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Cosmetic Dermatology

Acne Scarring

Without early intervention, severe acne can produce lifelong scars.  These scars can improve with treatment and Dr. Miller will work with you toward this goal but realistic expectations are important.

Dr. Miller uses a variety of techniques depending on the type of acne scar (rolling, icepick, boxcar).  Subcision is effective for rolling scars.  Dr. Miller first numbs the skin and then uses a long needle under the skin to loosen adherent
scar tissue.

The CROSS technique uses 80-100% TCA for icepick scarring.  By inducing a controlled injury to the focal scars, collagen production increases to fill the deep scar.

Finally, microneedling uses a motorized pen with tiny needles to smooth the surface of both rolling scars and boxcar scars.Finally, microneedling uses a motorized pen with tiny needles to smooth the surface of both rolling scars and boxcar scars.

Chemical Peels

Chemical peels can be a helpful treatment for anti- aging as well as for acne. The full benefit is achieved after 4- 6 treatments spaced every 3-4 weeks. If you don’t have time for a series of peels, a single chemical peel with salicylic acid can help brighten the appearance of your skin. We use superficial peels which have almost no downtime so that you don’t have to miss work or school.

Salicylic Acid Peels

Fillers (hyaluronic acid)

Fillers typically contain hyaluronic acid which works by absorbing water in your skin and plumping up the tissue.  Belotero is a filler that works well for fine lines around the mouth, tired eyes, and lip enhancement.

Laser Treatment

 

A LASER is a type of concentrated light which can specifically target various components of the skin leading to improvement in the appearance of discoloration, scars and hemangiomas. Dr. Miller uses a pulsed dye laser (PDL) in the treatment of dilated blood vessels (telangiectasia) on the face, scars, hemangiomas, and overall redness on the face caused by rosacea.  

How many treatments are needed?

Usually it takes 3-4 treatments to see a significant improvement.  Each treatment takes about 15 minutes.

Is there any downtime?

You may have mild redness or bruising for a couple of days but nothing that makeup can’t cover.

Is it painful?

There is some mild discomfort but patients generally tolerate this procedure without any difficulty.  No pre or post procedure pain medications are needed.

Is it expensive?

It depends on how large of an area is being treated.  Some people just need their nose treated which is less expensive than the full face.

What kind of training does Dr. Miller have in using this laser?

Laser training is a key component of a dermatology residency and is included in becoming a board certified dermatologist.  Dr. Miller had the unique opportunity to gain additional training under world experts such as Edward “Vic” Ross, MD in San Diego and Jill Waibel, MD in Miami, FL. 

Below are some of Dr. Miller’s patients.

 

 

 

Lentigo/Sun Spots

These are brown, flat spots that develop on the hands and face from years of sun exposure.  There are numerous treatment options including bleaching agents, cryotherapy, and laser therapy. 

Melasma

Melasma is a condition most often in women that presents with darker patches of skin on the face.  It is due to many factors and can be difficult to treat.  Hormones, pregnancy, sun, and heat are all contributory.  Certain bleaching agents can be helpful in minimizing the effects of melasma.  There are also certain sunscreens that are more effective for Melasma than what you may be currently using.  Please contact our office for a consultation.

 

Microneedling

Microneedling is an excellent option for certain acne scars and for tightening saggy skin that develops as we age.  By creating a controlled injury, microneedling stimulates the skin to increase collagen production.  By prepping with a topical numbing cream, it is relatively painless and very well tolerated.  Three to four treatments are recommended for optimal results. 

In addition to being a relatively comfortable procedure for the patient, there is minimal downtime and patients can expect a return to normal activities within 1-2 days. 

Neuromodulators (Xeomin, Botox)

This class of medications includes brands such as Botox or Xeomin which work by partially decreasing the activity of over-expressive muscles on the face.  The result is not a frozen look but rather a softening of the face.  Your friends will think you look refreshed but will not realize you had a procedure done. 

Click to learn more about Neuromodulators. 

Below are some photos of Dr. Miller’s patients: 

 

Skin Tag Removal

This is a quick in-office procedure that is NOT covered by insurance companies.