Beyond the Beauty Aisle

Needles, lasers, and peels, oh, my! They can be pricey and painful, but sometimes they’re the best route to the beautiful skin you crave. Get the insider facts about what doctor’s-office treatments can and can’t do, then decide what’s right for you.

Q: I’ve done everything to get better skin, but I’m still not satisfied. Should I try a high-tech treatment?

A: As SELF’s beauty director, I’m asked this a lot, and I always say, Do you need to try a more serious treatment like needles, lasers and peels to solve your skin issues? No. Should you? That’s a personal decision, but after you exhaust the at-home options, make sure you know what’s involved before you head to the dermatologist. That’s where our guide comes in. You’ll find the latest info on which procedures work best for acne, wrinkles and more, what they cost and the all-important pain factor. Here’s a tip to start you off: To find a good dermatologist, go to AAD.org and type in your zip code. Then read on; we’ve made the rest of the advice about that easy! –Elaine D’Farley

Smooth Wrinkles

Consider these options if you’ve already tried… Vitamin A creams (such as RX retinoids or ones with retinol) and alpha hydroxyl acids, such as glycolic and lactic, which help soften wrinkles by stimulating new collagen growth and, of course, broad-spectrum sunscreen, to fight off the free radicals and sun damage that cause lines in the first place.

For Fine Lines:

“If you begin using Botox or other freezers as soon as you notice subtle expression lines and continue as you age, you can absolutely prevent certain wrinkles from forming,” says Dr. Dennis Gross. There’s also nothing better for treating movement-related lines you already have: “Even in your 30s, you usually end up with 100 percent smoothing,” says Dr. Patricia Wexler M.D., associate clinical professor of dermatology at the Mount Sinai School of Medicine.

What Can I Expect?

You will feel a slight pinch from the needle; injection sites might be red and puffy for a few hours.


Sessions: 1 every 6 to 12 months

Cost: $700-$1,400/session

Downtime: 2 days

Ouch Factor: 3/5


Clear up skin

Consider these options if you’ve already tried… Over-the-counter products containing 5 percent bacteria-killing benzoyl peroxide; 2 percent salicylic acid, a pore declogger that quells inflammation; sulfur, a drying ingredient; and finally, prescription retinol and birth control pills for hormonally related acne, as well as prescription retinoid creams and antibiotics.

For Painful Acne:

To treat the worst cases of acne, dermatologists rely on the Isolaz laser and on photodynamic therapy (PDT), which is similar to IPL. The Isolaz uses a vacuum to lift the skin gently and open pores to suction out oil; your derm will then shine a bacteria-killing light deep into pores. Seventy-five percent of patients end up acne-free after six to eight weekly treatments, Dr. Wexler says.

The other option, PDT, kills bacteria and shrinks oil glands by using a blue light on skin that has been pretreated with a light-sensitizing chemical known as Levulan. “It can out even severe acne into remission for 6 to 12 months,” Dr. Bank says. Your derm will help you decide which is best for your skin.

Will it hurt? Isolaz is relatively painless –you’ll feel a light tugging from the suction – and it may leave your skin extra rosy for a few yours. Like IPL, PDT treatments are also often likened to rubber bands snapping on the skin—annoying but tolerable. You’ll be red and swollen for a few days, then your skin will flake and peel. What’s key: avoiding the sun for at least 36 hours, as Levulan can leave skin more vulnerable to UV rays. Our tip? Do it before a long weekend so you can hole up and heal up.


Sessions: 6 to 8

Cost: $300/session

Downtime: 1 day

Ouch factor: 2/5


Source: Self: Beauty Report. April, 2011.