Dr. Kellett Answers Your Questions

Question: I'm 53, and over the last few months have noted that the skin on my face and neck is becoming soft and loose. I am not overweight and in good physical health. Is there anything I can do outside of surgery?
Answer: Thermage Radiofrequency treatment is an excellent option for patients who are looking to tighten their skin but do not want surgery.  It is a straightforward procedure resulting in tightening of the skin and is ideal for the eye area, lower face, chin and neck.  The best advice for you is to see a Dermatologist for a proper assessment and consultation.

Question: I am a 36 yr old Indian woman. I have a wheatish complexion and am interested in a 'Skin lightening procedure' for my face. Which is the best treatment for this? Kindly help me with this.
Answer: There are a number of topical preparations and treatments available to lighten the skin.  The ones chosen for you depend on your skin type and also other factors such as medical history, family history and sun exposure.  The best next step for you is to see a Dermatologist in consultation to develop a treatment plan that is best for you.

Question: How do I lessen the wrinkles around my mouth and lip area?  I exfoliate regularly and use roc retinol everyday.  I’m 47 other than that my face is in good shape, people always guessing my age at 38-40.
Answer: There are a number of treatments available to treat wrinkles around the mouth including non-ablative and ablative procedures. The newest and most effective one is the Profractional Treatment which causes changes in a patient’s collagen to smooth out wrinkles. I would suggest you have a proper Dermatology assessment to determine what option is best for you.

Question: How do I get rid of dark & bumpy skin under eyes?
Answer: Dark skin under the eyes can be caused by a number of issues including genetics, venous congestion and other benign papules under the eyes.  There are also many different treatment options that depend on the cause including injectable fillers, laser, radiofrequency and topical creams.  The best way to treat is to get a proper consultation followed by a management plan.

Question: For the last 4 months my skin on both palms is getting very dry and the skin just opens up (cracks) and I have to use ointment to heal. Then the skin heals for couple of days then it starts again. This happens only on my, and on my fingers.
Answer: Dry Skin on the palms is a sign of an underlying issue of which there are many possibilities including eczema, fungus, psoriasis and others.  The best thing to do is to see a Dermatologist for assessment and to also bring in what you are currently applying to your hands as well as anything that you come into contact with at home (hobbies too) or at work.

Question: I'm 53 years old. In the past couple of years I've notice an increase of small fatty deposits under my eyes and on my eyelids. What causes this and is there anything I can do about this?
Answer: There are a number of fat deposits that can occur on the eyelids.  One of them is xanthlasma which can be associated with an increase in cholesterol or fats in the blood.  There are a number treatments available for xanthlasma including surgery and laser.  It is important for a proper diagnosis and investigations to treat these appropriately.

Question: What strength of SPF should I use with Retisol-A and can I use a moisturizer at night before or after I apply the Retisol-A? 
Answer: Without knowing the specifics of your skin condition and examining your skin properly, it is difficult to give you a specific answer but the use of any retinoid can make skin more sensitive to light. In general, an SPF of 30 or higher, appropriate for your skin type, should be used on all patients daily for sun protection. It is better to consult with your prescribing physician regarding treatment issues you might have. It is fine to apply moisturizer after applying any retinoid.

Question: I was wondering if you have any suggestions for me, I have dry skin now that it is cold out but my chin is breaking out and always has little white dots that I have to squeeze.  My skin is other wise in pretty good shape.  I do need quite a bit of moisture, do you think I got the right products? 
Answer: The best option for patient who tend to break out and have dry skin especially in the winter is to use water based, oil free products. In general, avoid white creams and lotions. The exception is an acne treatment cream which if it contains benzoyl peroxide is white. Look for gel based moisturizers and spray sunscreens that are clear.  With respect to makeup powders are better than liquids.

Question: What is the best approach to skin care for people with break outs?
Answer: We have many product choices. If you suffer from psoriasis or rosacea, mild products are the key.  Cleansers and moisturizers designed for sensitive skin types are your best bet as they are gentle enough not to aggravate or trigger a breakout. Avoid foaming cleansers which can be overly drying.
Acne sufferers, on the other hand, should use an exfoliating, non foaming gel cleanser to remove and wash away dead cells. You should also always opt for a water-based, oil-free gel moisturizer, and avoid white creams or cream based sun blocks which will clog pores and worsen your condition.

Question: I have all of a sudden got breakouts all over my face. Is this because I am stressed? What can I do to relieve these breakouts without spending a lot of money? eating different foods? trying different products?
Answer: There are a number of causes of breakouts including hormones, stress and even the products that you use. I suggest that all of my patients with acne breakouts use water based, oil free, gel products rather than thicker white products. The best advice for you is to consult with a Dermatologist for a proper assessment. You should bring in all the products you are currently using including skin care and makeup. In addition, it is helpful to bring a list of treatments you have had in the past for acne (both those that have worked and those products that didn't work! ) Many patients also find Diamond peels to be helpful in removing dead skin cells and excess sebum (oil). There are also many topical medications available  to treat acne before resorting to oral medications.
There are many options for treating your breakouts so please don't despair. Good luck on your road to clear skin!

Question: I get these small white hard cysts on my face. Why do I get them? And how do I get rid of them and/or prevent them?
Answer: There are a number of different types of white hard cysts that can occur on the face. One type is called milia which occur as a result of using products that are too rich or creamy for your skin. They are oil deposits and appear like little white balls of oil under the skin. Patients with milia should use gel based, water based products to prevent getting them. They are very treatable and my advice to you is to consult with a Dermatologist for a correct diagnosis and treatment.

Question: Being a young black woman in my 20s I have facial hair as well as ingrown hair scars, What treatments can I do to get rid of that? And how many time do I have to do it and how much will it cost me?
Answer: Ingrown hairs often cause scarring because of the inflammation underneath the skin. Because of this patients with recurrent ingrown hairs often consider laser hair removal as a means of removing the hair and thus getting rid of the cause of the scarring. Other options for hair removal include electrolysis although for larger areas laser hair removal is a cheaper option. Shaving and waxing do not get rid of the hair permanently and therefore are not good options. Laser hair removal requires 6 treatments for permanent hair reduction. It is best to see a Dermatologist first prior to undergoing hair removal to rule out an underlying cause of the hair growth and to assess the fact that you are a good candidate for the procedure. Good luck!