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At Skin Spectrum, we know everyone's skin is different. That's why we take the time to find unique solutions to fit your needs. We've made it easy for you to get advice on specific skin problems or to find out about the newest advancements in dermatology in Tucson, AZ. Read the entries below to learn more, or submit your own question to the doctors.

At Skin Spectrum we are leaders and innovators in skin rejuvenation and are dedicated to enhancing the health and appearance of your skin. For your comprehensive facial assessment, request a cosmetic consultation online or call (520) 797-8885.

Have a question for Skin Spectrum's dermatologists in Tucson? Click here

For more information on healthy skin care, be sure to tune into KVOA-TV News 4 at 4:00 to catch Dr. Jody Comstock's informative and invigorating segments to help you look your very best. (Check schedule for times and dates.)

Acne

Q. With all of the breakouts on my face, my self-esteem has taken a nosedive. How quickly can I achieve a healthy complexion?

Madison – Tucson

Dr. Comstock Responds: Most topical and oral treatments can take six to eight weeks to improve the skin. There are tricks to make the skin look better faster. Acne cysts can be injected to quickly flatten them and shorten the red/brown discoloration that follows. The redness and ruddiness also can be lightened or alleviated with new light or laser sources. Texture changes and scarring can be dramatically improved with a non-invasive laser.

Q. I had acne as a child. Why am I noticing scarring at age 43?

Anthony – Chandler

Dr. Comstock Responds: Acne can cause subclinical scarring that only becomes noticeable as collagen relaxes. Sun protection, healthy lifestyle and great genetics will minimize the visible scarring that continues to come. A topical skin care program that stimulates collagen is critical. Non-invasive procedures, such as Thermage®, can tighten the skin over several months. Depending on the depth of the scarring, invasive CO2 lasers like Fractional ActiveFX™ will smooth out the skin. We can also help fill in the scars with hyaluronic fillers such as JUVÉDERM® and Restylane®. These products not only fill in the scar tissue, but the product and the procedure will also help stimulate new collagen in those areas.

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Sun Exposure/Sun Damage

Q. I baked in the sun nearly every day as a teenager. Now I have deep wrinkles around my mouth. What can I do?

Karen – Green Valley

Dr. Pai Responds: Sun damage breaks down collagen and frequently causes some of the deepest wrinkles. For extensive sun damage you may need ablative laser treatments, which require healing time. For mild sun damage, you can get excellent results by using fillers such as Restylane® and JUVÉDERM®. Done properly, you should not be able to tell who has filler around the mouth; it should just look better.

Q. How can I make sure my kids' sunblock lasts all day?

Eric – Tucson

Dr. Comstock Responds: Use sunblocks that have zinc oxide, titanium oxide, or mexoryl. If your child sweats a lot or needs a touch up before an afternoon sport, try dusting a powder zinc oxide like Colorescience® over the face. It is great for not spilling in backpacks, purses, or cars. If your child is in the water and wiping their face, reapply every one to two hours or wear a micronized zinc oxide such as Desitin®, A+D® ointment, or skin-colored Sportz Bloc®.

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Skin Care

Q. My high school daughter has freckles. What should she do?

Karen – Tempe

Dr. Pai Responds: Freckles represent UVA damage. We don't recommend any treatments until the patient is consistently using sunblocks daily for six to twelve months. That alone will lighten the spots. If we do decide to treat, we usually begin with a prescription level bleaching agent, Retin-A and alpha or beta hydroxy acids. We watch and see how that lightens the spots. If the pigment is stubborn or too deep to lift, we recommend the Intense Pulse Light Treatment or a light peel.

Q. What are my options to remove brown age spots from my hands and face?

Melody – Tucson

Dr. Pai Responds: Facial age spots can fade nicely with prescription-level Retin-A and bleaches. But some facial and most hand spots need physical destruction for removal. We use liquid nitrogen, lasers and light sources to destroy unwanted pigment, with minimal discomfort. Before beginning any treatment, it is critical that all brown spots be thoroughly evaluated for melanoma. Additionally, everyone should use a sunblock to prevent more ultraviolet damage and spots. If you do heavy activities outside, try a skin colored zinc oxide like SportzBloc® for superb protection of the face. (.5 oz $8)

Q. With so many products and procedures available, how do I decide what I need for my skin?

Anna Marie – Scottsdale

Dr. Comstock Responds: It is important to have a thorough skin evaluation and global plan in place. Medical-grade products are always the first place to start. Select a physician to guide you who has skills with Botox®, fillers, and access to lasers, light sources and radiofrequency devices. A board certified physician must follow state safety protocols and is responsible for their work.

Q. I have a red nose and don't want to develop my father's red, bulbous nose. Can I do anything to prevent or treat this?

Edward – Phoenix

Dr. Pai Responds: The condition called rosacea is frequently seen in multiple family members and is common to fair individuals. Rosacea may consist of central facial acne, redness and/or flushing. It may be exacerbated by foods (spicy, tomatoes, citric acid) and with coffee and alcohol. Some people will get enlarged and textured nose skin with chronic inflammation. If you already have broken blood vessels or texture changes, lasers can erase and lighten the color. Early treatment can prevent the undesirable skin changes.

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Aging & Wrinkles

Q. What causes my skin to sag as I age?

Kimberly – Tucson

Dr. Frank Comstock Responds: Our skin ages two ways: "Intrinsic" or internal aging is programmed according to your genetics. It can be altered by medical illness and lack of necessary nutrients and hormones. "Extrinsic" or external aging can be accelerated by lifestyle and sun damage. Other outside factors include ultraviolet sun damage, irregular and erratic sleep, drugs, excessive alcohol, high blood sugars, unhealthy diets, and stress. We also credit the balance of muscle, bone, fat and skin for gentle aging. Proper nutrition with healthy intake of protein, healthy fats (fish oils, avocados, almonds), essential vitamins and minerals, along with maintaining healthy hormone levels are critical to minimize advanced aging. Heavy impact exercise will break down collagen in the skin. Individuals with osteoporosis may notice accelerated aging on their face as facial bones thin out.

Q. My eyebrows are disappearing with age. What do I do?

Marisol – Tucson

Dr. Comstock Responds: Many women lose their lateral eyebrow hair with normal aging. It could also be a sign of hormonal abnormality, such as low thyroid. One should discuss this with her primary care physician, especially if it is a sudden loss. Using an eyebrow pencil or having permanent makeup done are some cosmetic alternatives. Also, the new eyelash enhancing products work well to help with thinning eyebrows.

Q. My old smoking habit has left me with pucker lines around my lips. I no longer smoke and I'd like to look better. What can I do?

Maria – Tucson

Dr. Pai Responds: First of all, congratulations on quitting smoking! Wrinkles around the mouth are called rhytides and are hated by all of us. We use non-surgical laser treatments for patients with mild sun damage or patients who don't want healing time. Our favorite treatments are excellent fillers such as Restylane®, Perlane®, and JUVÉDERM®. These are hylaluronic acids that are identical to what our bodies make and last at least six months to a year. New studies also show they help build new collagen. Repeated treatments provide longer lasting results. Deeper wrinkles may need the more aggressive CO2 laser for optimal results.

Q. Our grandson came to visit us recently. I was holding his hand and helping him step into the pool when he asked, "Gram, what are those blue worms on your legs?" My quick reply was "old age." I'm too young to have "old legs." Can you help?

Caroline – Tucson

Dr. Comstock Responds: What your grandson calls blue worms (or crayon marks or spider veins) are varicose veins. First, have your legs assessed with an ultrasound exam to make sure the underlying veins are healthy. If the veins show reflux, a medical procedure called VNUS Closure® can be done in our office and is covered by most insurance. This new procedure can replace stripping the veins and a hospital visit. The remaining veins can be treated by injection of sclerosing solution.

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Eyes

Q. My under eyes are sagging and puffy at the same time. Help! I look older than I really am!

Lisa – Phoenix

Dr. Pai Responds: As we age, the normal fat pad under the eye bulges out of position, causing "bags" or puffiness of the lower eyelids. This in turn casts a shadow on the skin below, resulting in the appearance of dark circles. It's not a great combination, and it's something we can all relate to. It makes us look tired, old, and droopy.

There are several treatment options available. The most popular treatment in our practice is dermal filler injections. A product such as Restylane® or JUVÉDERM® is injected into the dark circles, filling in the hollowness and smoothing the contour of the lower eyelid. There is typically a remarkable improvement, and recovery usually consists of some minor swelling and bruising. Results usually last 2 – 3 years. For some patients, we recommend laser treatment or a chemical peel to help tighten the eyelid skin, soften crepey lines, or even out the skin color.

For some people, surgery is the best choice. The surgeon may remove some of the fat pad or reposition it to flatten out the puffiness, at the same time improving the dark circles. There is about a week of recovery after surgery.

Q. I've struggled for years with dark circles under my eyes. What can you do to get rid of them?

Carly – Tucson

Dr. Pai Responds: You can make dark circles less noticeable by getting proper sleep, maintaining excellent nutrition and hydration, and keeping your allergies under control. Collagen stimulators such as alpha hydroxy acids or Retin-A can also help. Treatment with a laser or a light source can make the skin smoother and lighter in color. Our favorite fix is injecting a small amount of hyaluronic acid filler just beneath the skin. It lightens the shadow and lasts two to three years.

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Skin Conditions

Q. My granddaughter has flat warts on her face. Will they scar her?

Michael – Tucson

Dr. Pai Responds: Flat warts do not cause scarring. It is a contagious virus. Various treatments could cause scarring if done too vigorously. Flat warts occur most commonly on the face, hands, arms and legs. People can present with hundreds of them. They are usually picked up from casual contract. Treatment can include oral antivirals, cimetidine, vitamin A treatments, topical benzoyl peroxides, Aldara, alpha hydroxy acids, liquid nitrogen, lasers, and some injectables. They can be stubborn, so be patient with treatment.

Q. I get cold sores regularly on my lips. They look terrible and hurt. What can I do?

Jessica – Tucson

Dr. Comstock Responds: Cold sores are a common virus that can appear after sun exposure, physical or mental stress, or for no reason at all. They reoccur at the same place and are contagious to oneself and others. Wear sun protection on your lips, especially when skiing or at the pool/beach, and use toothpastes without mint and cinnamon flavorings. Start a prescription antiviral treatment as soon as the tingling sensation begins. We have also found that 200/mg per day of aspirin and for women, permanent makeup to the lips decrease the outbreaks of cold sores.

Q. I hate the moles on my face, but I don't want to have surgery to remove them. What can I do?

Lauren – Tucson

Dr. Comstock Responds: We prefer using a topical anesthetic and shaving the moles off of the face. We usually don't have to use additional anesthesia, and no needle pokes. The moles heal in five to seven days and may be pink or red for a couple of week afterwards. Sometimes deeper pigment or a non-cancerous mole can be removed by laser treatment. We treat hundreds of moles a month with this technique, with great results.

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Hair/Shaving

Q. My neck is always red and bumpy after shaving. Any tips?

Jack – Tucson

Dr. Comstock Responds: Hair on the neck and sometimes the cheeks can grow at different angles. This causes the hair to get trapped under the skin, creating an irritated site around the hair itself. The best treatment is a hair laser. It can completely eliminate the hair, usually in three to five treatments. On some patients, the laser can simply thin the hair enough that with one or two treatments, it no longer gets trapped with shaving. We find Baxter Shaving Cream, Matte for Men, and Obagi Foaming Gel Cleanser are useful products for sensitive skin.

Q. I read once that shaving your arms is good for your skin. Won't my hair get thicker growing out?

Monica – Oro Valley

Dr. Pai Responds: We advise all our patients to shave the hair on their arms. Most patients wonder what medical school we have attended! Shaving exfoliates the skin and stimulates collagen. Just look at a man's beard on his face. A normal hair tapers on the end and is programmed to grow only so long. After shaving, it may feel thicker because it's been cut at a thicker portion of the shaft and feeling the tapered end is more familiar. If a patient doesn't like to shave their arms, just let the hair grow back. It will look the same as it did before.

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