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  • You know those little imperfections that show up on your skin seemingly out of nowhere to spoil your youthful complexion?  You don’t have to live with them if you don’t want to. Now there are some highly effective solutions such as plastic surgery lasers and cosmetic treatments to rid yourself of moles, skin tags, stray hairs, red veins, and the occasional freckle and brown spot.

    Here are some simple clinical solutions to some of your most common beauty afflictions that can add years to your face:

    Open Pores – Pores expand because they become clogged with dead cells and oil – which make them look larger. Sun damage, lack of exfoliating, and clogging blackheads are common culprits.  To get pores back to their normal size, you need to get rid of the blockage that causes them to expand. The key elements are unplugging the pores and cleaning dirt, bacteria and oil; limiting sun exposure; exfoliating and using the right ingredients like retinoids or vitamin A, Azelaic acid, glycolic and lactic acid. According to Dr. Judith Hellman, a dermatologist in New York City, “Cynosure Affirm Multiplex is great for reducing pore size, and we have seen good results with Syneron eMatrix RF as well. Salicylic and glycolic acids in combination are important skincare ingredients to reduce pore size.”

    Cynosure Affirm

    Moles: As moles age, the pigment gets deeper so they lose their color and stick out more, which makes them more visible. Moles can be raised or flat; found under the skin or they may be a pigmented growth resting on the skin’s surface. After a careful diagnosis is made to rule out skin cancer, they can be removed if desired. Some moles can be removed by a simple shave biopsy can bring the mole down to the level of your surrounding skin. “If done with care, a shave biopsy will only leave a minimal scar,” says Dr. Hellman. Moles can also be removed by laser or electrocautery, as well as excision, but these modalities may leave a scab and eventually a scar.

    Skin Tags: A skin tag is a bit of skin that sticks out and may appear attached to the skin. Skin tags may be smooth or irregular, flesh colored or pigmented, raised or dangling. They most commonly appear on the eyelids, neck, armpits, and under the breasts in women. They can be instantly snipped away by your doctor with a pair of surgical scissors. “I use EMLA topical anesthetic cream or inject a local anesthetic to make the procedure painless when patients request it,” says Dr. Hellman.

    Seborrheic Keratoses: Known as the “barnacles of old age,” these benign lesions occur from excessive growth of the top layer of skin cells. They can show up on the body, under the breasts, shoulders, and in places where they get rubbed by clothing. They can range from light tan to black in color, and look like they have been pasted on your skin. Electrocautery using a metal tip can be used to melt these right off. Ablative lasers can also be effective.

    Dermatoses Papulosa Nigra: These little black or dark brown bumps usually appear on darker skin types, and start out as little freckles under the eyes and on the top of the cheekbones. They can grow in clusters, and tend to run in families. Electrocautery can be used to melt these right off or they can be scraped away or frozen. “Treatment is the same as with skin tags, and EMLA can be used to minimize discomfort if needed,” says Dr. Hellman.

    Xanthelasma: Flat or raised yellowish fatty or cholesterol deposits that tend to show up around the eyelids, and sometimes show up in people with high cholesterol. They can be frozen with liquid nitrogen or burned away with electrocautery. Ablative lasers can melt them away. They can also be excised if they are really deep, but this can leave a small scar.

    Eccrine Spiradenoma: These are little flesh toned bumps that appear under the eyelids. Electrocautery can be used to melt these right off. Lasers such as Erbium:Yag can also work.

    Sebaceous Hyperplasia: There are enlarged sebaceous or oil glands and the pore looks like a pit in the middle. They are usually yellowish, soft, and rounded, and may show up on the forehead, cheeks, and nose, or areas of the face that have a large concentration of oil glands. Electrocautery can be used to melt these off. DUSA Levulan® Photodynamic Therapy uses aminolevulinic acid applied to the skin and activated by a light. Lasers such as Hoya Conbio DermaSculpt Er:YAG can also get rid of them.

    Spider Veins: Spider veins or “telangiectasias” are commonly found around the nose and cheeks, legs, chest, and almost anywhere. They are small, super fine capillaries that lie close to the skin’s surface. They can show up as a true spider shape with a squiggly mass of capillaries radiating out from a dark center, resemble tiny branches or appear as thin separate lines. They are more common in women, especially when estrogen levels rise.  Vascular lasers and light sources, such as Cutera Laser Genesis, Cynosure V-Star, and Candela V-Beam can be used to cause veins to collapse. Hoya Conbio V-Raser® can treat vascular lesions. For leg veins, sclerotherapy injections, such as the new Asclera® from Merz, in which a solution is injected into the veins, will cause them to collapse.

    Milia: These are clogged ducts or teeny sebaceous cysts on the face. Milia can show up around the eyes, cheekbones, and on the forehead. Over moisturizing or using too products that are very creamy or greasy can be the culprit. Sun damage and laser treatments are also possible causes. Your doctor may use a small needle or blade to pluck out the glob of thickened oil. They can be treated by extraction, and microdermabrasion and peels can also help. As Dr. Hellman explains, “Please do not do this at home to avoid scarring and infections. See a Dermatologist to have these properly treated.”

    Shaving Bumps: Called Psudo-Folliculitis Barbae, shaving bumps are a widespread problem, especially among women with curly hair and in the bikini area and underarms. As the hair follicle grows out of the skin, it immediately curls and re-enters the skin. The skin becomes inflamed and irritated, creating bumps. Wash the area twice daily with an exfoliant to raises the hairs from under the skin and prevent them from growing back into the skin. Bumps can also be relieved by using glycolic acid lotions, antibiotic gels, and Retin-A®. Other options include laser treatments such as Cynosure Alexandrite can be used to remove the hair follicles. “You can also use a clean toothbrush to free up ingrown hairs so they can be removed,” says Dr. Hellman.

    Keratosis Pilaris: A genetic condition of the follicles that sometimes resembles acne, but appears as rough bumps on the upper arms, backs of the thighs, and buttocks. It is also common in teens. Common remedies include exfoliating and using Retin-A® or lactic acid creams and lotions daily, such as Amlactin® Body Cream or Lotion or Anushka Sea Sluff, for regular exfoliation. Avoid scratching the bumps, as this may lead to scarring or spreading. “A topical prescription strength cortisone cream will be helpful to reduce redness,” says Dr. Hellman.

    Poikiloderma: These pigmented areas (combination of brown spots and dilated blood vessels which are red) appear most often on the chest, neck and face, caused by prolonged sun exposure. Lasers can target the blood vessels and clear up the spotty appearance of skin. “I recommend Syneron Fotofacial RF which treats both red and brown and restore even skin tone after a series of treatments,” says Dr. Hellman. “Daily use of high SPF is mandatory to maintain clearing and prevent future damage.”

    Sun Spots: They may be called freckles when you are young, and some people may think they are cute, but in your 40s, they appear as dark brown patches that come up from sun exposure. Age spots on the face or hands can be treated with bleaching agents, peels, and lasers. Hydroquinone is a doctor’s staple for lightening excessively pigmented skin. Lumixyl is a new skin brightening peptide clinically proven to reduce discoloration and the Lumixyl Skin Brightening System can lighten brown spots in eight weeks of continued use. Microdermabrasion and chemical peels uncover a fresh layer of skin. “I combine a skin lightening agent with glycolic acid for better penetration and faster results. In some cases, a retinoid such as Differin or Retin-A may also be used,” says. Dr. Hellman.

    Wendy Lewis is President of Wendy Lewis & Co Ltd, Global Aesthetics Consultancy, and Founder/Editor in Chief of Beautyinthebag.com. You can reach Wendy Lewis at wl@wlbeauty.com.

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