Basic Skin Care

- For Acne, Pigmentation and Fine Wrinkling -

The best skin care relates to specific goals for specific issues. Skin of different types may develop various problems which we will address below. For those that have asked, skin care products appropriate for the different problems are recommended. Reseller links are included for those so inclined.


Acne is a low grade infection of sorts of the skin. The inflammation and scarring that result can be disfiguring. Keeping it under control can avoid a fair amount of corrective surgery later (heavier TCA chemical and laser peels). At the basis of acne is oily skin with plugging of the skin pores. To prevent it, lotions to clean and exfoliate (removing debris and oil) are ideal. Oral antibiotics are not all that effective except for exacerbation. Avoiding creams and lotions that plug pores can also prevent worsening of the problem.

Minimal control may be achieved with a cleanser alone, but more commonly a cleanser and an exfoliator (fruit acid wash, salicylic acid, lactic acid, glycolic acid) are useful when used together. More extensive acne can be helped via facial peels of higher strength that can be obtained via a doctor's office. Deeper acne "ice pick" scars may require a combination of surgical removal and a series of facial peels of varying strengths. These maneuvers need to be carefully planned taking the patient's skin type into account to minimize risk.

Pigment and Sun Damage

Pigment irregularities and hyperpigmentation (too much pigment often placed unattractively) can affect skin of all pigment types - fair through darker. In the fair-skinned patient, freckling can be made less apparent. Oral birth control can make deeper pigment patches formerly referred to as the "mask of pregnancy." Darker skinned individuals can also have pigment speckling. The unevenness of this pigmentation can make treatment desirable.

In most skin types a sun screen and a bleaching gel can keep pigment under control. Sun exposure can make freckling and darker pigment (sun spots) more appreciable. Sun screens help keep the areas from progressively darkening. Fade gels can help decrease the existing pigment. Some patients may desire the judicious use of exfoliators, such as those used in acne. This also helps decrease superficial pigment making these "spots" less appreciable.

Patients with even more defined pigment problems may seek more involved treatments such as those available in a doctor's office (chemical peels, laser re-surfacing).

Sun damage frequently makes pigment problems worse, but can actually improve acne in small doses. The bigger problem is sun exposure's potential to contribute to the formation of skin cancer. For these reasons, a quality sun screen should be worn regularly. Choosing a foundation with a sun screen is an easy way to integrate their use into your daily routine. For days in which extensive sun exposure is expected, heavier sun screens (SPF 30 +) are reasonable.


Wrinkles and other aging changes can be made worse by sun exposure and cigarette smoking. Sun screens and smoking cessation are a good start here.

There are a few creams that can help make wrinkles less appreciable. Retin A and related medications can be obtained with a prescription. A few other creams can be obtained online. They usually work by improving skin hydration therefore making wrinkles less visible.

Glycolic acid formulations can be useful in combination to make wrinkling less prominent by "peeling" the superficial skin. More extensive "wrinkle reduction" can involve deeper peels and surgery found at the doctor's office.

When Might I See Dr Di Saia

Dr Di Saia is a double board certified Plastic Surgeon who had been personally and professionally involved in skin care since 1996. He performs heavier peels and is in association with a very good aesthetician who takes care of the rest.





© John Di Saia, MD... an Orange County California Plastic Surgeon       Dr John Di Saia, an orange county california plastic surgeon