Pimples

Dear Dr. Jen,

I have multiple scars from acne.  And on top of that, I still get pimples daily.  I am tired of applying so many things on my face.  My doctor told me I have a hormonal imbalance.  When I took the pills, I became very moody and everyone around me complained and so I stopped taking it. Is there any hope for my skin?  I would really prefer not to use any foundation and concealer.

Trina

Dear Trina,

Hormonal imbalance can cause pimples, unwanted hair growth in the face, obesity and even diabetes.  The common culprit for hormonal imbalance among women with pimples is polycystic ovary syndrome.  Treatment can be a challenge for dermatologists to treat because the heart of the matter is really the imbalance between estrogen and progesterone.

While application of medicines may help to some degree, correction of the root of the problem is more important.  Dermatologists can work hand in hand with your gynecologist to find the proper pill or metformin with the least side effects.  There are multiple brands and each will give you different responses.  It’s a matter of finding the right brand for you.

Treatment for acne scars should start alongside the pimple therapy.  There are three kinds of scars you may be dealing with.  The dark scars, the bumpy scars and the depressed, irregular ones.

Dark scars will respond to bleaching agents.  But for bumpy ones, this may need injection to flatten them out.  The depressed scars can be addressed with laser.  Fractional laser can both lighten and improve depressed scars.  This may take several sessions depending how deep your scars are.  Once scars and acne are treated, you will reach the point of not needing any makeup at all.  Best of luck!

Dear Dr. Jen,

I’ve been getting botox once a year for the lines on my forehead and around my eyes.  Lately, I noticed that everything is sagging more and more. Is this due to too much botox?  Is it possible to be dependent on botox?  What other options do I have aside from this that do not include going under the knife?  I am already in my 50s.

Emilia

Dear Emilia,

Botox can be a wonderful tool, when used correctly, to put a pause on aging and even a reverse effect.  While twice a year is the general recommendation for its usage, even minimal use can already provide benefits to wrinkles.  The aim of botox is to provide a youthful version of yourself by smoothing out wrinkles.  The most common wrinkles that bother people are the frown lines between the brows and the crow’s feet seen around the eyes. When botox is used, the facial muscles targeted are forced to relax.  However, mobility should still be present.  Meaning, the eyebrows should still be able to move, the eyes should still be able to squint and such.  Botox can also be used off label for other areas that may need lifting like the jowls or the cheeks.

Radiofrequency is a wonderful tool in tightening the face and neck in a more natural manner.  The effects are quite subtle.  This brings about collagen remodeling giving the patient younger-looking skin. Fractional lasers are also good to encourage new skin in coming out, making splotchy skin tones more even and smooth.

When used in tandem with fillers, the deeper lines along the nasolabial folds and sallow cheeks can be addressed. Caution should be observed from overuse of fillers to avoid the puffy face effect.  The main goal of rejuvenation efforts should be to achieve a relaxed face while enhancing the patient’s features.  Overzealous efforts are too obvious and can come off as looking fake.  Discuss all options with your nearest PDS dermatologist and make sure you have the same goals before attempting anything.

Dr. Tan is a diplomate of Philippine Dermatological Society (PDS) and is affiliated with the Perpetual Succour Hospital (PSH). Information on PDS is at www.pds.org.ph. Questions or concerns regarding the skin may be sent by text to 0932 857 7070 or emailed to [email protected]; or coursed thru The Freeman – (032) 2531276, or thru PSH – (032) 2338620 and 2325929. Inquiries will be forwarded to Dr. Tan.