Tracy Evans, MD, FAAD

These prescriptions should not cause problems with the Fraxel treatment.  Be sure to tell the provider that you are seeing so he or she is aware.  Generally speaking, many providers will not do Fraxel on "active acne" meaning new red bumps or white heads.  This type of acne can be worsened by Fraxel treatment.  At your consultation/evaluation, the provider can tell you what he or she thinks.  Hope this helps!

You are a perfect candidate for Latisse!  Apply it to the last line every night with a tiny eyeliner brush.  Give it a few weeks and you will see growth.  At 16 weeks or 4 months you will see maximum growth and length.  It works great!  I even use it in my practice for brows.  Many people have had "bad wax jobs" and this is the cure!  

Most patients notice a change as quickly as a few days, but based on the scientific studies, you should see the "final" results at about 10-14 days.  This is when the muscles should be the weakest and you should have the least movement.  I often bring patients back at about the 2 week farm for a "recheck" or "touch-up" if necessary.  

Botox lasts, on average, about 3-4 months.  There are several factors that can change this.  For example, if you exercise a lot, your Botox will likely wear of quicker than someone who doesn't exercise.  Another factor might be how the botox was done and how concentrated the solution is.  

At this point, there are no long term studies that show issues with long term Botox use.  No long term side effects have been documented yet.  Great news!  Hope this helps!  

Thanks for your question!  No, 19 is not too young.  I often treat late teens and 20s with more of a "preventative" focus.  We aren't treating deep lines or wrinkles, we are only inhibiting the movement to prevent lines and wrinkles from developing later.  My only recommendation is find a board certified provider that you trust to do your preventative botox.  

IPL and Fraxel are not beneficial for melasma, in fact, they can make it worse!  I would highly recommend you see a board certified dermatologist to have a consultation, but my personal recommendation would be combination therapy.  I like to use 4% hydroquinone cream with tretinoin 0.05% cream, and Clear & Brilliant treatments every 4-6 weeks.  I have found that this combination works very well in patients with your skin type.  You can expect to need 4 to 6 treatments, but we stop when we are happy with the results.  It is also very important you use a high quality sunscreen on your face daily.  My favorite is Elta MD UV Clear, it is SPF 46 and comes in tinted form.  Also, consider wearing sun hats or baseball hats when you are outside for extended periods of time.