Dr. Joel Schlessinger discusses the difference between Botox and fillers.

















If you are considering an injection, it’s important to understand the difference between the two most common types, wrinkle relaxers like Botox, and fillers. Botox and fillers are distinctly different, but they are often combined to help patients achieve their best anti-aging results.

Botox helps relax wrinkles, says Dr. Joel Schlessinger.

Botox, a wrinkle relaxer, is a neurotoxin that blocks the action of nerves on muscles. It works by weakening certain muscles and blocking certain nerves so that they relax, softening the appearance of fine lines and wrinkles.

Botox works especially well on expression lines caused by muscle movement like the “eleven” mark that appears between the eyebrows, crow’s feet and forehead wrinkles. Physicians must be cautious about adding Botox to the area around the mouth, as too much causes a stiffened appearance. For that area, fillers are more appropriate.

Dr. Joel Schlessinger uses fillers to add volume to places like cheeks and lips.

Fillers are used to help “fill in” wrinkles, thereby softening their appearance. They help add volume to the skin, giving a plumper, firmer appearance. There are many different types of fillers available, but the majority of them are composed of hyaluronic acid, a naturally occurring substance in the body that holds up to one thousand times its own weight in water.

As previously mentioned, fillers work well to fill in lines around the mouth (nasolabial folds), as well as depressed cheeks and areas around the chin and jaw. Many patients opt to have fillers placed in the lips to achieve a plumper, smoother pout. While Botox typically lasts for about three months, fillers last anywhere from three months to a year.

Dr. Joel Schlessinger recommends a combination of Botox and fillers.

To achieve the best results, a combination of Botox and fillers is recommended. Your physician will be able to sit down with you during your initial consultation, discuss your primary areas of concern and offer a rejuvenation plan that is customized for your needs. Injection procedures require finesse, planning and a skilled cosmetic surgeon. Always seek the care of an experienced, board-certified physician.

Do you have a question for Dr. Schlessinger? Let us know in the comments section.

No Comments | Category: Aging Skin Care, Injections and Fillers

Joel Schlessinger MD and discusses the 2015 American Academy of Dermatology conference

The American Academy of Dermatology (AAD) holds an annual educational conference to discuss the latest developments in skin care and dermatology. Last weekend, Joel Schlessinger MD and his team attended the conference, enjoying lectures, viewing exhibits and meeting with other professionals from across the country.

“The team and I attended AAD for the 25th time in my career as a dermatologist,” he says. “Truly, it is the best way to get a pulse of what is happening.”

The AAD meeting is a chance for Joel Schlessinger MD and other professionals to learn about new skin care products and procedures.

The 2015 AAD conference featured new treatment options that dermatologists will be able to incorporate into their practices. Joel Schlessinger MD looks forward to offering these new treatments for his patients.

“This year, there was a bit of excitement for ATX-101, the new chin fat buster that we did the clinical trials on here in Omaha,” he says. “Additionally, the work on Revance’s topically applied alternative to Botox seems to be back on track.”

Joel Schlessinger MD finds the annual AAD conference beneficial for both himself and his staff.

After attending for many years, Joel Schlessinger MD still appreciates the educational value of the annual AAD meeting.

“As always, it is a great time to get the team up to speed on everything dermatology and learn about the advances that will benefit my patients,” he says. “It is a terrific meeting and one that sets us apart from other clinics and websites due to our attendance and attention we pay to the science behind our products and procedures.”

Do you have a question for Joel Schlessinger MD? Share with us in the comments.

No Comments | Category: Dermatology, Skin Care, Skin Care Innovation

Joel Schlessinger MD recommends daily supplements that keep skin healthy

An easy way to keep yourself healthy and make sure you are getting the proper nutrition is to take a multivitamin daily. If you choose the right formulas, your daily supplements can also help you maintain healthy skin, hair and nails. Here are some of the best skin care supplements, according to Joel Schlessinger MD.

Certain supplements can help protect skin against damage and boost your health, says Joel Schlessinger MD.

Sun damage is one of the major causes of aging and signs of damage on the complexion. To amp up your regular sun protection, Joel Schlessinger MD recommends taking Heliocare Sun Protection Pills. The key ingredient in this supplement is calaguala leaf extract, a potent ingredient with antioxidant properties. It helps improve the body’s tolerance to UV rays and helps skin maintain its immune response to sun damage. While these supplements improve your skin’s protection, they do not replace sunscreen so you should continue to apply a topical sun protection product daily.

As we age, our metabolism slows down, which can result in the appearance of cellulite as well as dull, sluggish skin. Along with a healthy diet and lifestyle, Elemis Body Enhancement Capsules – Cal-Metab Plus can improve microcirculation and boost metabolism. These supplements encourage the body’s natural fat burning process to keep it working properly.

Joel Schlessinger MD recommends supplements for thinning hair and brittle nails.

Healthy hair and nails cannot grow without the proper nutrition. PHYTO Phytophanere Dietary Supplements are made with botanicals that contain vitamins, fatty acids and antioxidants to improve hair and nails. Studies show that 95% of user saw improved results after three months. To encourage more growth, you can take Viviscal Professional Supplements. This formula contains the AminoMar complex, which nourishes thin hair that is prone to breakage to encourage more growth.

Questions for Joel Schlessinger MD about supplements? Ask him below in the comments section.

No Comments | Category: Skin Care

Laser tattoo removal remains the best method, says Dr. Schlessinger.



















It is estimated that around 40% of adults have at least one tattoo, so it is no surprise that a tattoo removal cream would be in high demand. Alec Falkenham, a PhD student in pathology at Dalhousie University in Halifax, Nova Scotia, is currently developing a topical cream that he hopes will eventually remove tattoos. However, Dr. Schlessinger believes it is too early to tell if this cream will be effective.

Bisphosophonate liposomal tattoo removal cream works by expediting the natural tattoo fading process.

When a tattoo is received into the skin, the ink pigments get eaten by macrophages, or white blood cells, to protect the surrounding tissue from the foreign substance. The cells then form the tattoo that is visible on the skin, and as macrophages are replaced over time, the tattoo fades. Falkenham’s cream targets macrophages with bisphosphonate to expedite the natural fading process.

Inspired by the connection between his pathology work and the tattooing process, Falkenham set to work creating the method for what he refers to as bisphosphonate liposomal tattoo removal. This technique allows the bisphosphonate drug to reach into the skin via a topical cream, eliminating the cells that contain tattoo pigment while leaving other skin cells untouched.

“There are many hurdles for this scientist to go through,“ Dr. Schlessinger says.

Dr. Schlessinger finds the idea of bisphosphonate liposomal tattoo removal intriguing, but cautions that those with tattoo regret not get too excited just yet. So far, research is still in its earliest stages, and studies have only been conducted using mice. Among the challenges are getting the bisphosphonate to actually penetrate the skin and testing the cream through what will probably amount to millions of dollars in clinical research.

“There is a lot of interest in this topic, but the future of the project and the cost estimates are unclear,“ says Dr. Schlessinger.

For now, he recommends that those considering a new tattoo carefully weigh that decision, and that those with tattoo regret seek a skilled, experienced dermatologist who can help them achieve their best laser tattoo removal results.

Do you have a question for Dr. Joel Schlessinger about tattoo removal? Let us know in the comments section.

No Comments | Category: Tattoo Removal

Dr. Joel Schlessinger explains how enzymes help your skin

Dermatologists, beauty gurus and makeup artists will all tell you how important exfoliation is to maintain healthy, radiant skin. For some people though, scrubs can be too abrasive for the complexion. To get the same exfoliation, cell renewal and radiance without the need for harsh scrubbing, you can use products with enzymes. Here, Dr. Joel Schlessinger explains the benefits of this ingredient and how to incorporate it into your routine.

What are enzymes? Dr. Joel Schlessinger explains.

On the top layer of our skin are dead skin cells. These cells prevent skin from renewing itself, resulting in a rough texture and dull appearance. Exfoliation is necessary to remove this debris and keep the complexion looking youthful and radiant. Enzymes are ingredients that break down dead cells that sit on top of the complexion.

Enzymes can be found in many natural sources such as papaya, pineapple and pumpkin. Cleansers, treatment products and masks containing enzymes can be added to your regimen to encourage skin renewal, keep pores clear and fade signs of aging without the need for a powerful chemical or physical exfoliant.

Dr. Joel Schlessinger recommends his favorite products with enzymes.

For daily exfoliation using enzymes, cleanse with Revision Skincare Papaya Enzyme Cleanser. This face wash contains papaya fruit extract to gently exfoliate and reveal a brighter complexion. You can also treat your complexion weekly with LovelySkin Pumpkin Clarifying Mask. Pumpkin is a natural source of enzymes and this mask helps keep pores clear so it is ideal for acne-prone skin.

One of the main benefits of enzymes is that they are more easily tolerated by those with sensitive complexions. If regular exfoliators leave your complexion red, inflamed and flaky, use a gentle enzyme treatment such as Phytomer Peeling Vegetal Exfoliant. The formula contains enzymes as well as hydrating ingredients to keep skin healthy.

Ask Dr. Joel Schlessinger any other questions about enzymes in the comments.

No Comments | Category: Skin Care

Dr. Joel Schlessinger discusses the link between skin and psychology

The American Psychological Association recently published an article titled “The link between skin and psychology,” which focuses on the relationship between psychological and dermatological problems. The field of study, called psychodermatology, embraces the idea that common skin conditions are affected by psychological issues. In this blog, Dr. Joel Schlessinger sheds light on this idea and why we shouldn’t always blame skin conditions on stress or other psychological factors.

It’s difficult to prove skin conditions are caused by stress, Dr. Joel Schlessinger explains.

According to the APA, psychodermatology focuses on “skin problems affected by stress or other emotional states, psychological problems caused by disfiguring skin disorders, and psychiatric disorders that manifest themselves via the skin, such as delusional parasitosis.” Psychodermatology is common in Europe but not as commonly noted in the United States.

“I think this is a really easy thing for some doctors to blame skin conditions on stress, but stress is very difficult to prove as a cause as it is nearly impossible to reproduce or quantify,” Dr. Joel Schlessinger says. “Therefore, the onus of improving the disease is placed onto the patient (‘You are causing your disease’), rather than the physician. That doesn’t seem fair to me and would only serve to increase a patient’s stress level.”

Dermatologists should holistically treat skin conditions, says Dr. Joel Schlessinger.

Even if stress does play a role in worsening skin conditions, Dr. Joel Schlessinger says patients shouldn’t have to treat themselves. Instead, he prefers to do what he can as a dermatologist to treat their concerns using more traditional methods in combination with other natural and environmental factors being addressed when necessary.

“Stress is something that is part of everyone’s life and while we all try to be care-free, we can’t be in most cases,” he says. “Therefore, I would rather try to focus on what I can change as a dermatologist and avoid throwing salt on the wound by insisting on a daunting task for my patients in order to treat their condition. This doesn’t mean that we shouldn’t try to be as stressful as possible and work on improving it when we can, along with other natural and holistic treatments, however.”

Do you have a question for Dr. Joel Schlessinger? Let us know in the comments.

No Comments | Category: Dermatology, Research and Studies, Skin Care, Skin Care Myths

Probably the most interesting of all the movies I saw this awards’ season was Boyhood. Not only does it have a compelling premise around the growth and development of the main character over 11 years, but it shows the aging of the other characters over the same period.

My career as a dermatologist puts me in a position to stall the effects of aging in many of my patients who desire services such as Botox, fillers, lasers and more. While we see aging in this movie in the mother and father (Patricia Arquette and Ethan Hawke), do they seem to age normally or are they doing their best to stop the clock?

My thoughts are that Hawke is not doing anything to stall the effects of aging, whereas Arquette is almost certainly undergoing treatments such as fillers and neurotoxins. The changes on Hawke’s face are significant but due to normal activities like frowning. Similar to a piece of paper that is folded hundreds of times will ultimately retain a crease, the human face will also respond to repeated activities over time.

Hawke develops a crease in the middle of his forehead (glabella) over the course of the movie. Presently, he is 44 years old and shows definite signs of aging, perhaps more than his chronological age should show. With some very simple interventions, he could regain his youthful appearance. For example, just a little Botox or Dysport and filler, such as Restylane or Juvederm, could improve the mid-forehead crease. And he also seems to be a little gaunt, which could easily be improved with fillers such as Voluma in the mid-cheek area.

Lastly, EltaMD sunscreen would help with the Hawke’s noticeable sun damage. Being raised in Texas, Hawke most likely experienced quite a bit of sun growing up and this hasn’t helped him. It takes about 20 years for the effects of sun exposure to show up. We are now just seeing the results of sun exposure in his 20′s, so it may be rough over the next few years if he hasn’t ever protected himself. Additionally, if he is a smoker, smoking could complicate matters by contributing to premature aging.

As for Arquette, it seems she has done everything she can to keep her skin healthy. Her complexion is alabaster throughout the majority of the film and that is going to help prolong the excellent appearance of her skin and keep her looking youthful. It does appear that she is probably no stranger to the dermatologist, as she appears to have some fillers in her cheeks and minimal, if any, developing frown lines.

While many actresses let their wrinkles show up when they appear in movies lest they look ‘done’, my guess is that she is being treated with neurotoxins such as Botox, as she has little or no signs of aging. She does have some wrinkles around her eyes, which are also treatable with Botox, but they are very minimal. In short, Arquette is doing the sorts of things that will continue to keep her looking good for many years and as long as she stays out of the sun and doesn’t go overboard with treatments (something which is important and rests not only in her hands, but in the hands of her dermatologist), she will do just fine.

Whether or not the lack or presence of cosmetic surgery among the ‘parental’ cast of Boyhood will influence the award’s season decisions is not something I can say, but the fact that neither headliner in this movie did anything too drastic to their faces during the time of the shoot was helpful in portraying a relatively realistic aging sequence.

No Comments | Category: The Dermies

Dr. Joel Schlessinger discusses body piercings: the good, the bad and the ugly

Piercings are a common accessory for both teens and adults. Earlobe piercings often heal without problems, but body piercings are a different story. These piercings are more risky and can result in infections even if they are done properly. Dr. Joel Schlessinger explains the pitfalls of body piercing.

Piercings in areas with significant bacteria can become infected, explains Dr. Joel Schlessinger.

Infection is a common concern for new and even older piercings. Pierced skin leaves an open wound that is vulnerable to contamination. The upper areas of the ears and the nose, both common spots for piercings, are made up of cartilage. These areas are often harder to clean, take longer to heal and are more likely to become infected at any time after a piercing. Additionally, clothing can trap dirt and other activities can lead to infections. Serious infections often require the piercing to be removed and can even lead to loss of an ear or nasal deformity if severe. Once removed, the piercing may cause scarring.

If you do decide to get a piercing, make sure the person doing the piercing is an experienced professional, Dr. Joel Schlessinger says.

To minimize the risk of infection and other complications, always see a reputable and trained professional for piercings. The challenge with this is that there aren’t any serious regulations on body piercing and you could have one done in a mall or by a person with zero experience or talent. The area should be cleaned with alcohol very carefully before the piercing is done. The person who is doing the piercing should be wearing gloves and professionally trained on equipment and procedures.  Sadly, there is no way to assure this other than by word of mouth.

Try to make sure the environment and equipment have been sterilized. Without sterilization, there is a risk of spreading diseases such as hepatitis B, hepatitis C or HIV. Blood infections, or sepsis, can also occur if the person doesn’t use a sterile technique. If you have doubts about the cleanliness of the environment, leave immediately.

Problems with the type of jewelry can also be an issue, specifically if you have metal allergies. Make sure the jewelry used is hypoallergenic and the item is designed to be used with your specific piercing. Don’t remove the jewelry while the area is healing as this can cause more irritation.

Dr. Joel Schlessinger shares how important it is to care for your skin if you do decide to get a new piercing.

If you do decide to get a piercing (whichever area you choose), proper hygiene is essential to avoid infection and other complications. Gently clean the skin around the piercing twice a day using a cotton ball or pad dipped in rubbing alcohol to disinfect the area and prevent scabbing. If the piercing site becomes very tender or red, it’s important to see a board-certified dermatologist as these could be signs of an infection.

Do you have a question for Dr. Joel Schlessinger? Share with us in the comments.

No Comments | Category: Dermatology, Skin Care


The birthmark, a ‘port-wine stain’, that is seen on Agatha’s (Saoirse Ronan) face in the “Grand Budapest Hotel” affords a huge opportunity for The Dermies to explain a condition that many dermatologists see and treat routinely, although it occurs in less than 1% of the population. I would like to think that this is one of the reasons this movie has been acclaimed during the awards season.

Port-wine stains are usually noted at birth as a flat pink mark on the face. Generally, they follow one of three distributions on the face in a pattern on the upper, middle or lower third of the face and on either the left or right side, but not on both. Over time they can become larger and often develop bumps or larger nodules that occasionally bleed. The port-wine stain in this film is slightly less noticeable than many we tend to see in persons the age of the actress in this film. Ms. Ronan doesn’t have a birthmark in real life, so the producers of the film intended to present it to audiences. The most noticeable person in recent times who brought attention to this mark was Mikhail Gorbachev, the leader of the Soviet Union from 1988 to 1991.

Many different lasers have been used over time in treatment of port-wine stains, pulse dye lasers and intense pulsed light devices most recently, and have generally been successful in diminishing them. Treatments are usually started early in life, with multiple treatments necessary to result in significant improvement. Some affected people have also used makeup, such as Dermablend that can effectively cover up the birthmark.

I was impressed with the portrayal and treatment of Agatha’s birthmark in the movie. Additionally, I was delighted to see that her beauty was a central factor of the movie, notwithstanding her birthmark. While I treat many birthmarks for patients who desire modification, it often strikes me that these are beautiful people whose birthmark accents their beauty, rather than detracting from it. Sadly, childhood isn’t easy for many of my patients with birthmarks or other, more common, conditions such as acne, and treatment does appear to be the rule rather than the exception because of the negative notice engendered by a birthmark.

While I wouldn’t bestow The Dermie for Best Picture on Grand Budapest Hotel, I do feel the movie deserves applause for allowing its heroine to display one of the more common birthmarks and introduce this to film audiences.

No Comments | Category: The Dermies

Dr. Schlessinger discusses pitted acne scars

Acne scarring of any kind can serve as a painful reminder of previous breakouts, and it can distract from otherwise healthy skin. Pitted scars, also known as depressed scars, come in many shapes and sizes. These scars are characterized by narrow, round or boxy depressions in the skin, and they often occur in clusters or patches. Pitted scars form when excessive inflammation occurs, causing a break in the follicle wall. The deeper the inflammation, the more likely there will be tissue loss, and a visible depression left behind on the skin.

Consult with a board-certified dermatologist like Dr. Joel Schlessinger about scar treatment.

Pitted acne scarring will not fade away on its own. In order to successfully minimize its appearance, you will need to consult with an experienced, board-certified dermatologist to help determine the best course of treatment. Though there are no over-the-counter or prescription topical treatments known to effectively reduce the appearance of pitted scarring long-term, there are several professional procedures that can make a significant improvement.

Dr. Joel Schlessinger recommends the Fraxel laser resurfacing treatment to help minimize acne scarring.

CO2 laser resurfacing has long been regarded as the gold standard for effectively treating a variety of skin concerns, including fine lines, hyperpigmentation and scars. More recently, new developments in laser technology have made this option even safer for the treatment of acne scars.

Fraxel is a semi-ablative procedure that is founded on the skin’s natural healing processes. During the procedure, microscopic laser wounds are spaced evenly across the skin to help stimulate renewal and repair. This jumpstarts the production of healthy collagen so that instead of experiencing immediate results, Fraxel allows skin to continue to rejuvenate and improve in tone and texture over a period of about six months. Fraxel laser resurfacing also features a new delivery system that helps the laser’s tiny microbeams penetrate the skin while leaving healthy tissue behind. With healthy tissue intact, the healing process is expedited, and usually only one session is needed to produce visible results.

The best way to avoid pitted acne scars is to treat acne early on, says Dr. Joel Schlessinger.

Even with advanced treatments like Fraxel, the results are not permanent, and there is no way to completely eradicate the appearance of deep pitted scars. The best way to avoid pitted acne scarring is to seek professional treatment for acne early, usually as a pre-teen or teen when the initial mild to moderate breakouts appear.

Do you have a question for Dr. Schlessinger about treating pitted acne scars? Let us know in the comments section.

No Comments | Category: Uncategorized