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Kathleen J. Smith, MD

Dermatologic Surgeon, Board Certified in Dermatology

1670 Scott Blvd , Suite 202, Decatur, Georgia

+16789044932

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41 Questions Answered

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QUESTIONS ANSWERED

Is it OK to use Retin-A with a face oil? Which order should I apply the products?

Asked By:AnonymousANSWERS (1)

I do not recommend using face oils with retinA, particularly if you break out at all. I would recommend a product with dimethicone or cyclomethicone. In addition, ceramide containing moisturizers have been show to work very well with trentinoin either prior to or after application of the Retin-A, and can decrease irritation in individuals who are irritated by tretinoin.

Kathleen J. Smith, MD

Dermatologic Surgeon, Board Certified in Dermatology

Does having active gum disease decrease the amount of time that a filler such as Juvederm lasts.

Asked By:AnonymousANSWERS (1)

Prior to having facial fillers I recommend that individuals with active gum disease see a dentist and be treated. Oral gum disease is a biofilm which is secondary to bacteria that induce an inflammatory response. Although the inflammation induced by the biofilm may induce proteases as well as hyaluronidase which could decrease the life of any hyaluronic acid filler such as Juvederm this should not occur as rapidly as you describe. There may be some initial swelling that goes away in a couple of days. However, I believe the biggest risk from active gum disease is that it may predispose to facial biofilms with an filler.

Kathleen J. Smith, MD

Dermatologic Surgeon, Board Certified in Dermatology

What type of baldness do I have, and which medicine should I take? (Photo)

Asked By:AnonymousANSWERS (1)

It does look like you have female pattern alopecia which is associated with individuals with polycystic ovary syndrome. You may also be experiencing some hair loss termed telogen effluvium, which commonly occurs after child birth. In addition to anti-androgens such as spironolactone and birth control pills which can be beneficial in female pattern alopecia, individuals with polycystic ovary syndrome have increased androgens that is associated with more broad metabolic and hormonal dysregulation. It may be helpful to your general health as well as treating your hair loss if you see someone who specifically deals with skin and hair problems seen in individuals with polycystic ovary syndrome

Kathleen J. Smith, MD

Dermatologic Surgeon, Board Certified in Dermatology

What kind of treatment or procedure to remove a mole on the upper lip? How long it will take to heal and put make up? (Photo)

Asked By:AnonymousANSWERS (1)

I would initially do a shave removal of this lesion that appears pedunculated with a base that is smaller than the lesion itself. You will then get a pathologic diagnosis, which I think is important for this pigmented lesion. This will healing in relatively quickly and with not need sutures. In general the face heals in very quickly, and should leave you a nice cosmetic result. However, there is a chance that there may be some lesion deep and thus some residual pigment.

Kathleen J. Smith, MD

Dermatologic Surgeon, Board Certified in Dermatology

Any medicine for female hereditary baldness ? (photos)

Asked By:AnonymousANSWERS (1)

It does look like you have pattern or androgenetic alopecia. The first thing you need to do is to make sure your doctor has eliminated any abnormalities in your hormonal levels and other metabolic perameters. There are a couple of conditions that do result in androgen excess, that are not tumors, and one that is actually relatively common in polycystic ovary syndrome (you do not need to have demonstrated ovarian cysts). In addition, to topical minoxidil products, which non-specifically induce prolongation of the hair cycle and thickening of the hair, there are also oral, topical, and some new light sources that may be useful in the treatment of pattern alopecia. Remember minoxidil products are very dependent on being used daily and most twice daily, and if stopped even for a short period of time the positive effects go away almost immediately.

Kathleen J. Smith, MD

Dermatologic Surgeon, Board Certified in Dermatology

Celiacs disease with Rosacea and need anti aging product as well. Any suggestions?

Asked By:AnonymousANSWERS (1)

There are a number of different factors that would affect any recommendation. I assume you are on a Gluten free diet. In general most rosacea patients have sensitive skin and should use a mild cleanser. Sun screens are important and are available in ceramide containing topical agents that improve the barrier in individuals with Rosacea. In the evening I would probably use again a ceramide contining moisturizer with some added nicacinamide. The specific topical medication would depend on the dominant features present in you Rosacea, i.e. folliculitis, telangectasias, erythema, and there are compounded products now available that are very useful in some individuals.

Kathleen J. Smith, MD

Dermatologic Surgeon, Board Certified in Dermatology

Should juverderm cause hard lumps in the lips after 3 months?

Asked By:AnonymousANSWERS (1)

The delay that you describe could occur with either granuloma formation or formation of a biofilm? For either it would be unusual for the areas to go totally away in one area and appear in another although biofilms can spread. I would suggest a small punch biopsy during an active period to attempt to determine exactly what is going on

Kathleen J. Smith, MD

Dermatologic Surgeon, Board Certified in Dermatology

Can I use a Salicylic acid peel or lactic acid peel while breastfeeding? My son is 11 months.

Asked By:AnonymousANSWERS (1)

Alpha hydroxyl acids such as lactic acid and glycolic acid are considered safe when breast feeding. Salicylic acid, particularly the concentrations used for peels in a no no during pregnancy and should not be done while breast feeding.

Kathleen J. Smith, MD

Dermatologic Surgeon, Board Certified in Dermatology

I have purchased a Retinol lotion....50. Will it work to eliminate my hyperpigmentation?

Asked By:AnonymousANSWERS (1)

Retinoids can help with hyperpigmentation and have other benefits for your skin. Retinoids and alpha hydroxy acids i.e. glycolic may decrease pigmentation and brighten skin in part through increased peeling (sheading) of the superficial keratin layer of the skin, which does contain pigment. In addition, there are other agents that treat hyperpigmentation through various mechanisms including by directly inhibiting pigment productions i.e. hydroquinone, arbutin, Kojic Acid, Decreasing pigment transfer i.e. soy, niacinamide, and through the inhibition of reactive oxygen species i.e. antioxidants i.e. vitamin C, Vitamin E, alpha-lipoic acid, ferulic acid. It is also very important to wear sun screens with a sun protection factor of at least 30 and the label should say it also has broad or UVA protection.

Kathleen J. Smith, MD

Dermatologic Surgeon, Board Certified in Dermatology

I'm 21 years old with moderate severe acne, I really want to try Accutane, will it help with my acne and keep me acne free?

Asked By:AnonymousANSWERS (1)

Accutane was one of the Isotretinoin products that is no longer marketed, but there are a number of other products. Isotretinion is very useful for the majority of individuals who have moderate severe acne, and it remain the only medication that has the potential to not just suppress acne but to induce long term improvement after a coarse. However, there are individuals who need more than one coarse and there are rare individuals who do not respond to isotretinoin. Since pregnancy is contraindicated with isotretinoin, females need to use to forms of birth control and have negative pregnancy tests though out and following the coarse of isotretinoin. Birth control pill are usually one of the methods of birth control and may also have some benefit in the hormonal flairs you describe, and there are some birth control pill that may be somewhat more effective is controlling hormonal acne flairs.

Kathleen J. Smith, MD

Dermatologic Surgeon, Board Certified in Dermatology