF 30 or greater to prevent darkening of the spots from the sun. Lastly, I would use a skin brightener that can help fade the melanin pigment in the skin, such as Lytera or Discoloration Defense. A stronger prescription-strength pigment reducer is hydroquinone and requires a prescription and monitoring by your dermatologist. Lasers can also help get rid of this pigment, such as the Clear and Brilliant laser


How do I get rid of my sunspots?

I love treating sunspots because patients feel much more confident in their own skin after this treatment! I tailor each patient’s treatment depending on a patient’s skin type, whether they have sunspots, hyperpigmentation or melasma, and their skin quality. We have over 50 lasers in our clinic ranging from mild to more aggressive to help get rid of these sunspots. Of course, I combine each laser treatment with a good topical regimen, such as sunscreen and a skin brightener to help keep those sunspots away. 


What is better a powder sunscreen or a lotion sunscreen?

Great question! There was a recent study that compared lotion, mousse, stick, powder, fluid and compact powder sunscreens in about 100 subjects and the actual SPF from the amount of sunscreen applied was measured. It turns out that the lowest SPF was from the compact powder, then fluid, stick, and mousse. The lotion had the highest SPF rating. So, when you are going to have a lot of sun exposure or you want the most SPF coverage I would start with a lotion-based sunscreen. Throughout the day it is then ok to apply the powder or stick sunscreen as a supplemental form of sun protection.

What can I do for thinning hair?

As we get wiser, our thin starts to thin out. For men, they have a receding hairline and lose hair on the vertex of their scalp, while in women, they have a widened part or loose hair in the temple area. Topical minoxidil, known commercially as Rogaine, is the best place to start with thinning hair. It prolongs the anagen, or growing phase of your hair and can prevent further loss of hair. Another thing to add is hair supplements that contain antioxidants to help hair grow. Actually, a lot of my colleagues, other derms, have been using them successfully.


How long do lip fillers last?

Depending on which lip filler product you choose, lip fillers last from 6 to 12 months. 

What are good exfoliators?

The goal of exfoliators is to remove dead skin cells and give the skin a more even light reflex. The traditional exfoliators use friction to remove the dead skin cells, while chemical liquid exfoliators are a little gentler and loosen the bonds between healthy and dead skin cells. Some good chemical exfoliators are SkinMedica AHA and BHA exfoliators with gentle microscopic beads. Affordable options are Neutrogena 2% salicylic acid oil-free acne wash and the Ordinary 7% glycolic acid toning solution.


What skincare is clean and natural?

 Coola is a brand that advocates for clean beauty and has at least 70% organic ingredients, sustainably sourced, cruelty-free, and uses a lot of plant cell active. Colorescience is another good clean beauty brand with quality ingredients and is vegan. I will say natural is more of a marketing term to get consumers to buy their products and doesn’t necessarily mean the products are safe or effective. Poison ivy is natural, after all. 

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