Years ago I had a chemical peel, and it took me several weeks to show my face in public. I especially remember the second week, sitting across from my then-husband at dinner and watching his pained expression as he tried to eat while my charred skin dropped from my scarlet face into my Caesar salad.
Not a pretty sight.
At Palos Verdes Dermatology Associates (PVDA), a clinic located inside the Promenade on the Peninsula, Dr. Howard Fein said patients want to avoid such a drastic suspension of their normal lives.
“They want procedures with quick results and minimal down time,” Fein said. “The technology has evolved so that, rather than removing the entire top layer of skin in one procedure, only a fraction is removed at a time.”
With the treatments broken up, the dermatologist said, the patient experiences fewer annoying side effects and needs only a couple of days to recover.
New laser resurfacing treatments such as Fraxel, “remove the outer layers very precisely, very selectively,” said Fein, director of dermatologic surgery at Harbor-UCLA Medical Center. Lasers are helpful for correcting a variety of conditions, including acne scars, sun damage, increased pigmentation and wrinkles.
Fraxel works by splitting the laser beam into tiny pinpoints of light. Since only a set percentage of the skin is treated in each session, healing is quick and the patient is not prone to scarring or loss of normal skin color.
Where laser treatments are expensive, costing several hundred to thousands of dollars, chemical peels can cost less, but might also be less effective.
Popular are “lunchtime peels”, which require no downtime, Fein said. These superficial peels require the use of chemicals such as glycolic, lactic, or salicylic acid. Medium and deep peels involve stronger acids. Chemical peels, depending on the depth, require from two to six treatments and begin at $125 per treatment.
Although the end result is much the same, patients don’t have to hide from the world for two to three weeks, and families aren’t subjected to loved ones who look like hideous creatures escaped from “District 9.”
Innovations in the medical dermatological trade happen steadily, but with way less fanfare than the retail cosmetic industry that spends millions on advertising — advertising that can be as misleading as a used-car salesman peddling an SUV with a rolled-back odometer.
At least whatever is new, old or improved in a doctor’s office is tested to death and up to FDA standards.
Nowadays, a lot of procedures and products have been improved, the doctor said. Old standbys such as Botox have competition (the slightly less-expensive Dysport from Europe); fillers like Restylane and Juvéderm are formulated with anesthetics to reduce pain of injections, and topical creams and serums are reaching deeper into chemistry and DNA to reduce the effects of aging.
Skincare lines sold mostly in medical offices (many available online) are improving all the time, Dr. Fein said. A new product such as Revaléskin, for example, is made from coffee berry extract, an “antioxidant more powerful than pomegranate or green tea,” he said. Used regularly, Revaléskin creams (from $90 to $130) can diminish skin pigmentation, fine lines and redness.
It’s not always necessary to purchase a whole skincare system, however, said the doctor, whose offices once served as re-election headquarters for former President George W. Bush.
“Sometimes they need to create a [cleanser] just for doing it,” he said.
A moisturizer for the price of two Frappucinos at Starbucks
Not one to shy away from recommending reasonable, over-the-counter products, the USC Med School graduate pointed to CeraVe, a moisturizer available at drugstores for the price of two Frappucinos at Starbucks.
CeraVe, Fein said (carried at Rite Aide, CVS and Walgreen’s), increases absorption of moisture by adding oils (ceramides) already found in the skin. The cost is minimal (to say the least), about $16 for the moisturizing cream, $13 for the PM moisturizing lotion.
(Take that, $1,000, La Prairie Cellular Cream Platinum Rare!)
Other resurfacing procedures at PVDA include microdermabrasion and the newer micropeel.
According to Lilah Pezzillo, a licensed, medical esthetician who performs both treatments at the clinic, microdermabrasion is a method of exfoliating the skin with a handheld device that sands and suctions away impurities. (Cost is $100; $125 with a scrub and facial massage.)
Micropeel, otherwise known as dermaplane, is “a little more intense,” said Pezzillo, 32, a Redondo Beach resident who has been with Dr. Fein’s group ever since he opened six years ago.
“It’s basically scraping off the dead skin with a blade,” she said, producing an instrument that resembled an exacto knife. “Some people worry the villous hair (fine hair on the face) will grow back thicker, but it doesn’t. It grows back the same.”
Preparing Anna Kim, 30, of Rancho Palos Verdes for a treatment, the radiant-skinned, blonde esthetician explained that a micropeel is done in three steps. First, dermaplaning or exfoliation of the skin. Second, application of a peel solution (glycolic or lactic acid, depending on sensitivity). And third, cryogenic therapy (reduces pores and removes bacteria with a C02 ice ball).
The $125 treatment is considered “corrective,” Pezzillo said. Accomplished in a series of four to six sessions, Micropeel is good for patients with dry, hyper-pigmented and normal skin, she said; Micropeel Plus suitable for patients with acne and/or oily skin.
With Kim stretched out on the esthetician’s table, her olive skin looking about as perfect as a child’s (she’s had microdermabrasion, it turns out), Pezzillo cleansed her face, wiped it with acetone, then began the dermaplaning, starting at the forehead. A painless procedure, it took about ten minutes.
Afterward, the esthetician dabbed balm around Kim’s eyes, lips and corners of her nose (“any sensitive areas,” Pezzillo said), and donned rubber gloves. Placing a plastic eye shield over Kim’s eyes, she then applied the peel solution with a large cue tip.
A “light tingling feeling”
After two minutes, Kim’s face was wiped down with a peel neutralizer in preparation for Cryogenic Therapy: a C02 ice ball wrapped in gauze and dipped in acetone.
As the ice ball was drawn over Kim’s face, you heard a sizzling sound. The result for the client was a “light tingling feeling,” Kim said.
The final stage included another cleanse, an application of SkinCeuticals (a skincare line Pezzillo uses in all her facials) Epidermal Repair, sunscreen and lip balm.
Kim appeared delighted with the results and said her skin felt soft, smooth and refreshed.
Of the six who work at PVDA, along with Dr. Fein and Pezzillo, one, Erica Rutman, is a physician’s assistant, a med school graduate who sees patients, including those who suspect skin cancer.
Palos Verdes Dermatology Associates — open Monday thru Friday from 9 a.m. to 4:30 p.m. — is a welcoming place, so long as you don’t get lost trying to find it. Call for directions 310-541-7800. Some streets have changed names since the Promenade on the Peninsula was built, and MapQuest has yet to catch up.