Ashley B

Subcision for acne scars: The specialized training behind our approach at Schlessinger MD

Ashley B — Wed, 21 Oct 2026 18:03:33 +0000

When a breakout finally clears, it doesn’t always leave clean skin behind. An indent or a stubborn mark can linger, often because the damage sits deeper than any topical product can reach.

At Schlessinger MD, board-certified dermatologists Drs. Joel and Daniel Schlessinger perform a specialized procedure called subcision, which treats indented acne scars at the depth where they form. Dr. Daniel helped to advance this remarkable technique during his fellowship in cosmetic dermatology and has co-authored a textbook chapter on it. Those details matter more than they might seem, because subcision is a nuanced, technically challenging procedure where technique determines the result.

What is subcision?

Subcision is a procedure that frees indented scars from the tissue pulling them downward. Dermatologists have used it since the 1990s, and the method has been refined steadily since then. Releasing the bands that pull scarred skin down lets it lift back to a more even surface, and the healing that follows helps fill in what’s left behind.

“When cystic acne heals with a scar, it is deep in the skin. Like a black hole, the contracted scar tissue sucks everything in around it. Subcision is really the only procedure that is good at releasing this tethered-down scar tissue,” says board-certified dermatologist, Mohs surgeon and cosmetic surgeon Dr. Daniel Schlessinger. “First, we numb the area with injections. After the numbing medication takes effect, we use a special needle, cannula, or a subcision tool called the Taylor Liberator to release the underlying scar tissue from multiple angles. Once the scar tissue has been released, we follow it with a small amount of hyaluronic acid filler to fill the gaps, level out the skin under the scars and prevent the scar tissue from reforming.”

Dermatologists vary in how they approach the procedure. Dr. Daniel trained in subcision under Dr. Murad Alam, a world-renowned expert in subcision who published a pivotal study over 20 years ago describing his experience with subcision. That training shapes how we perform it at Schlessinger MD.

Why surface treatments for acne scars miss the mark

“If you think about what makes an acne scar, it often starts with a cyst that’s deep under the surface of the skin. So the scar is deep underneath the skin too, and it won’t respond to something very surface-level like plain old microneedling or a mild chemical peel. You have to surgically release this deep scar tissue in order to get it to go away,” says Dr. Daniel.

That depth is what separates subcision for acne scars from the treatments most people try first. Rather than working on the skin’s surface and hoping the change reaches far enough down, the needle goes to the tethered tissue directly.

Why technique makes the difference

Subcision looks simple on paper, but in practice, small decisions can change the outcome considerably. Dr. Daniel’s textbook chapter on minimally invasive scar treatment covers several of them. Every scar is meticulously mapped out before numbing the area, since swelling from the numbing can blur the edges and hide the very indentations that subcision is aimed at correcting. One scar may also need to be approached from a few different directions before it fully releases. You won’t notice either of these steps while you’re in the chair, but both affect the result.

One session of subcision is often enough when it’s done thoroughly and when accompanied by other treatments such as hyaluronic acid filler and laser resurfacing following the procedure. Changes will be noticeable right away, although it takes 1-2 weeks for the swelling to resolve and about 4-6 weeks to see the final effects of the procedure.

Releasing the scar tissue opens a space, and a small amount of hyaluronic acid holds that space so the tissue doesn’t re-tether as the area heals. It also helps fill in the gaps to level out the surface imperfections in the skin.

Research supports the pairing: patients who received hyaluronic acid filler after subcision saw much better results than those who had subcision alone.

Depending on the type or degree of scarring that is present, Dr. Schlessinger may recommend resurfacing laser too, using ProFractional erbium or HALO to blend the texture of the skin’s surface.

What subcision treats, and what it doesn’t

Depth isn’t the only variable when it comes to scarring. Subcision works on a range of acne scars, but indented rolling scars tend to respond best. In contrast, ice pick scars run narrow and deep (more like a thin, deep puncture than a dent) and often need a different approach, and other scar types fall outside the procedure’s range entirely.

“While subcision is outstanding for scars that are depressed and ‘pincushioned’ in appearance, there are other scars that are more elevated or scars due to trauma that may respond better to laser, injections with a steroid or even with excision and closure with stitches,” says Dr. Joel Schlessinger, board-certified dermatologist, Mohs surgeon and cosmetic surgeon. “Laser, in particular, is used for scars that occur after a procedure or excision. Additionally, other lasers such as intense pulsed light devices can be used on reddish or traumatic scars.”

That’s why the consultation matters as much as the procedure. A board-certified dermatologist can identify what kind of scar you have and match the treatment to it, or sometimes point you toward options you didn’t know existed. Subcision is also used on certain types of cellulite, for instance. Dr. Joel Schlessinger was involved in the evolution of this treatment and clinical research for other approaches to it, including Endermology and Qwo, two treatments that were some of the earliest effective options for cellulite.

“Cellulite can sometimes be treated with subcision if it’s the type that’s pincushion in nature,” Dr. Joel says. “We’ve used devices, such as Cellfina, which is no longer on the market, to treat cellulite in this manner. Because it didn’t address the cellulite that is more wavy in nature, it didn’t gain favor. Having said this, there are many cellulite areas, especially on the buttocks, that respond nicely to subcision.”

What our dermatologists wish patients knew about acne scarring sooner

Waiting is the most common mistake we see. Untreated acne is more likely to leave scars, and those scars are harder and more expensive to treat than the acne would have been. That’s especially worth knowing for teenagers, where the instinct to let it run its course is strongest and the window to prevent scarring is open.

Treating acne as soon as it appears can lower the risk of scars forming at all, since the deeper breakouts that tend to scar never get the chance to develop.

“If you have acne scarring, go to a board-certified dermatologist who knows how to do subcision,” Dr. Daniel says. “If they don’t know how to perform subcision and aren’t offering it at their practice, they are missing out on the single greatest treatment for acne scars and it is likely they aren’t really giving you the full range of options. I can’t tell you how many patients I’ve seen who have spent tens of thousands of dollars on ineffective treatments for acne scarring prior to finding us and then having wonderful results with a single session of subcision.”

“After struggling with acne scarring for more than 15 years, I can honestly say that seeing Dr. Daniel Schlessinger was one of the best decisions I’ve made for my skin.

Over the years, I’ve spent thousands of dollars on treatments that promised improvement for acne scars, including microdermabrasion, chemical peels, microneedling, RF microneedling, and various laser treatments. While some provided minor improvements, none delivered the kind of noticeable results I was hoping for.

I spent a few weeks researching subcision and trying to locate a provider in Omaha who offered this service. To my surprise, Dr. Daniel Schlessinger was really the only provider in the area offering subcision, so I scheduled a consultation—and I’m so glad I did.

The results have been amazing. This is the first acne scar treatment I’ve ever had where people actually noticed a difference without me pointing it out. Once the healing process was complete, friends and family began commenting on how much smoother my skin looked, which was incredibly validating after years of trying different treatments.

What impressed me most, however, was Dr. Daniel Schlessinger himself. During the procedure, he was extremely thorough and took his time. He explained exactly what he was doing, why he was doing it, and what areas he was targeting. At no point did I feel rushed. It was obvious that he genuinely cared about achieving the best possible outcome and was invested in my results.

Even at my follow-up appointment, he was excited to see my progress and just as enthusiastic about the results as I was. That level of care, attention, and dedication is rare and made a huge impression on me.

If I could go back in time, I honestly would have skipped many of the other treatments I tried and gone straight to subcision. For anyone struggling with acne scarring and considering treatment options, I cannot recommend Dr. Schlessinger highly enough. The results, expertise, and patient care exceeded my expectations.

10/10 experience. I would absolutely trust Dr. Schlessinger again and would recommend him to anyone looking for meaningful improvement in acne scarring.” – Sara T., Google

If indented acne scars have bothered you for years and nothing has moved the needle, a consultation with Dr. Joel or Dr. Daniel through our appointment portal is the right place to start.

Schlessinger DI, Walocko F, Alam M. Minimally invasive procedures in scar management. In: Labadie JG, Alam M, Dover JS, eds. Procedures in Cosmetic Dermatology: Scar Management. 2nd ed. Elsevier; 2025:38-44.

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Inside clinical trials at Schlessinger MD: One of Omaha’s best-kept secrets

Ashley B — Wed, 23 Sep 2026 18:36:43 +0000

Long before a new wrinkle relaxer, eczema medication or hair loss treatment reaches your dermatologist’s office, it spends years being studied and tested in real patients. You may be surprised to learn that much of that testing happens right here in Omaha at Schlessinger MD. The Skin Research Center that Drs. Joel and Daniel Schlessinger have built has grown into one of the most respected dermatology trial sites in the country, and it all started with a simple question: What’s next, and how do we get it to our patients years ahead of everyone else?

“Clinical trials allow us to see the next generation of medications, devices and treatments years before nearly every other dermatologist in the country. They give our patients access to treatments up to five years or more before other clinics in the area. They can even completely alleviate issues where there haven’t been solutions before, or better treatments than available otherwise,” says board-certified dermatologist, Mohs surgeon, and cosmetic surgeon Dr. Joel Schlessinger.

That reward is just as much about the patients on the receiving end for Dr. Daniel Schlessinger, also a board-certified dermatologist, Mohs surgeon, and cosmetic surgeon. “The most exciting part is getting access to medications and treatments years before they ever come to market and being able to offer them to patients who have tried, and failed, everything else that is currently available,” he says.

That head start is the whole idea. Patients at the Schlessinger MD Skin Research Center can access tomorrow’s treatments today, at no cost, often after everything else has come up short.

Why we built a research center

Curiosity got the department started, but results are what kept it growing. Over the years, our team has run trials across nearly the full range of dermatology, and that breadth is genuinely unusual.

On the medical side, we have conducted trials for psoriasis, atopic dermatitis and eczema, alopecia areata, hidradenitis suppurativa, vitiligo and common warts. On the cosmetic side, we have studied wrinkle relaxers like BOTOX®, Dysport®, Jeuveau and DAXXIFY®, as well as a range of fillers including newer options like HArmonyCa™, injectables designed to reduce submental fat like KYBELLA® and devices such as Ultherapy and Liposonix.

Running both medical and cosmetic trials under one roof is rare. Most research centers commit to one lane or the other. That combination sets the program apart, along with a few others worth naming: we are among the most published dermatologists in Nebraska, with several of those publications coming directly from research conducted at Schlessinger MD. Additionally, we are often the highest-enrolling site for the trials we take on, and we were recently voted first place in Best of Omaha as the best clinical research facility.

None of that happens without the people carrying it out. “Our study team is outstanding, not only as measured by our respect and appreciation for them, but also by the companies that come to us and applaud them for their efficiency, devotion to doing things right and the results they obtain,” says Dr. Joel. “Even one minor thing done incorrectly can change everything and lead to a patient who can’t be in the study or who is harmed. This is why they are so special.”

That dedication also helps the program keep growing. “We are constantly looking to expand our reach and offer more cosmetic trials for new injectables, anti-aging and skin care products and energy-based devices,” says Dr. Daniel Schlessinger.

Behind the scenes: How a clinical trial works

Most people picture a clinical trial as a mystery, but it’s a highly organized process. Every study runs on a protocol, a detailed roadmap from the drug company that spells out exactly what happens at each visit, from which labs are drawn to when medication is given. Our team builds custom tracking around it, so every visit follows the same careful, documented steps.

Studies also run in phases. Most of ours are phase two and phase three, the stages that evaluate dosing and determine how well a treatment works compared to a placebo or another medication. We enroll patients as young as two.

Studies are also carefully controlled. Sometimes even our own nurses don’t know which patients are receiving the active treatment and which are receiving a placebo. That structure, called a blinded or partially blinded study, along with close monitoring at every visit, is what keeps the findings trustworthy.

What it costs to participate

Here’s the part patients rarely expect. Our paid clinical trials don’t run through insurance and they cost participants nothing. There’s no bill and no coverage to sort out. Patients are also compensated for each visit they complete.

Studies fill through a mix of channels. Sponsors sometimes fund advertising, and we also enroll through patient referrals, referrals from other dermatologists or community awareness. For clinical trials in the Omaha area, our list of enrolling and upcoming studies is updated regularly.

The stories that stay with us

Compassion and trust guide everything our team does, and the payoff is seeing the changes we get to be part of. For many patients, a trial is a turning point after years of treatments that didn’t work.

Dr. Joel points to early eczema trials as an example of why the work matters. “We saw patients who had children who were literally clawing themselves raw, and parents who were beyond any reasonable level of stress,” he says. “They were fractured, and their lives revolved around keeping their children as comfortable as possible. Our clinical trials offered treatments that allowed these families to sleep. I was so happy to make an impact that affected so many people and changed their lives.”

That kind of outcome is why our team holds itself to such a high standard. Over the years, we’ve watched patients with severe alopecia regrow full heads of hair and patients with widespread psoriasis clear almost completely over the course of a study. With skin, the difference is often something you can see across the room, and it’s a privilege to help make it happen.

If you’re living with a skin condition that traditional treatments haven’t helped, or you’re interested in trying tomorrow’s cosmetic and medical breakthroughs before they reach the market, you may be a candidate for one of our current studies. You can find out what studies we’re currently performing here, or schedule an appointment to see Dr. Joel or Dr. Daniel through our appointment portal.

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GLP-1 hair loss: What your dermatologist wants you to know

Ashley B — Tue, 15 Sep 2026 19:28:46 +0000

GLP-1 users are noticing changes in their hair. Several factors tied to rapid weight loss can play a role, and understanding them is the first step toward getting your hair back on track. Board-certified dermatologists, cosmetic surgeons and Mohs surgeons Drs. Joel and Daniel Schlessinger employ a comprehensive approach to determine what’s going on and how to treat it.

Does Ozempic cause hair loss, or is it every GLP-1?

GLP-1 medications have been around for decades, with the FDA first approving them for use with type 2 diabetes in 2005. However, they have become much more widespread and well-known in the last few years as they were approved for weight loss in non-diabetic patients.

You may know GLP-1s by their brand names like Ozempic, Wegovy, Mounjaro and Zepbound, or their active ingredients tirzepatide or semaglutide. Although hair loss was less commonly reported in diabetic patients, the recent increase in GLP-1 use for weight loss has changed the side effect profile.

“I think there is a tendency to think that starting a GLP-1 medication will improve all aspects of your health, but hair loss (among other things, such as loss of facial volume) is one of those things that affects a surprisingly large number of people a few months into the treatment,” explains Dr. Daniel Schlessinger. “It’s not exactly from the medication but rather from the metabolic stress and nutritional depletion that many GLP-1 users experience.”

How much and how quickly someone loses weight, rather than the specific drug, seems to drive excessive hair shedding. Doses used in diabetic patients tend to produce less dramatic weight loss, so hair loss is often less severe.

“Any kind of shock to the body, ranging from childbirth to a significant illness, traumatic event or COVID infection, can trigger a form of hair loss called telogen effluvium. Significant, rapid weight loss can have the same effect, pushing your hair’s growth cycle from the anagen (active growth) phase to the telogen (resting) phase. This happens about three to six months after the stressor,” says Dr. Joel Schlessinger.

Do I have GLP-1 hair loss or something else?

Hair loss can be especially tricky to diagnose, and sometimes, patients may experience multiple forms at once. While hair shedding related to rapid weight loss is a known side effect, other factors may be contributing, which is why it’s important you see a board-certified dermatologist before assuming.

“If you are having significant hair loss, you probably need to see a board-certified dermatologist. We thoroughly evaluate each patient, examine the scalp and go over a set of questions that guide us to a likely answer. Then, we can consider treatment options tailored to your unique needs and the diagnosis we feel you have based on our examination and assessment,” says Dr. Joel Schlessinger.

Diagnosing any kind of hair loss can involve blood tests and a hair or scalp sample that reveals more about underlying hair health. While GLP-1 medications are a likely cause in many cases, it’s essential to look for other causes to ensure nothing else is at play.

Will my hair grow back after GLP-1 use?

Fortunately, telogen effluvium (the form of hair loss associated with GLP-1 medications) is typically temporary. What you do during this period can support your hair’s long-term health.

“When you’re taking GLP-1s, you need to ensure you are getting adequate nutrition and protein,” says Dr. Daniel Schlessinger. “GLP-1s reduce your appetite, so although it may feel easier to reach for convenient foods, you must prioritize protein, iron, biotin and zinc so your hair follicles (and the rest of your body) get the nutrients they need.”

If you’re experiencing telogen effluvium, your hair will usually regain its full appearance within six to nine months. Since it’s temporary, we won’t necessarily recommend stopping the GLP-1 medication. Instead, we’ll provide treatment options to help ease the recovery period.

How to stop hair loss from Ozempic and other GLP-1s

After a board-certified dermatologist has determined the cause of your hair loss, there are in-office and at-home treatments that can help. For many patients, we take a comprehensive approach.

We often recommend platelet-rich plasma (PRP) treatment for our hair loss patients, which uses growth factors from your own blood to support your existing hair. We may also prescribe treatments like oral minoxidil (the pill version of the topical medication known as Rogaine for men and women), or low-level light therapy devices like the HairMax LaserBand 82 ComfortFlex Hair Growth Device or FOREO FAQ 302 Hair Regrowth Scalp Massager to stimulate hair growth.

If you’re noticing more shedding since starting Ozempic, Wegovy, Mounjaro or Zepbound, don’t wait it out. You can schedule a consultation with Drs. Joel and Daniel Schlessinger through our appointment portal today.

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Can non-invasive and minimally invasive treatments improve acne scars?: Derm-approved treatment

Ashley B — Wed, 25 Jun 2025 20:35:44 +0000

Signs of acne don’t always go away when a breakout clears. Sometimes, you may be left with lingering discoloration or scarring, which can be even more difficult to treat than the breakouts themselves.

Board-certified dermatologists, Mohs surgeons and cosmetic surgeons Drs. Joel and Daniel Schlessinger are well-versed in improving acne and any lingering signs. In this blog, we’ll discuss the ins and outs of acne scarring, including:

Everything you need to know about acne scars
Microneedling for acne scars
Chemical peel for acne scars
Acne scar laser treatment
Other treatments your dermatologist may recommend
The best products for acne scars

Everything you need to know about acne scars

Acne scarring is typically caused by deep, cystic acne. However, untreated breakouts may also cause acne scarring. That’s where the most important kernel about acne scarring comes from—an ounce of prevention is worth a pound of cure.

If you’re experiencing new or worsening breakouts, it’s important you see a dermatologist as soon as possible. “There is no benefit to leaving acne alone or letting it run its course. Acne treatments have gotten better over the years, and there is no reason nowadays to let acne progress to the point of scarring,” Dr. Daniel Schlessinger says.

However, if you have an active acne breakout and acne scarring, the active acne must be treated before the scarring can be addressed. “I like to compare this to trying to clean up from a fire while the fire is still burning; you need to fully put out the fire first before picking up the pieces it left behind. The same goes for acne scarring,” Dr. Daniel Schlessinger says.

There are different types of acne scarring, though their types (icepick, boxcar or rolling) are mostly relevant to dermatologists, as some respond better to certain treatments than others. Acne scars can either be raised (hypertrophic or keloidal) or atrophic (indented or depressed). What treatments you and your dermatologist decide upon may depend on the type of scarring you have.

Microneedling for acne scars

Microneedling is a common procedure for people with textural concerns and is a minimally invasive treatment that superficially punctures the skin with small needles to stimulate the body’s wound-healing response. This treatment can help improve collagen and elastin production in the area.

While microneedling on its own may provide slight improvements, it shows the best results when combined with other treatments. “We do microneedling treatments with the ENDYMED System, which uses radiofrequency to stimulate collagen. Many of the acne scarring cases we see are a result of collagen loss, which is why ENDYMED can help,” Dr. Joel Schlessinger says.

He continues, “AQUAGOLD® Fine Touch™ Microneedling is another option, which combines microneedling with fillers, like Juvederm or Restylane, but it may also contain BOTOX®, which can help remodel scars.”

We recommend visiting a licensed medical aesthetician or board-certified dermatologist for a microneedling treatment in any variety to prevent additional scarring or skin damage.

Chemical peel for acne scars

Chemical peels are another common treatment for those with acne scarring. It uses a chemical substance to stimulate skin regeneration. However, chemical peels come with their own set of risks and can even exacerbate scars if not performed correctly. If you’re considering a chemical peel to help with your acne scarring, it’s important to seek the advice of a board-certified dermatologist and make sure a licensed medical aesthetician administers it.

“Chemical peels are a great option for someone with scarring in its early stages. It can help up to six to twelve months after a scar is formed, but it isn’t as effective for older scarring. I recommend glycolic peels or the afa® Clay Peel, which incorporates bentonite clay and a proprietary ingredient called afaLUXE™. This ingredient works similarly to glycolic acid, but patients tend to experience less irritation and side effects. It is gentle and can help with active acne, some scarring and post-inflammatory hyperpigmentation,” Dr. Joel Schlessinger says.

Acne scar laser treatment

Lasers can be effective for certain kinds of acne scarring. Depending on the type and extent of acne scarring, as well as the patient’s skin type, acne scar laser treatment can be effective. Single or multiple laser types may be used depending on your dermatologist’s guidance.

Exercise the same caution when getting a laser treatment as you would with microneedling or chemical peels. However, laser treatments can potentially exacerbate symptoms if not performed correctly.

“For redness, IPL or BBL can be quite helpful. For textural concerns in skin of color, MOXI® is safe and effective, though it is gentler and will require a series of treatments over time to achieve maximal results. For lighter skin types, HALO, Erbium ProFractional, Erbium TRL and CO2 may all be reasonable treatment options,” Dr. Daniel Schlessinger says.

The type of laser you and your dermatologist decide on depends on your skin tone, your overall concerns and the type of scarring. Each laser works on a different wavelength and with different strengths, which is why it’s important to discuss it with a board-certified dermatologist.

Lasers, microneedling and chemical peels aren’t the only solutions for acne scars.

“Depending on the type and extent of acne scars, subcision or fillers may be great options as well. Subcision involves numbing the area of scarring with lidocaine and using a needle to enter the skin from beside the scar to release the tethering that pulls skin down. It can be quite effective. Sometimes, it is done in conjunction with fillers or laser resurfacing for even better results,” Dr. Daniel Schlessinger says.

“As far as deeper scarring goes, it remains a challenge even with invasive treatments like lasers and peels,” Dr. Joel Schlessinger adds. “Topical sheets of silicone or silicone-based gels such as Stratpharma products can help in the early phases of healing,” he says.

The best products for acne scars

Some acne scars aren’t actual scars but simply pigment left behind by a breakout. “We call that post-inflammatory hyperpigmentation, or PIH for short,” Dr. Joel Schlessinger says.

“PIH can be improved by products that target pigment and improve cell turnover. We recommend LovelySkin LUXE Clarifying Gel Cleanser, along with the LovelySkin LUXE treatment gels, which are made in graduated strengths. The cleanser and treatment gels are made with the same ingredient afaLUXE™ found in the afa® Clay Peel, but are designed to be used daily.

We recommend starting with Acne Care Gel 9% or Exfoliating Gel Mild 11%. Once you’ve finished a full bottle with no side effects, you may graduate to Exfoliating Gel Plus 15% before moving on to Exfoliating Gel Max 19%,” he continues.

Ready for your dermatologist to help you learn how to improve acne scars? You can schedule a consultation at Schlessinger MD using our appointment portal today.

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How Does Accutane Work? Board-Certified Dermatologists Explain What to Expect from Treatment

Ashley B — Mon, 16 Jun 2025 16:44:21 +0000

Sometimes, a good skin care routine isn’t enough to clear up acne. You may need antibiotics or other acne treatments that can only be prescribed by a physician or dermatologist. One of those treatments is known as Accutane, or isotretinoin.

Since acne is a unique condition, and symptoms vary from person to person, you and a board-certified dermatologist should discuss whether Accutane is right for you.

Drs. Joel and Daniel Schlessinger, board-certified dermatologists, Mohs surgeons and cosmetic surgeons, have years of experience evaluating and treating acne for the best patient outcomes. In this blog, we’ll discuss details of Accutane treatment, including:

How does Accutane work?
How long does Accutane take to work?
What is an Accutane purge?
Accutane pros and cons
What’s the difference between tretinoin vs. isotretinoin?
Accutane before and afters

How does Accutane work?

Accutane is a very concentrated form of vitamin A that comes in capsule form. Vitamin A is found naturally in the body and in some foods, but taking this form of it by mouth in a highly concentrated dose is incredibly effective at treating acne. “Accutane works by reducing the sebum that is in your glands, which in turn decreases the ‘food’ for acne and the normal inhabitants of your acne-related glands,” Dr. Joel Schlessinger says.

Some forms of acne can be treated with prescription-strength skin care products and antibiotics, but if your acne isn’t responding to treatments like these, it may be time to consider Accutane. While it can be greatly beneficial, it may not be the best fit for everyone.

“We don’t prescribe Accutane to individuals who are unwilling or unable to guard against pregnancy and are people of childbearing age, as isotretinoin can cause severe birth defects. We are also cautious of prescribing it to individuals with serious concerns for depression or suicide, only using it in coordination with their psychiatrist or mental health professional,” Dr. Joel Schlessinger says.

It’s ideal for moderate to severe acne that has not improved with other treatments. Depending on the case and severity, it can also be beneficial for acne scarring.

How long does Accutane take to work?

As part of your daily routine, patients generally take it once to twice daily. The dosing is dependent on your body weight, and how long you take it depends on your unique concerns and results.

“Usually, we will start to see benefits within the first month or two, but to get the best results, you should stay on it for at least five to six months at a fairly high dose. This will often result in remission (complete improvement) of acne for at least six months to a few years. Often, it will lead to a complete cure if hormones are in play and patients are nearing the end of massive swings in hormones of adolescence,” Dr. Joel Schlessinger says.

Dr. Daniel Schlessinger adds, “Since Vitamin A is a fat-soluble vitamin, it’s important to take it with a fatty meal, so it can be fully absorbed into your body. Although, some versions are better absorbed even without a fatty meal now. Our clinic worked on one, Absorbica, during their clinical trials.” It is also recommended to take it with a full glass of water to avoid irritating the esophagus.

What is an Accutane purge?

When you first start taking isotretinoin, you may experience what’s called an “Accutane purge.” An Accutane purge is a short period that occurs as you start taking isotretinoin, when breakouts may increase.

“We have a special approach to starting Accutane that often totally avoids this purge, leaving people with a smooth transition from acne to no acne. It is rare for other practices to do this, but we find more than 90% of our patients never have a purge,” Dr. Joel Schlessinger says.

“This approach involves treating any bacterial or yeast infections prior to Accutane and a gentler approach to the initial Accutane dosage, among other methods we use,” he continues.

Pros and cons of Accutane

Accutane can be a major help when it comes to persistent acne. “Bar none, it’s the best treatment for acne,” Dr. Daniel Schlessinger says. “But it also has many side effects to monitor for, some of which are serious, such as potential for worsening depression or suicidal thoughts, an increase in inflammatory bowel disease symptoms and the risk for brain swelling that leads to headaches and blurry vision. For this reason, it isn’t the first thing we reach for when we see someone with acne and we usually try to calm down the acne as much as we can with other methods before starting Accutane. In the right patients, though, it is an incredible treatment that avoids or even reverses scarring and serious acne-related skin issues.”

“When administered correctly,” Dr. Joel Schlessinger continues, “Our patients usually see great improvements. There is an art to it, so not every practitioner administers it the same way and achieves the same results.”

Invariably, patients will have dry skin and some joint pains, which can be easily managed and don’t cause too many problems. However, it does require some guidance. Dr. Daniel Schlessinger came up with the idea for FixMySkin 1% Hydrocortisone Healing Balms when he took isotretinoin as a teenager to combat some of those concerns.

“Dealing with the dry, cold winters compounded with the effects of isotretinoin, I was in need of an easy solution,” Dr. Daniel Schlessinger says. “We put all of our Accutane patients on FixMySkin, and they love it. FixMySkin can be used on the face, hands, lips and body, so any areas of irritation can be soothed,” he continues.

Joint pain is also common but can usually be improved with medications like ibuprofen or other non-steroidal anti-inflammatory agents.

One of the most important things to consider with Accutane, though, is the necessity to avoid pregnancy during treatment. “Accutane is teratogenic, which means it can cause severe birth defects to an exposed unborn fetus,” Dr. Joel Schlessinger says.

All patients taking Accutane are required to enroll in the the iPLEDGE Program, which is a federally mandated system to ensure safety around Accutane usage. For patients who are capable of becoming pregnant, the program requires monthly pregnancy tests throughout treatment and the pledge to use two forms of birth control during and before treatment.

“It’s also integral to keep an eye on your mood during Accutane treatment, as depression and even suicidal ideation can be a concern. With appropriate concern and management, most problems with Accutane are easily avoided or treated,” Dr. Joel Schlessinger says.

Lastly, Accutane can interfere with wound healing and increase the risk of scarring for procedures performed during Accutane usage. “We recommend that our Accutane patients avoid elective procedures or trauma to the skin, including wisdom teeth extractions, tattoos, piercings or laser resurfacing during the course of treatment and for several months after finishing the treatment,” says Dr. Daniel Schlessinger.

Accutane is usually an affordable option when purchased with health insurance. Even without insurance, it costs about $150 a month at discount pharmacies.

What’s the difference between tretinoin vs. isotretinoin?

There are many forms of vitamin A, some of which can be taken orally (like Accutane). There are other forms of vitamin A you can apply topically, like tretinoin or differin, which are retinoids. In fact, many dermatologists recommend starting a retinoid after Accutane treatment to extend your results. If you’re wondering about the difference between tretinoin vs. isotretinoin, think of them as an oral treatment vs a topical treatment. Tretinoin, or Retin-A, is a topical form you apply to your skin at night. Isotretinoin, however, is the capsule form you take twice daily known as Accutane.

Accutane before and after

While individual results will vary based on the severity of your acne or scarring, we’re familiar with good Accutane results at Schlessinger MD. We have been treating acne patients for over 25 years and have many Accutane before and after photos to show the range of results.

CASE #302

A 27-year-old female who was treated with Accutane to improve the appearance of acne and overall skin texture.

CASE #2728

A 18-year-old male who was treated with Accutane to improve the appearance of acne and overall skin texture.

We look forward to taking part in your acne journey. Visit our appointment portal to schedule a consultation today.

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BOTOX® alternatives: Which wrinkle relaxer is right for me?

Ashley B — Tue, 10 Jun 2025 18:17:24 +0000

Wrinkle relaxers can improve existing signs of aging and prevent new signs from forming, and while using them is a personal decision in your own skin’s journey, it can sometimes be confusing to determine which one is right for you.

Board-certified dermatologists, Mohs surgeons and cosmetic surgeons Drs. Joel and Daniel Schlessinger have years of experience using wrinkle relaxers and an expert understanding of facial anatomy to ensure you get the best results. From classic BOTOX® to BOTOX® alternatives, they’re an excellent resource when determining which wrinkle relaxer will meet your needs. In this blog, you’ll learn all about:

BOTOX® pros and cons
Dysport® vs. BOTOX®
Jeuveau vs. BOTOX®
Xeomin® vs. BOTOX®
DAXXIFY® vs. BOTOX®
Letybo vs. BOTOX®

BOTOX® pros and cons

While BOTOX® is arguably the best-known wrinkle relaxer, there are also BOTOX® alternatives on the market. As with all wrinkle relaxers, it works by temporarily relaxing the muscles you use to express yourself, which can cause forehead lines, crow’s feet or frown lines.

How long any wrinkle relaxer lasts depends on your body’s metabolism and where and how the injections are placed, but BOTOX® typically lasts up to three months (or perhaps a little longer if you are new to neuromodulators). Results occur within a week, usually beginning a few days after treatment. You’ll experience full results in about seven days.

As with other wrinkle relaxers, there is minimal to no downtime with BOTOX®. The treatments are quick, usually taking about five to ten minutes, and you can generally go about your day afterwards. Though, Drs. Daniel and Joel Schlessinger don’t recommend lying down for the first three hours after treatment and also discourage exercising or facial massage or manipulation after having BOTOX, as it may lead to bruising or inadvertent “spread” of the BOTOX®.

Dysport vs. BOTOX®

Dysport is created with a similar mechanism to BOTOX®, though it shows activity over a wider area around each injection point due to its unique molecular structure. “Dysport is one of the strongest neurotoxins on the market,” Dr. Joel Schlessinger says. Having conducted many of the clinical studies at Schles s inger MD Skin Research Center and written several papers on the topic, Dr. Joel Schlessinger has extensive experience with Dysport, having used it since 2003.

“It takes effect quicker than other toxins,” Dr. Joel Schlessinger says. It also tends to last slightly longer than other wrinkle relaxers, with results lasting up to 100 days.

“It’s my go-to option for people who have very strong movement and is a great option for men. It can also be a good alternative for women whose BOTOX® wears off more quickly,” Dr. Daniel Schlessinger says.

When comparing BOTOX® vs. Dysport, it’s important to note, while both are wrinkle relaxers made of the same botulinum toxin type A, each will provide slightly different benefits. “I recommend you consider trying several neuromodulators to see which one is best for you,” says Dr. Joel Schlessinger.

Jeuveau vs. BOTOX®

Jeuveau was created to help improve moderate to severe frown lines. Dr. Joel Schlessinger has published work on this neurotoxin and also conducted many of the clinical studies at Schlessinger MD Skin Research Center, so he has unique insight into the injectable.

“It’s a great treatment for people in their 20s and 30s or first-time patients who may be apprehensive about trying neurotoxin. Because it has a softer effect than traditional BOTOX®, it’s perfect for patients who’d like to preserve some expressivity, and I sometimes call it ‘training wheels’ for BOTOX®,” Dr. Daniel Schlessinger says.

If you’ve narrowed your choices down to BOTOX® vs. Jeuveau but can’t decide between the two, consult with a board-certified dermatologist to get an expert opinion. They both tend to last about three months, so it’s more about the strength of results you want to achieve than the longevity.

Drs. Joel and Daniel Schlessinger have found Jeuveau tends to have a lighter effect than other wrinkle relaxers. “It gives a natural look to younger individuals or older patients who have heavy lids or foreheads they’d like to be able to move to some degree,” Dr. Joel Schlessinger says. “I love it for people in the public eye who want a little bit of relaxation but not so much that they look ‘done.’”

Xeomin vs. BOTOX®

Xeomin is another neurotoxin similar to BOTOX®, Jeuveau and Dysport but with a different molecular structure. Dr. Joel Schlessinger also performed clinical studies on Xeomin at Schlessinger MD Research Center and has published work on it as well.

Dr. Daniel Schlessinger says, “I like using Xeomin for patients with hooded or heavy upper eyelids and the neck area, as it tends to be less potent than traditional BOTOX®.”

While other neurotoxins have a molecular weight of about 800-900 kilodaltons (kDa), Xeomin is only about 150 kDa. “This structure may possibly be a benefit to someone who is resistant to other forms of neurotoxins. Some people respond to Xeomin who may not respond to other wrinkle relaxers,” Dr. Joel Schlessinger says.

“Because of Xeomin’s unique molecular structure, it can be useful when someone develops BOTOX® resistance,” Dr. Daniel Schlessinger says. “BOTOX® resistance is becoming more common than previously thought. We have patients who have been receiving neuromodulator injections for many years who experience a gradually diminished effect over time. Sometimes, this means we have to inject more units to achieve the same effect, and other times, we may need to switch the type of neuromodulator to one they haven’t tried in the past,” he continues.

Fortunately, there are many new alternatives, so there are options if this occurs. If you’re trying to decide between BOTOX® vs. Xeomin or another wrinkle relaxer, consider Xeomin lasts eighty to 85 days. You’ll also possibly experience faster results, noticing its full effect within three to seven days.

DAXXIFY® vs. BOTOX®

DAXXIFY® is one of the newest neurotoxins on the market. While it does offer wrinkle relaxing benefits, its formulation is slightly different from BOTOX®, containing a peptide which theoretically helps stabilize the active ingredient and improve its ability to target the nerves.

Its unique mechanism of action gives the start of results in as little as two days, with full results visible around two weeks. It also helps it last slightly longer than other wrinkle relaxers, with results lasting anywhere from three to nearly six months in some individuals.

“We performed some of the clinical trials on DAXXIFY® at Schlessinger MD Research Center and are impressed with the longevity to some degree,” Dr. Joel Schlessinger says.

Since this neurotoxin is newer than others on the market, it doesn’t have as much history and data as something like BOTOX®. If you’re trying to decide between BOTOX® vs. DAXXIFY®, consult your board-certified dermatologist.

“There are more side effects with DAXXIFY®, and those side effects can last a little longer if they do happen. BOXOX®, Jeuveau, Dysport and Xeomin tend to be our top choices, though we do still use DAXXIFY®. We expect that over time, DAXXIFY® may be a nice addition to our options,” Dr. Joel Schlessinger says.

Letybo vs. BOTOX®

Letybo is the newest form of neuromodulator on the market and we are proud to say we performed clinical trials on it as well. “From my view,” says Dr. Joel Schlessinger, “Letybo is similar to Xeomin or Jeuveau, though time will tell. Its results and longevity are most similar to Jeuveau thus far, though it’s still being studied.”

“During clinical trials, products can vary in effect based on the patient types that are selected within the trials. Once the products are more widely available, we are able to get a better view and understanding of their place within the full portfolio,” he continues.

Letybo may provide minor results as early as one day after treatment and usually within three days. As with any wrinkle relaxer, individual results may vary, but it tends to last anywhere from three months or a little longer.

Ultimately, the type of wrinkle relaxer you get is dependent on your goals and your facial anatomy, which is why discussing your options with a board-certified dermatologist and cosmetic surgeon is ideal for achieving the best results.

When you’re ready to talk to someone about wrinkle relaxers, Drs. Joel and Daniel Schlessinger look forward to discussing your options with you. They are experts in injectables and personally handle all injectable treatments at Schlessinger MD.

Whether you and either Dr. Joel Schlessinger or Dr. Daniel Schlessinger decide to use BOTOX® or BOTOX® alternatives, the treatment process is simple and relatively painless. We offer numbing prior to the injections at no extra cost so it can be as comfortable as possible, and we price each injectable at similar points to ensure the best results are our main focus.

If you’re new to injectables at Schlessinger MD, you can also take advantage of our new patient special by saving up to $300 off BOTOX® and fillers. Visit our appointment portal to schedule your consultation today.

<ALL BLOGS

Lipoma vs. cyst: When is removal necessary?

Ashley B — Mon, 05 May 2025 16:39:53 +0000

Do lipomas and cysts need to be removed? The board-certified dermatologists at Schlessinger MD are here to discuss what they are and what to expect from your visit. Please keep in mind that this information is not meant to be medical advice. It’s best to see a board-certified dermatologist if you have a concerning area on your skin or body.

In this blog, we’ll discuss:

What a lipoma is
What a cyst is
The difference between a lipoma or cyst
When lipoma or cyst removal surgery is needed

What is a lipoma?

A lipoma is a type of soft tissue tumor made up of fat cells. When they’re new, they are usually soft and painless, though they can become harder over time. While they are considered tumors, they’re almost always benign and otherwise harmless.

Anyone can develop a lipoma, but as they tend to take many years to develop, they’re most common among adults. Among the population, about one in every thousand people develop one, and they can be found anywhere on the body.

While their cause is unknown, genetics or trauma to the area where the lipoma appears likely plays a role. Lipomas also tend to be more common with patients experiencing obesity, high cholesterol or diabetes and occur more frequently in men.

What is a cyst?

Cyst is a broader term referring to capsules or sacs that form inside the body or the skin. There are many different types of cysts, and they can be filled with fluid, air or pus.

Cysts are almost always benign, and most develop when dead skin cells build up under the skin, forming a small cave-like ball surrounded by a lining. Cysts can be found almost anywhere on the body.

A pilar cyst, for example, is a cyst usually found on the scalp. There are many other kinds, such as those that form near the earlobe or in the sebaceous glands of your skin, called sebaceous cysts or epidermal cysts.

Most cysts aren’t dangerous and don’t require treatment unless they become inflamed or infected. While a cyst is different from a tumor, it’s easy to mistake one for the other. If you have an unexplained bump on your skin, it’s integral to see a board-certified dermatologist.

How to know if you have a lipoma or cyst

Knowing the difference between a lipoma or cyst is ultimately up to an expert. At Schlessinger MD, we’re experts in all things skin, and we can help you determine if something is cause for concern. While lipomas and cysts aren’t usually problematic, a dermatologist can help rule out the possibility of something else.

We understand that a lipoma or cyst may be bothersome. If it’s causing pain or discomfort, lipoma removal or cyst removal surgery is possible.

When is a lipoma or cyst removal surgery necessary?

When you visit a board-certified dermatologist for a lipoma or cyst, they will both look at and feel the lump to determine its cause. However, with a lipoma, diagnosis can only be made under a microscope. This requires removing the growth and sending it to a lab for a biopsy or pathologic exam.

“While lipomas are not commonly dangerous, they can sometimes be bothersome or even painful. If they are increasing in size and causing discomfort, removing them is possible,” says board-certified dermatologist, cosmetic surgeon and Mohs surgeon Dr. Daniel Schlessinger.

When it comes to cysts, there are many different treatment avenues. A board-certified dermatologist can usually determine if you have a cyst based on a physical exam. If the cyst appears inflamed or infected, they may drain the cyst and prescribe antibiotics to shrink its size.

“If a cyst is inflamed or infected and needs to be drained, cyst removal surgery may be necessary. This involves numbing the area where the cyst is and opening it via a small hole. Antibiotics are usually needed for several weeks. Once the swelling and infection have gone down, additional surgery will usually be needed to remove the remaining cyst sac,” says Dr. Daniel Schlessinger. “We always send cysts for pathologic confirmation (biopsy) to make sure that it is a cyst and not a concerning growth, and that it has been fully removed.”

The many different treatment avenues, in addition to catching concerning issues early, is why seeing a board-certified dermatologist is important. Whether you have a lipoma, a cyst or something else, an expert can help you determine what it is and if it needs to be removed.

For questions like lipoma removal near me and cyst removal surgery cost, the experts at Schlessinger MD are happy to help. Visit our appointment portal to schedule a consultation today.

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What is KYBELLA®, and how can it help with unwanted chin fat?

Ashley B — Tue, 08 Apr 2025 17:21:38 +0000

If you’ve lost weight and are left with unwanted chin fat, or simply wish for a more contoured jawline, KYBELLA® could be a solution for you. Board-certified dermatologist, Mohs surgeon and cosmetic surgeon Dr. Joel Schlessinger has a longstanding relationship with this treatment, having performed the clinical studies at Schlessinger MD Skin Research Center. Read on to learn:

What is KYBELLA®, and how it can help a double-chin
If there are side effects with KYBELLA® injections
What a KYBELLA® before and after looks like

What is KYBELLA®, and how can it help with a double-chin?

KYBELLA® is an injectable treatment made with a synthetic form of deoxycholic acid, a naturally occurring molecule in the body that helps break down and absorb the fats you eat in your diet. When injected into fatty areas (such as the fat beneath your chin), it helps break down fat cells, so they can no longer accumulate fat, leading to a reduction in fullness under the chin.

“Many treatments can be done to help create a sculpted jawline, and KYBELLA® is often an excellent choice. That being said, not everyone is a candidate, so consultation with an experienced dermatologist is key to assessing whether or not you will respond to treatment,” says Dr. Daniel Schlessinger, board-certified dermatologist, Mohs surgeon and cosmetic surgeon.

Dr. Joel Schlessinger has been working with KYBELLA® for over fifteen years and has a great deal of experience in what it can and can’t do. “There are certain chins that respond well to KYBELLA® and some that won’t, but the key is knowing the difference. The fact that we have three methods of fat removal, including Kybella, CoolSculpting ELITE and SmartLipo, means we are poised to help more patients sculpt their ideal chin and neck areas,” he says.

Will I experience side effects with KYBELLA® injections?

If you are a candidate for KYBELLA®, Drs. Joel or Daniel Schlessinger will create a treatment plan that can include anywhere from two to six treatment sessions. When you receive KYBELLA® injections, they will perform a series of small injections under your chin to the desired area, with results visible after approximately one month, and improvement after each session.

Side effects range from person to person, but you will likely experience some swelling with a KYBELLA® treatment, as well as bruising, pain or numbness. At Schlessinger MD, we will numb the area with a numbing cream prior to injection so treatment is as painless as possible. After determining where to place the treatment, we perform a series of injections. “It is a quick and targeted procedure that only takes about three minutes,” Dr. Daniel Schlessinger says.

What do KYBELLA® before and after images look like?

While treatment outcomes vary from person to person, these KYBELLA® before and after images provide insight into what results can be achieved.

SEE MORE KYBELLA® BEFORE AND AFTER IMAGES

Visit our appointment portal to schedule a KYBELLA® consultation with Drs. Joel and Daniel Schlessinger today.

<ALL BLOGS

What is Sculptra and how is it different from other cosmetic injections?

Ashley B — Mon, 17 Mar 2025 16:39:12 +0000

As we age, collagen naturally declines, leading to signs of aging like wrinkles and loss of firmness. Sculptra is a unique injectable that aims to counteract the effects of collagen loss by stimulating your body to produce its own natural collagen. At Schlessinger MD, Drs. Joel and Daniel Schlessinger are experts in cosmetic procedures like dermal fillers, wrinkle relaxers and skin tightening treatments, Sculptra among them. Read on to learn:

What is Sculptra?
How long does Sculptra last?
Sculptra pros and cons

What is Sculptra?

Is Sculptra a filler? Yes, Sculptra is considered a filler. However, its function is unique from traditional hyaluronic acid fillers, which help smooth and plump skin by providing temporary volume.

While Sculptra does add volume to the skin, it also helps your skin create its own natural volume over an extended period. According to board-certified dermatologist, cosmetic surgeon and Mohs surgeon, Dr. Daniel Schlessinger, “It’s like the difference between giving a man a fish versus teaching him how to fish. With Sculptra, you are actually stimulating the body to produce its own connective tissue.”

He says, “While most fillers are made of hyaluronic acids that add volume to our skin, the poly-L-lactic acid that makes up Sculptra actually stimulates our skin to produce more collagen. It is a thinner filler that can be spread over broader areas (like the entire cheeks, temples or jawline). As a result, it is better for people with thinner faces or who have lost a dramatic amount of volume in their entire face, such as patients taking GLP-1 medications like Ozempic or Mounjaro.”

Sculptra is FDA-approved and has been used across the globe since 1999. It’s naturally absorbed by the body and helps create natural volume and structure in desired treatment areas over time.

How long does Sculptra last, and does it have any side effects?

Sculptra’s unique formulation provides longer-lasting effects than traditional hyaluronic acid fillers. “Most patients notice an improvement within one to two months, with results lasting up to two years or more—though how long Sculptra lasts depends on your body’s metabolism,” says board-certified dermatologist, cosmetic surgeon and Mohs surgeon Dr. Joel Schlessinger.

Sculptra is a great option for people looking to improve loose skin on the cheeks, nasolabial folds (or smile lines), marionette lines (or lines around the mouth) and chin wrinkles.

Like with any filler, there are certain risks associated with treatment. As with hyaluronic acid fillers, there are risks, but they are minimized in experienced hands. Theoretical but rare side effects are nodules, infection, prolonged redness, injection site pain, bruising or migration.

Since Drs. Joel and Daniel Schlessinger personally perform every injectable treatment at Schlessinger MD and have perfected their craft with years of experience, the chance of side effects are low, though still possible.

That’s why talking to your board-certified dermatologist about a treatment plan is essential. They can discuss your goals to determine which dermal fillers would best meet your needs.

Sculptra pros and cons

Sculptra’s pros and cons depend on your overall goals. Your board-certified dermatologist is essential in determining what will work best for you. However, some things to consider before treatment are:

Progressive results: Since Sculptra works by helping your body produce its own collagen, it can take up to several months to show results. If you’re looking for an immediate improvement, you may want to try fillers such as the ones in the JUVÉDERM® or Restylane® family of hyaluronic acid fillers as results are visible right after injection. On the other hand, Sculptra results tend to last longer than traditional fillers if you desire long-term results.
Multiple treatment sessions: To see the best results, you will generally want to receive Sculptra in three or more treatment sessions over a span of one to two months.
Sculptra cost: The cost of Sculptra varies based on your unique treatment needs and where you receive treatment. At Schlessinger MD, you can expect to spend anywhere from $850 to $1500 per treatment session. We will discuss pricing with you before injecting to ensure you are comfortable with the cost of your treatment plan.
Rewards with your purchase: Each Sculptra purchase earns Galderma’s Aspire rewards, which can be used to save on future treatments.
Sculptra isn’t reversible: As a biostimulatory product, its results cannot be reversed. “This means it is important to go to someone who carefully evaluates when and if it is necessary and focuses on doing just the right amount and not ‘overdoing’ it. We are careful in our practice about this, but if weight gain occurs after Sculptra, this could be an issue, as with other permanent and semi-permanent fillers,” Dr. Joel Schlessinger says.

If you’re ready to see if Sculptra is right for you, you can schedule a consultation using our appointment portal

<ALL BLOGS

What is rosacea and how can I treat it?

Ashley B — Wed, 26 Feb 2025 20:03:06 +0000

Rosacea is a group of conditions that are more a description of a ‘red face’ than an actual disease. Despite this array of conditions under one umbrella, it can range from simply being more prone to flushing, skin irritation and redness, to an infection with a skin mite called the Demodex mite. “Rosacea is a term that is thrown around a lot, but isn’t very specific at all,” says Dr. Daniel Schlessinger, board-certified dermatologist, Mohs surgeon and cosmetic surgeon. “But, whatever the cause, it is nearly always frustrating to patients and sometimes debilitating. That’s one reason we love the ability to offer solutions and suggestions for improving it.” We’re here to break down what it is, how to treat it and some of our most recommended at-home products. Keep reading to learn:

What is rosacea?
What can a dermatologist do for rosacea?
What at-home products can I use to help?

What is rosacea?

Rosacea is a condition characterized by redness, flushing, broken blood vessels, inflammation and bumps that may appear like an acne breakout against a background of ‘damaged skin’. It generally starts in the center of the face, gradually spreading to the cheeks, chin, forehead, nose and even eyes. It affects all skin types, though the symptoms can be more difficult to detect in deeper skin tones.

Is rosacea autoimmune?

There is no one single known cause of rosacea, so it is impossible to say if a particular individual’s is based on immune response, but it can play a role directly and indirectly in many cases. If that’s left you wondering if rosacea is an autoimmune disease, we understand. While it is not considered an autoimmune disease, it is an immune response within the body and is more commonly seen in those with autoimmune diseases like celiac or rheumatoid arthritis. However, this may just be due to changes in the skin that leave it open to attack by elements from the outside and within.

Rosacea vs. lupus

Rosacea and the rash of lupus may appear similarly, but they are not the same. Both conditions tend to flare with sun exposure, but they have a different overall appearance and texture. While rosacea flushing and redness tend to appear on the face and upper body, the rash of acute lupus is usually in the malar (central facial) area and can appear anywhere on the face and body. Lupus may also be accompanied by a variety of other symptoms such as joint pains, oral ulcers, and pain with breathing.

Facial redness can be caused by any number of things, from skin allergies or autoimmune diseases to a staph infection and mites on the skin. It’s important to see a board-certified dermatologist who can evaluate and treat the underlying cause of the redness.

What can a dermatologist do for rosacea?

“Sadly, many dermatologists consider rosacea to be an incurable condition, but this isn’t the case if you can identify the cause and treat that cause. Many treatments work alongside the standard therapies, however, and these are ones we focus on in our clinic and at LovelySkin,” says board-certified dermatologist, Mohs surgeon and cosmetic surgeon Dr. Joel Schlessinger.

When you visit the dermatologist, they will examine your skin to determine what is leading to your facial redness and will recommend some lifestyle changes that may help minimize symptoms.

We know rosacea flare-ups occur most often due to sun exposure, sudden changes in temperature, spicy foods, alcohol consumption and irritants in skin care products. To avoid these triggers, your dermatologist will recommend limited sun exposure (and ask you to wear a daily broad-spectrum sunscreen), avoid alcohol, cut back on spicy foods when possible and change your skin care routine. Hopefully, if a cause is identified, these won’t be as obvious in the future.

Then, your dermatologist will recommend products and medications. “Rosacea can be treated with medications like ivermectin and oral antibiotics under the guidance of a board-certified dermatologist. Depending on the type of rosacea, like forms that cause enlargement of the nose, other treatments can be used, such as lasers or other in-office procedures. Often, there are blood vessels left over after treatment that need to be lasered as well,” says Dr. Daniel Schlessinger. The best success is usually seen with a combination of medications, in-office procedures and at-home products.

The best moisturizer for rosacea and other at-home products

When it comes to products for rosacea, the key is looking for ingredients that won’t irritate your skin. Once your dermatologist helps you determine the kind of rosacea you’re experiencing, they may recommend any number of products. These are some we recommend most at Schlessinger MD.

Jan Marini Skin Research RosaLieve Redness Reducing Complex

This treatment combines azelaic acid, botanicals and peptides to alleviate skin redness, soothe inflammation and keep skin soft and calm. Dr. Joel Schlessinger conducted the clinical trials on this product at Schlessinger MD Skin Research Center and can directly speak to the benefits it provides to rosacea-prone skin.

LovelySkin LUXE Exfoliating Gel Mild 11% and Gentle Cream Cleanser

For patients with mild rosacea, Dr. Daniel Schlessinger likes to recommend this duo. The Gentle Cleanser helps remove makeup and impurities while gently exfoliating. The Exfoliating Gel uses a dermatologist-developed ingredient called afaLUXE™ that encourages natural exfoliation and cell turnover to boost collagen production and skin barrier function.

La Roche-Posay Toleriane Hydrating Gentle Cleanser and Toleriane Sensitive Fluide

People whose skin is highly sensitive, which is a large subset of what is diagnosed as rosacea, may need a less irritating option. The Hydrating Cleanser gently washes skin without stripping it, and the Sensitive Fluide helps hydrate and calm to reduce redness without leaving behind a greasy finish.

Oxygenetix Oxygenating Foundation

“While this isn’t a product I personally use, this is a foundation my wife swears by,” says Dr. Joel Schlessinger. “She says it offers long-lasting coverage, looks very natural and doesn’t feel like she’s wearing any makeup. As a dermatologist, I recommend this to my patients who have eczema, psoriasis or rosacea as it helps provide the coverage they want while delivering oxygen to skin to promote healing and healthy collagen growth.”

If you’re ready for expert help with your rosacea treatment, it’s easy to visit our appointment portal and schedule an appointment with Drs. Joel and Daniel Schlessinger.

<ALL BLOGS

Ashley B

Subcision for acne scars: The specialized training behind our approach at Schlessinger MD

What is subcision?

Why surface treatments for acne scars miss the mark

Why technique makes the difference

What subcision treats, and what it doesn’t

What our dermatologists wish patients knew about acne scarring sooner

Inside clinical trials at Schlessinger MD: One of Omaha’s best-kept secrets

Why we built a research center

Behind the scenes: How a clinical trial works

What it costs to participate

The stories that stay with us

GLP-1 hair loss: What your dermatologist wants you to know

Does Ozempic cause hair loss, or is it every GLP-1?

Do I have GLP-1 hair loss or something else?

Will my hair grow back after GLP-1 use?

How to stop hair loss from Ozempic and other GLP-1s

Can non-invasive and minimally invasive treatments improve acne scars?: Derm-approved treatment

Everything you need to know about acne scars

Microneedling for acne scars

Chemical peel for acne scars

Acne scar laser treatment

Other treatments your dermatologist may recommend

The best products for acne scars

How Does Accutane Work? Board-Certified Dermatologists Explain What to Expect from Treatment

How does Accutane work?

How long does Accutane take to work?

What is an Accutane purge?

Pros and cons of Accutane

What’s the difference between tretinoin vs. isotretinoin?

Accutane before and after

CASE #302

CASE #2728

BOTOX® alternatives: Which wrinkle relaxer is right for me?

BOTOX® pros and cons

Dysport vs. BOTOX®

Jeuveau vs. BOTOX®

Xeomin vs. BOTOX®

DAXXIFY® vs. BOTOX®

Letybo vs. BOTOX®

Lipoma vs. cyst: When is removal necessary?

What is a lipoma?

What is a cyst?

How to know if you have a lipoma or cyst

When is a lipoma or cyst removal surgery necessary?

What is KYBELLA®, and how can it help with unwanted chin fat?

What is KYBELLA®, and how can it help with a double-chin?

Will I experience side effects with KYBELLA® injections?

What do KYBELLA® before and after images look like?

What is Sculptra and how is it different from other cosmetic injections?

What is Sculptra?

How long does Sculptra last, and does it have any side effects?

Sculptra pros and cons

What is rosacea and how can I treat it?

What is rosacea?

Is rosacea autoimmune?

Rosacea vs. lupus

What can a dermatologist do for rosacea?

The best moisturizer for rosacea and other at-home products