Hollywood Dermatologists

Can Use of Botox Cause Facial Expression to Change Once It Wears Off?

For about 3 years I have been getting botox injections between the eyebrow about twice a year. Its been about 8 months since my last treatment and I have noticed (or rather other people have noticed) that the expression I make with my eyes has changed. I seem to make a wide eye expression (with wrinkling of entire forehead) quite often when I speak. I can only attribute this to the botox, as it is something new that I did not do before. Could it be an unintended consequence of the botox?

Repeating BOTOX injections on a regular basis is a great way to selectively weaken muscles causing the lines that bother you. However, it is unusual to change your expression in a wholesale fashion. You should consult with the dermatologist or physician who administers your treatments, so that you can evaluate before and after photographs for changes in your expression, if available.

Barry Resnik, MD

Miami Dermatologist

Low Dose Accutane for Seborrhea

Dear Doctors, I have had excessive production of sebum (seborrhea) from my nose pores since I was 16 years old. Since 5 years ago I get seborrheic dermatitis on my nose. My dermatologist prescribed 40mg/day Isotretinoin to treat the seborrhea - I weigh 80kg I read about low dose regimes of 2.5mg per day to control seborrhea but it is long term treatment. For seborrhea would 40mg/day and reaching target 120mg/kg dosage have more chance of permanent sebum reduction than the low dose regime?

Lo dose isotretinoin works very well for seborrhea and desultory acne breakouts. A 40mg/d dosing is more along the lines of the Full Court Press, where we are looking at a 5-7m course of treatment as a definitive therapy. Lo dose is adjusted by the patient as needed. I usually dose at 10mg Mondays and Thursdays.

Barry Resnik, MD

Miami Dermatologist

Can a Chemical Peel and Topical Numbing Agent Cause Facial Burns if Done Consecutive ?

Moderate chemical peel on my face,& on my eyelids/scars on Wednesday, Thursday I had my permanent eyeliner done. 1st the topical did not work at all and she had to stop and put more topical on. The topical wore off within the hour. Within 12 hours my face were the topical had been applied had 1st & 2nd degree burns. A freak thing or a combination of 2 chemicals?

Anything is possible, although this is not likely. It is more likely that you had a contact dermatitis to the topical medicine. I urge you to see your dermatologist or the physician who performed the peel for you so that you can have the contact dermatitis treated. Doing so early and aggressively will lessen the likelihood of long-term changes. In the future, you should allow some time between procedures to give the best possibility of healing.

Barry Resnik, MD

Miami Dermatologist