Guidance on improving my skin? (Photo)

Question

I am 27 years old, interested to see how to improve my skincare routein and any cosmetic treatments (lasers, microneedling, peels, etc) or precription topicals that would improve the apearance of my skin. I have been using precription strength tretinon on my face for 3 months. In addition, I use Cereve Renewing Night Cream, Cereve sunscreen SPF 30 during the day, and a HA serum in the PM and AM.

Raffy Karamanoukian, MD, FACS · Answer

Our treatments use combination therapy to improve the epidermis and dermis for most deep scars. The options available for acne scars depend on the character of your scars, in terms of topography and contour. We see atrophic and hypertrophic acne scars, as well as scars that have hypo and hyperpigmentation. We begin each scar evaluation with an assessment of scar quality and subtype. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to decide whether early subcision should be started.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

John L. Burns Jr., MD · Answer

You are young and in a great place to focus on skin care and minimally invasive modalities to maintain your skin.  SkinVive is new treatment where micro droplets of hyaluronic acid are injected into the skin for smoothness and hydration.

Michael A. Persky, MD · Answer

Hi Sam,
Great question.  SkinVive is the first and only hyaluronice acid microdroplet injectable indicated to imporve skin smoothness of the cheeks.  I have used it off label over the entire face with excellent results and very high patient satisfaction.  SkinVive is not a filler, it is a skin booster, it hydrates the skin and gives the skin a lasting glow.  SkinVive is injected with a tiny needle, just below the surface of the skin spaced between 0.5 to 1 cm apart in miniscule amounts.  SkinVive is capable of attracting up to 1000 times its weight in water molecules, thus increasing hydration resulting in smooth glowing skin that lasts up to 6 months.  SkinVive was approved for use in the US 9/2023, but was used in other countries for many years as Volite.  It has a proven track record of safety, effectiveness, and very high patient and physician satisfaction.   As we age, our skin loses hyaluronic acid and overall smoothness.  SkinVive is a modified form of HA that facilitates the skin retention of its natural moisture, improving skin smoothness and fine lines.  The treatment takes about 10 to 15 minutes, is approved for all skin types, and does not disrupt everyday activities.  Some patients choose to have topical numbing cream applied to treated areas while others tolerate the injections without anything.  It feels similar to Botox injections.  Keep using your retinol and sunblock.  As with any aesthetic procedure it is imperative to chose your treating injection physician carefully!  Good luck and be well!
Michael Persky, MD
Encino, CA

Aaron Gilson, DO · Answer

You might consider looking into treatments like Skinvive. It's a hyaluronic acid injectable, but unlike more traditional fillers, it's designed to improve the skin's texture and hydration rather than altering structures or volumes. The hyaluronic acid in Skinvive works on the subtle side, aiming to provide a gentle boost in skin smoothness and a healthy-looking "glow" by hydrating from within. It's an option for those who might be seeking to extend their skincare beyond topical applications, offering a different approach to maintaining skin health and appearance over time.

Brandon Richland, MD · Answer

Hi there, thank you for your question.Microneedling is excellent for improving texture (fine lines, bumps, scars) and can reduce the appearance of some hyperpigmentation.IPL is the most effective option for hyperpigmentation and reducing redness associated with broken capillaries.Peels are a great way to improve both texture and hyperpigmentation but do require a bit more downtime than the previous two options.As for skin care, you are doing well with having started tretinoin and using SPF. Another serum that could improve skin tone would be vitamin C. I would recommend consulting with a skin care specialist with experience in all of the aforementioned treatments above to come up with a plan that would suit your desires and budget.Best of luck!

Nima Shemirani, MD · Answer

Hi @sam95ub. I recommend an in person consultation to discuss the best treatment plan tailored to your specific skin.

Best of luck,

Dr. Nima

Jason Emer, MD · Answer

"I suggest reaching out to an expert for a formal consultation. I like to recommend my patients start a combination of facial rejuvenation treatments.

1) Skincare with products and microneedling/PRP
2) PDT Light Therapy a few times per month with growth factors
3) Laser treatments like Clear + Brilliant regularly and others (Fraxel, Moxi, Viva, CO2, Erbium, Halo) a few times per year
4) Sculptra injections a few times per year for collagen production with fillers like Juvederm, Restylane, Belotero, Radiesse, and/or Bellafill
5) Thermage/Ultherapy for yearly skin tightening with or without PDO or cone-based Instalift threads for lifting
6) Botox every 2 to 3 months to stop movement lines and prevent lines at rest

Best, Dr. Emer."

Camille Cash, MD · Answer

I encourage you to begin by visiting with an experienced aesthetician at a board certified plastic surgeon's office.  She/He will perform a skin analysis and talk to you about what treatments are best for your skin and lifestyle.  We always recommend using medical grade skin care products, like Transform MD, and wearing sunscreen every day.  You will learn at this visit about which treatments are right for your skin type and how often you should consider having them.