Determined to Rid My Brown Spots, I Tried Fraxel and Here's What Happened

I've had my post-summer Fraxel appointment booked since summer began and it finally came. The last week of August seemed like the perfect time.  Even though it was right before Labor Day Weekend, I knew my plans wouldn't have me basking in the sun.  Yesterday, I entered my trusty derm's office, Dr. Ilyse Lefkowicz, anxious and excited, but more than anything nervous as I'm big on instant gratification and this is as close as it gets when it comes to clearing your complexion of hyperpigmention.  I was ready to say good by to my brown spots – all of them. So what have I done so far to get rid of them?  Most recently I've been using topicals like Vitamin C, but I've even bleached my face out in an unsafe way with hydroquinone in the past.  I've also done an IPL (targeted laser treatment that gets rid of brown spots), which worked, but obviously like any obsessed beauty guru who is about to turn 30 (in 6 months) I wanted more.  After speaking with my derm about whether or not to do a few more IPL sessions she recommended one Fraxel treatment as it would be more cost effective and get the job done.  I was after a perfect complexion.  Fraxel is a cosmetic laser treatment that helps to renew the skin.  Depending on the setting, it can rid brown spots, acne scars and help diminish fine lines and wrinkles.

Prior to lasering, Dr. Lefkowitz coated my face with a thick numbing cream and I sat for an hour checking my emails as my lips went numb... then, everything else.  She explained that she was going to do eight passes over my face with the laser and I would feel a tingling sensation.  The machine has a cooling agent attached to the laser so I felt cool air blowing on my numb skin as I felt an irritating, yet tolerable scratching pins and needles like sensation. My forehead was the most sensitive and I just kept breathing as Dr. Lefkowitz fried the skin on each section of my face.

Overall the treatment took about 20 minutes and then I iced.  I left embarrassed as I left her office as I looked like I had a horrible sunburn on my face and neck with puffy eyes and cheeks.  Being that I'm so pale everywhere else I really looked ridiculous.  Wishing I had a scarf to wrap myself up in, I did my best to hide behind my sunglasses and ran home.

This week, as I hibernate I'll experience peeling (new skin!) I'm using gentle cleansers and moisturisers with SPF provided to me by Dr. Lefkowicz.  One of them being Cerave.   This time next week my face will be as soft, smooth and clear as a baby's bottom.  The type of setting my Fraxel treatment was set for was key for targeting photo-damage: brown spots from the sun or aging.  Dr. Lefkowitz did mention that treating melasma is tricky and this may not be the answer.  Some patients may also need more than one treatment to rid their photo-damage.  Looks like I'll only need one (I hope).  I'll write next week and post "After" pics to show you how it came out!

Dr. Ilyse Lefkowicz can be found at 875 5th Ave, New York, New York 10065.  Call her for an appointment at (212) 288.3200.

Everything You Need to Know About Sunscreen Including the New FDA Regulations

I'm completely obsessed with knowing everything there is to know about my skin, aging, sun damage and SPF.  My derm, Dr. Ilyse Lefkowicz, can back me up on that as I'm constantly picking her brain and bugging her for more and more info.  My days basking the sunshine are over and I now understand everything there is to know about protection  – sun protection to ensure I don't age any quicker and never welcome skin cancer.  Of course, I had to share her knowledge with you, because it's beyond interesting and helpful. Incidental sun exposure received during everyday activities accounts for approximately 80% of an individual’s lifetime exposure," states Dr. Ilyse Lefkowicz.  "Therefore, I always recommend applying a broad-spectrum sunscreen with an SPF of 30 or higher on a daily basis in order to help prevent skin cancer and aging."

When shopping for SPF you want to look for three things:

• Broad-spectrum protection (protects against UVA and UVB rays)
• Sun Protection Factor (SPF) 30 or greater
• Water resistance

Broad spectrum is super important (UVA and UVB coverage) because the different types of rays do different types of damage that can both lead to skin cancer.  UVA rays can prematurely age your skin, causing wrinkles and age spots and can pass through window glass.  UVB rays are the primary cause of sunburn and are blocked by window glass.

"Because most people don’t apply sunscreen the way they are supposed to (most apply less than 1/4 of the amount they should, , I always advise my patients to use a higher SPF," Dr. Lefkowicz comments.  The proper dosage is about a shot glass full, or an ounce, to cover your entire body.

To break it down, Lefkowicz explains that SPF not only indicates how much longer protected skin can resist getting red than unprotected skin, but also what percentage of UV rays are screened.  An SPF 15 screens 93% of UV rays whereas an SPF 50 protects against 98% UV rays.  Her thoughts on an SPF 100?  Well, doubtful it can do much better than 50.

Beginning in 2013, you’ll see several changes to sunscreen labels required by the FDA.

• For a sunscreen to carry the claim that it can prevent skin cancer and sunburn, it must offer both: 1) broad-spectrum coverage 2) an SPF of 15 or higher.

• The FDA will ban companies from claiming that a sunscreen is “waterproof” or “sweat proof.” This is simply not possible. You’ll now see the term “water resistant.” The label also must state how long the water resistance lasts, either 40 or 80 minutes.

Putting Lasers to the Test: I Tried A PhotoFacial

Now that I'm 29 (yes, 29 and freaking out about my skin since I grew up a sun worshiper) I've been picking my dermatologist, Dr. Ilyse Lefkowicz's, brain about what I should do to make sure it looks the best it possibly can.  As I creep near the big 3-0 I want to make sure my skin ages as gracefully as possible.  Yesterday, she convinced me to try a PhotoFacial, otherwise known as Intense Pulsed Light Therapy (IPL) to help rid my brown spots (thanks tanning), which dull my complexion and make me look older than I am.  Since I trust her tremendously, I happily surrendered to the PhotoFacial and let me tell you, it's no "facial." This was my first laser treatment.  More anxious than nervous I sat in the chair, put on a pair of goggles and listened as Dr. Lefkowicz told me I was going to be uncomfortable as she targeted brown spots with the laser on my cheeks, chin, nose and forehead.  When it comes to beauty, I'll take discomfort.  As a matter of fact, there's not much I wouldn't do for flawless skin.

The laser felt like a hot rubber band snapping for a second on each brown spot.  After one pass around my face, Dr. Lefkowicz waited a minute and checked in with me and went back for a second and then a third.  The forehead was by far the most sensitive, but the overall experience wasn't that bad, just slight discomfort.  The pulsed light hits the melanin in the skin, which causes the dark pigment to disappear.  When I looked in the mirror I noticed the brown spots were all darker and I had little red marks all over my face where she hit me with the laser.  It took about a half hour for my skin to calm down as it was a little inflamed.

For the next two days my brown spots will be darker and then naturally fall off.  I won't be able to go out without concealor and foundation on to hide them (and I don't normally wear face makeup).  Therefore, I would recommend doing this facial when you don't have any big meetings or events that week.  I'm instructed not to scrub or try to peel them off.  The care is simply to keep my face moisturized and wear SPF.  As you can imagine, I'm completely anxious to see results and will post a round two next week.

The IPL is great for people with brown spots, age spots and even rosacea and can be used on your face, chest.  Of course, treatment is different depending on the patient.  I may be happy after this one treatment, but sometimes several treatments are needed (up to four) spaced two to four weeks apart.

New App Detects Skin Cancer, Does It Really Work?

Earlier this month I received an email from a publicist about SpotCheck, a new application available on iTunes and invented by Dr. Bobby Buka that allows you to upload an image of a potentially dangerous mole with your smartphone, send it into a board of dermatologists for review with no co-pay.  Sounds genius right?  Of course, but as a skeptical journalist I spoke with Dr. Ilyse Lefkowicz to get another opinion before you spend the $4.99 submitting a photo. "While this sounds like a wonderful app for those who can't get in to see a derm or who can't afford it, I have many issues with it," remarks Dr. Lefkowicz.

Top Concerns:

1. The quality of the photo

If a user logs onto the website, they'll see photo instructions that advise to choose a room with lots of light, not to zoom in on the mole and not to use flash.  However, I doubt most users would log on to review the tutorial.  "I would not feel comfortable making a diagnosis based on a picture taken by an ameteur," Dr. Lefkowicz comments.  The FDA recently approved of Melafind after years of research, which is a hand held scanner and computer program that dermatologists are using in office now to analyze images of moles.  This app doesn't compare.

2. History matters

"When diagnosing a skin lesion I need to know the whole story when forming conclusions," states Dr. Lefkowicz.  While SpotCheck doesn't actually diagnose, it does let you know if your mole is potentially dangerous and recommend whether or not you visit a derm.

3. It's not always cancer

When being told by an app that you have a potentially dangerous mole, you're automatically going to think the worst – melanoma?  However, that may not be the case. It's important for dermatologists to perform a full body scan, because often times many people have several abnormal moles, which is OK.  "It's comforting when I see a patient has more than one abnormal lesion," comments Dr. Lefkowitz.  "Even though they may appear suspicious, it's typical and they don't always have to come off."

As I suspected, the app is beneficial for those who don't regularly visit a derm or those who are on a budget.  I can only hope that those who are using it are sending in clear enough photos and taking action by following up with an in office visit if they get a negative response.  In the end, when it comes to potentially life threatening moles, the choice is yours.  Ask yourself... is relying on your smart phone worth it?