Author Bio: Dr. Sanusi Umar MD is the author of this article.
In a world of seemingly endless beauty tips, tricks, and procedures to enhance physical appearance, skincare is a primary concern. Finding the right cosmetic dermatologist for medical advice and treatment can make the difference between dull, sagging skin and a firm, smooth, glowing complexion. This type of specialist differs from a general or medical dermatologist in their area of expertise, certification, and practice; they are focused on the aesthetic goals of their patients, rather than disease prevention or etiology.
The office of any cosmetic dermatologist treats most areas of concern through injectables and fillers, as well as skin laser treatment. In some patients, the desire for aesthetic improvement stems from a pre-existing skin condition that may or may not have been resolved. For instance, people who struggle with moderate or severe acne may find brown spots and pigmentation issues left in the wake of their breakouts. After becoming pimple free through the care of a medical dermatologist, these patients usually seek out the expertise of a cosmetic dermatologist. This specialist can help them attain a smooth and spotless skin through an array of technologies and treatments, such as microdermabrasion or the aforementioned fillers and lasers.
Other areas of concern, unrelated to disorders like acne or rosacea, stem from genetics and aging. A cosmetic dermatologist can subtly manipulate facial-skeletal structure through non-surgical facial contouring and lip augmentation, or dramatically reverse sun damage after years of exposure. However, not all doctors are equal in their knowledge or artistry. A patient may want fuller lips. But some doctors may not have the right expertise to create natural-looking results, causing the lips to appear oversized. Likewise, many people want to reduce wrinkles. But again, a less skilled doctor can make errors in their use of injectable wrinkle treatments like Botox, causing the face to appear immobile or “frozen.”
At Dr.U Skin Clinic, Dr. Umar’s years of experience and dual board certifications enable him to strike a balance that results in natural-looking beauty. Being qualified to practice both medical and cosmetic dermatology, he also commonly treats the underlying conditions that compound a patient’s aesthetic concerns, such as eczema, vitiligo, genetic skin disorders, cysts, moles, and birthmarks.
Whether you’re dealing with acne and acne scars, or simply seeking more youthful skin through a careful injection of Botox, educating yourself on the role of a cosmetic dermatologist is paramount.
What Does a Cosmetic Dermatologist Do?
The job of a cosmetic dermatologist is to treat a number of superficial concerns in order to help patients look their very best with regard to their skin, hair, and nails. The standard treatments, therapies, and solutions provided include:
- Reduce wrinkles and fine lines (crow’s feet, forehead lines, nasolabial folds, etc)
- Diminish brown spots and pigmentation issues (age spots, sun spots, liver spots)
- Firm and lift sagging or hollowed skin
- Under eye bag treatment
- Spider vein removal
- Scar removal
- Acne scarring
- Surgical or other scarring
- Facial contouring
- Non-surgical nose job
- Non-surgical cheek lift
- Non-surgical chin augmentation
- Non-surgical jowl lift
- Lip augmentation
- Laser hair removal
- Tattoo removal
To learn more about these services at Dr.U Skin Clinic, contact us for a free consultation.
Defining a Cosmetic Dermatologist Versus a Medical Dermatologist
If you’re searching for a dermatologist, but unsure which type you need, it is important to understand what each subspecialty does. The major difference between a cosmetic dermatologist and a medical dermatologist is the aim and scope of their practice, as follows:
- Cosmetic Dermatology focuses on correcting or enhancing the skin and hair aesthetic using non- or minimally-invasive medical treatments.
- Medical Dermatology aims to manage or cure diseases of the skin, hair, and nails using non- or minimally-invasive treatments and/or surgical methods.
Methodologies and Treatments Used by a Cosmetic Dermatologist
Cosmetic dermatologists are relied upon by their patients to improve a wide range of aesthetic issues. They use their expertise to devise highly individualized anti-aging treatments, smooth out uneven pigment, remove or diminish scars, and improve facial contours.
Today’s cosmetic dermatologist use a number of safe and minimally invasive tools at their disposal. These typically include:
- Injectables and fillers
- Skin laser treatment
In many cases, patients can benefit from a combination of therapies achieve the most optimal correction or enhancement.
Some, but not all cosmetic dermatology clinics may offer procedures that erode the outer skin layer to a greater or lesser degree. These include
- Chemical peels
- Dermabrasion and microdermabrasion
Such treatments require highly skilled practitioners with advanced experience in these areas to deliver safe and effective treatments.
Botox, Injectables, and Fillers for Youthful Skin and Facial Contouring
Injectables and fillers offer non-permanent options to reduce wrinkles and the appearance of fine lines, smooth out scars, and lift sagging skin. These treatments can also provide structural support beneath the skin for more extreme lifting and shaping, referred to as non-surgical facial contouring.
Perhaps the most famous injectable of all is Botox. Its active ingredient, botulinum toxin, temporarily paralyze specific facial muscles that cause deep creases, lines, and wrinkles. A cosmetic dermatologist will commonly use Botox (or comparative fillers like Dysport or Xeomin) for forehead lines, frown lines and crow’s feet, but the area must be injected with great care to avoid causing drooping eyes or eyebrows.
Fillers that contain a lab-derived variation of hyaluronic acid are able to plump and firm the skin by retaining thousands of water molecules. Fillers such as Juvederm and Restylane are injected in the cheeks and jowls to lift tissue and restore buoyancy to aging skin. They can also be injected into the lips for lip augmentation, and into depressed scars to create an even surface.
Other fillers like Radiesse are comprised of calcium hydroxylapatite, which is a longer-lasting and firmer gel compound that mimics the surrounding tissue area, including bone and collagen. Once the cosmetic dermatologist injects it into the skin, he or she can shape it into a specific form. It then solidifies into an appropriate level of firmness. Radiesse is typically used to enhance the cheeks, lift the jowls, and contour the nose.
A summary of common injectables and fillers and their treatment capabilities for skin is as follows (this list is not comprehensive):
- Botulinum toxin–used to temporarily freeze the facial muscles to reduce wrinkles and inhibit creasing in areas like forehead lines and crow’s feet
- Hyaluronic acid compound–used to firm, plump, lift and fill areas like sagging cheeks and jowls, nasolabial folds, crow’s feet, thin lips, scars, and under-eye bags
- Belotero Soft
- Calcium hydroxylapatite gel suspension–used to provide structural support for facial contouring and lifting; non-surgical jowl lift, non-surgical cheek lift, and non-surgical nose job
Skin Laser Treatment to Reduce Wrinkles and Reverse Sun Damage
A skilled cosmetic dermatologist uses the appropriate skin laser treatment to suit each individual patient. This takes into consideration the patient’s ethnicity, skin color, age, medical history, and cosmetic goals. Lasers have become a front-running therapy to achieve smooth and spotless skin, reduce wrinkles, and reverse sun damage, among many other benefits. They offer great precision in being able to modify skin structures beneath the surface. How they affect the skin and hair depend on the wavelength and type of light applied, its color, and how the light is emitted from the laser.
Ablative lasers are the most aggressive type of laser therapy in the office of a cosmetic dermatologist. These are able to vaporize deep, targeted layers beneath the skin in tiny, microthermal columns to tighten the skin’s surface area, stimulate collagen production and destroy melanin-containing cellular structures. Brown spots and pigmentation issues resolve with the healing process. This technology can also reduce wrinkles deep down and ultimately reveal more youthful skin. The Fraxel Repair and other CO2 and Erbium lasers are the most popular ablative lasers.
Non-ablative fractional lasers apply gentle, yet powerfully concentrated beams of heat to promote elastin and collagen growth, remove unwanted hair, and diminish uneven pigment. These are gentler than the ablative variety and considered safer in terms of unwanted side effects. They can safely reduce wrinkles at a shallower depth and clear up brown spots and pigmentation issues in the surface layers of skin. The Fraxel Dual laser is among the most common non-ablative resurfacing therapies.
Intense pulsed light therapy (IPL), also known as photofacial or photo rejuvenation, is often mistaken for laser treatment. However, it is not the same due to the use of multiple wavelengths, as opposed to a single one. Nonetheless, it offers another way to target pigmentation issues involving the reddened skin. This form of light therapy is typically used to reverse sun damage in particular.
A summary list of common photodynamic (light-based) treatments including lasers for skin and hair is as follows (this list is not comprehensive):
- Ablative fractional lasers–aggressive therapy used to reduce wrinkles, scars, and uneven pigment for smooth and spotless skin long term. Contraindicated in darker skin tones.
- Fraxel Repair
- Non-ablative fractional lasers–gentler therapy used to reduce wrinkles, scars, and uneven pigment at a shallower depth, remove unwanted tattoos, and remove hair. Can be used in darker skin tones.
- Fraxel Dual
- Nd-Yag laser
- Alexandrite laser
- Intense Pulsed Light (IPL/photofacial)–used to reverse sun damage and reduce excessive redness
Why Ablative Skin Laser Treatment is Contraindicated in Dark Complexions
A cosmetic dermatologist will not use ablative laser technology on patients with darker skin tones due to high risk of scarring and hyperpigmentation. People with darker complexions have more active melanocyte cells, which respond unfavorably to the vaporizing of deep tissue. Further scarring, damage, and pigmentation issues are likely to result.
Chemical Peels to Reverse Sun Damage and Achieve Pimple Free, Youthful Skin
Chemical peels are not as commonly used by leading cosmetic dermatologists today, as they are a higher risk treatment than lasers. Chemical peels can be highly abrasive to the skin, causing unwanted irritation and side effects, like burns. Many doctors consider certain laser technology to be a safer option to a chemical peel, since the depth of penetration can be controlled.
However, the intended outcome of a chemical peel can produce similar results to laser resurfacing. Chemical peels remove the top layers of skin to initiate cellular repair. This can reduce wrinkles, reverse sun damage, diminish mild scarring, and promote a pimple-free complexion. Chemical peels are generally safer and yield better results for people with fair skin. But discretion should be used for individuals with darker skin tones.
Dermabrasion and Microdermabrasion for Smoother Skin
While once popular, dermabrasion and microdermabrasion have also become somewhat outdated methods of skin resurfacing. Implementing dermabrasion, a cosmetic dermatologist uses a special device to “sand” the skin, removing surface layers to eventually diminish scarring (particularly acne scars), brown spots and pigmentation concerns. This method can be abrasive and is not recommended in people with darker skin tones due to risk of scarring.
Microdermabrasion is a gentler treatment wherein the practitioner uses a device to “spray” the skin with exfoliating crystals. This method of exfoliation only produces subtle results, and is best utilized across multiple treatments spanning a long period of time. It is safe to use on people with darker skin tones.
Benefits of a Doctor with Combined Practice as a Medical and Cosmetic Dermatologist
For patients with an underlying condition causing superficial malformations like scarring, brown spots, and pigmentation issues, seeing a cosmetic dermatologist alone will not suffice. First, a medical dermatologist will need to assess and treat the illness or skin condition. Once the condition has been resolved, the patient can address any cosmetic repercussions.
In this case, it is advisable to seek out a physician with a dual practice, who can treat the disease itself as well as the aesthetic fallout. By using a comprehensive course of treatment end to end, a dually certified dermatologist would target both the acne and acne scarring, for example. This would also apply to rosacea and any vascular malformations, psoriasis and uneven pigment, and so forth.
As a double certified cosmetic dermatologist, Dr. Umar developed a course of treatment tailored to this patient’s case of rosacea.
Medical and Cosmetic Dermatology at Dr.U Skin Clinic of Los Angeles
Dr. Umar is a double board certified physician in the fields of Internal Medicine and Dermatology. He also completed a fellowship in Cosmetic Surgery during his training. Widely published in both dermatology and medicine, he holds positions as a UCLA associate faculty member, and the Harbor-UCLA residency program’s Director of Cosmetic Dermatology.
Dr. U’s research and developments in cosmetic dermatology have garnered attention from the mainstream media, with featured stories in Elle Magazine, The New York Times, NBC News, Good Morning America, and many others.
In addition to the injectable/filler and laser treatments discussed above, Dr. Umar also performs:
- Split earlobe repair
- Botox for excessive sweating
- Birthmark removal
- Hair restoration surgery
Frequently Asked Questions – Cosmetic Dermatologist Services in Manhattan Beach, Los Angeles
If I have darker skin, how can I find a cosmetic dermatologist who can help me reduce wrinkles, reduce sun damage, and get rid of brown spots and pigmentation using the right skin laser treatment?
Patients with darker skin can make the best decisions about choosing the right cosmetic dermatologist by looking clat beforebefore and after images and video showing past patients they have treated. It may also be helpful to find blog posts and published articles describing their philosophies and rationale for using certain treatments on darker skin tones. Using a combination of therapies, such as non-ablative laser resurfacing and dermal fillers, the desire to reduce wrinkles as well as diminish brown spots and pigmentation problems can be addressed.
As a cosmetic dermatologist who specializes in ethnic skin, Dr. Umar has successfully treated African American patients and individuals of all skin tones using the appropriate type of laser treatment, applying specific settings for individual conditions.
Does a cosmetic dermatologist perform surgery for facial contouring procedures?
No, a cosmetic dermatologist does not perform surgery to achieve facial contouring. Facial contouring in a dermatology office uses non-invasive injectable fillers like Radiesse to temporarily re-shape and contour the desired features. Permanent surgical procedures are performed by a plastic surgeon or facial plastic surgeon.
I want smooth and spotless skin, but I have severe acne. Should I see a medical dermatologist before getting help from a cosmetic dermatologist?
Yes, anyone with active acne needs to have this condition resolved by a medical dermatologist before pursuing treatment for the resultant scarring. Attempting to address the scars and pigmentation issues before the acne itself would be futile since more scar tissue will be created. Once the acne is under control, a cosmetic dermatologist will help you to attain the smooth and spotless skin you desire.
Have more questions about cosmetic dermatologist services? Ask Dr. Umar using the form linked below: