Ultherapy Prime or Sofwave: Which treatment delivers better lifting results?

Ashlei Johansen — Tue, 17 Feb 2026 21:48:46 +0000

When it comes to non-invasive skin tightening treatments, Ultherapy has long been considered the gold standard since its introduction. Now, with the release of Ultherapy Prime—an enhanced system offering faster, more comfortable, and more precise treatments—this pioneering technology has reached an entirely new level, surpassing newer competitors like Sofwave. If you’re weighing your options for achieving a tighter, more youthful appearance without surgery, understanding what sets these treatments apart can help you make the best choice for your unique skin care needs.

How do these treatments work?

Both Sofwave and Ultherapy Prime harness ultrasound energy to trigger your skin’s natural healing response, but their depth and precision differ significantly.

Ultherapy Prime uses microfocused ultrasound with visualization (MFU-V) to target the deep foundational layer of skin that surgeons address in facelifts—the SMAS layer. This FDA-cleared treatment heats tissue to depths of 1.5mm, 3.0mm and 4.5mm beneath the skin’s surface, creating thermal coagulation points that stimulate new collagen production over time. This multi-depth approach allows for comprehensive treatment from superficial lines to deep structural lifting. The advanced visualization technology allows providers to see beneath the skin’s surface in real-time and precisely target the optimal tissue layers before delivering energy.

“Ultherapy has been the gold standard for non-invasive lifting for years because it reaches depths that other devices simply can’t,” says Dr. Joel Schlessinger, board-certified dermatologist, cosmetic surgeon, and Mohs surgeon. “The visualization technology allows us to see the layers of tissue we’re treating in real-time, which gives us precision that translates to better, more predictable results.”

Sofwave uses Synchronous Ultrasound Parallel Beam SUPERB technology to target only the mid-dermal layer at a depth of 1.5mm. While this FDA-cleared treatment delivers controlled heating with simultaneous surface cooling for comfort, its singular depth of penetration limits its ability to address the deeper structural changes that occur with aging.

What to expect during treatment

Ultherapy Prime treatments typically involve some discomfort as ultrasound energy penetrates the deeper layers where real lifting occurs. The procedure usually takes 60-90 minutes, depending on the treatment areas. While you may experience tingling, heat or prickling sensations during treatment, most patients find the temporary discomfort well worth the dramatic, long-lasting results. For enhanced patient comfort, our office offers Pro-Nox, a self-administered nitrous oxide (laughing gas) system that allows you to control your comfort level throughout the procedure. This safe, fast-acting option helps minimize discomfort without the need for numbing injections or sedation, and it clears out of your system within minutes so you can resume normal activities immediately after treatment.

Sofwave treatments are uncomfortable as well. They have a built-in cooling mechanism and shallower depth of treatment; however, it is not painless and has a limited area of treatable tissue as opposed to the multiple layers treated with Ultherapy Prime.

The results you can expect

Ultherapy Prime results typically become visible over 2-3 months, with continued improvement for up to 6 months as collagen builds and remodels. Because it reaches the deeper SMAS layer—the same foundational tissue addressed in surgical facelifts—Ultherapy Prime can provide noticeable lifting effects, particularly in the brow, under chin, and neck areas. The results can last up to a year or more, with some patients experiencing benefits for 1-2 years.

Sofwave results begin to appear within a few weeks, with optimal results visible at twelve weeks. While the treatment can improve fine lines and overall skin texture with some tightening effects, the lift is generally more subtle and may not adequately address moderate to advanced sagging. Results typically last 6-12 months, requiring more frequent maintenance treatments.

Why Ultherapy Prime stands out

What makes Ultherapy Prime superior comes down to several key advantages. The ability to treat at multiple depths, including the crucial 4.5mm depth, allows Ultherapy Prime to address the true structural cause of sagging. No other ultrasound device can reach this depth.

The advanced imaging in Ultherapy Prime ensures treatment is customized to each patient’s unique anatomy and that energy is deposited exactly where it will be most effective for lifting and tightening. This enhanced imaging provides even greater clarity for treating sensitive areas with maximum precision.

The extensive clinical evidence supporting Ultherapy is unmatched. With over a decade of peer-reviewed studies, long-term safety data and consistent real-world results across diverse patient populations, the Ultherapy platform offers proven, predictable outcomes you can trust. Newer devices simply don’t have this depth of clinical validation.

Finally, with three different depth options, Ultherapy Prime can address everything from fine lines to deep structural sagging in a single treatment session, providing comprehensive rejuvenation without needing multiple different devices or procedures.

Is Ultherapy Prime right for you?

While Sofwave may appeal to those prioritizing convenience, Ultherapy Prime remains the gold standard for patients who want the most dramatic, longest-lasting lifting results without surgery. The technology’s ability to target multiple depths, including the foundational SMAS layer, sets it apart from other non-invasive options on the market.

According to Dr. Joel Schlessinger, “I have personally been treated with both the Ultherapy and Sofwave treatments, and there was no difference in the pain level for each of them. One of the reasons we decided to invest in Ultherapy Prime was the difference in outcomes I saw compared with Sofwave. To me, it all comes down to results.”

“When patients come to us wanting real, non-invasive lift—the kind of improvement that makes people notice they look refreshed and rejuvenated—Ultherapy Prime is what delivers,” adds Dr. Daniel Schlessinger, board-certified dermatologist, cosmetic surgeon, and Mohs surgeon.

If you’re ready to address sagging skin with results backed by extensive clinical research and proven over more than a decade of use, Ultherapy Prime offers the most compelling solution in non-invasive skin tightening.

Ready to experience the lifting power of Ultherapy Prime for yourself? The expert team at Schlessinger MD offers personalized consultations to assess your skin and create a customized treatment plan. Book your Ultherapy Prime consultation with Schlessinger MD today and take the first step toward a more lifted, youthful appearance.

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A guide to aesthetic treatments in your thirties

Ashlei Johansen — Tue, 18 Nov 2025 19:17:30 +0000

Your thirties mark a pivotal decade for skin health. While you’re likely noticing the first signs of aging, you’re also in the perfect position to take proactive steps that will benefit your skin for years to come. Board-certified dermatologists, cosmetic surgeons and Mohs surgeons, Drs. Joel and Daniel Schlessinger, share their expert insights on the most effective aesthetic treatments for maintaining youthful, healthy skin throughout this transformative decade. In this post, we’ll discuss the following treatments:

Understanding your skin in your thirties – The science behind aging and why this decade matters
BOTOX: Your first line of defense – Preventative injections for expression lines
Moxi laser: The gentle giant – Minimal downtime skin rejuvenation
Halo laser: Hybrid technology – Comprehensive skin resurfacing
BBL laser: Photo-rejuvenation – Targeting pigmentation and redness
CoolSculpting: Body contouring – Non-surgical fat reduction
SkinTyte: Skin tightening – Non-invasive collagen stimulation
Creating your treatment plan – Combining treatments for optimal results
FAQ – Common questions answered

Understanding your skin in your thirties

Your thirties are where the rubber hits the road when it comes to your skin. Sun damage takes about 20 years from the time of exposure to show up, so teenage years start manifesting in your early thirties.

The science behind aging skin

During your thirties, your skin also undergoes several fundamental changes. Collagen production begins to decline by approximately 1% per year, resulting in a gradual loss of skin firmness and the development of fine lines. Cell turnover, which occurred every 21-28 days in your twenties, now stretches to 30-45 days, resulting in surface damage and dullness.

If you are a woman, your thirties often coincide with hormonal fluctuations, including pregnancies, postpartum changes, or even early perimenopause. Estrogen levels begin their gradual decline, affecting collagen levels, while potentially triggering melasma or hyperpigmentation. The cumulative effects of sun exposure from previous decades become apparent with sunspots, uneven pigmentation and collagen breakdown.

The window of opportunity

Despite these changes, your thirties are a great time for an intervention. Dr. Joel Schlessinger says, “Your skin can still snap back if you catch it early. This is the ideal time to focus on a preventative strategy that can slow the aging process and maintain skin health for decades to come.”

BOTOX: Your first line of defense against dynamic wrinkles

How long does BOTOX last?

BOTOX injections typically last three to four months, making it one of the most popular preventative treatments for people in their thirties. The treatment works by temporarily relaxing facial muscles that create expression lines around the eyes, forehead and between the brows.

“I love BOTOX for my thirty-something patients because it’s like hitting pause on the aging process,” says Dr. Daniel Schlessinger. “You’re preventing those deeper grooves from forming. Most of my patients are easily able to work it in over a lunch hour or prior to the workday.”

How often should you get BOTOX?

Most patients in their thirties benefit from BOTOX injections every three to four months. For preventative BOTOX, many dermatologists recommend starting with treatments every four to six months to prevent deeper lines while maintaining natural facial expressions. Effects are most noticeable within 24 hours to two weeks after treatment.

“Preventative BOTOX is one of the most rewarding treatments because we’re retraining the muscles to avoid habits that cause fixed wrinkles,” explains Dr. Daniel Schlessinger. “We’re not just treating existing lines—we’re preventing the muscle memory that creates deep creases over time.”

Learn more about BOTOX treatments at Schlessinger MD.

Advanced laser treatments for skin rejuvenation

Moxi laser: the gentle giant

The Moxi laser is an excellent choice for those seeking minimal downtime skin rejuvenation. This non-ablative laser stimulates collagen production and improves skin texture, tone and radiance. Moxi laser leads to significant improvements with minimal recovery time.

Benefits include:

Improved skin texture and tone
Reduced appearance of sun damage
Enhanced collagen production
Minimal downtime compared to aggressive treatments

Halo laser: hybrid technology for maximum results

The HALO laser combines ablative and non-ablative wavelengths for a more aggressive approach, addressing fine lines, sun damage, enlarged pores and uneven texture simultaneously. HALO laser often leads to dramatic improvements in skin quality. Treatment typically requires one to three sessions with three to seven days of social downtime.

“The HALO represents precision and customization,” explains Dr. Daniel Schlessinger. “We can precisely control depth and intensity for each facial area, addressing multiple layers while stimulating natural regenerative processes.”

BBL laser: broad band light for photo-rejuvenation

BBL laser treatment targets pigmentation, redness and aging signs using broad-spectrum light energy. This versatile treatment addresses multiple skin conditions in a single session. BBL laser leads to significant improvements in skin clarity and tone. Most patients see optimal results after three to five treatments spaced four to six weeks apart.

Body contouring with CoolSculpting

Understanding CoolSculpting results

CoolSculpting treatment uses a patented cooling method to eliminate stubborn fat cells that resist diet and exercise. This non-surgical procedure effectively targets areas like the abdomen, flanks and double chin.

“CoolSculpting is the lifehack for busy professionals in their thirties who are doing everything right but still have stubborn areas that won’t budge,” says Dr. Joel Schlessinger. “I’ve had patients catch up on emails during treatment.”

The double chin area responds particularly well to CoolSculpting. CoolSculpting chin before and after photos show dramatic improvements in jawline definition. Most patients see optimal results two to three months after treatment.

SkinTyte: non-surgical skin tightening

SkinTyte treatment uses infrared light energy to heat the dermis and stimulate collagen production. This non-invasive procedure addresses mild to moderate skin laxity without surgery or significant downtime. SkinTyte effectively tightens skin on the face, neck and body.

The treatment triggers the body’s natural healing response and collagen remodeling. Most patients require three to five treatments for optimal results.

“SkinTyte shifted how we approach modest skin laxity,” notes Dr. Daniel Schlessinger. “Rather than waiting until surgery becomes necessary, we can stimulate the body’s own collagen production—preventative medicine at its finest. For those in their thirties, I use this most often for women with lax skin on the abdomen after pregnancy.”

Creating your personalized treatment plan

Addressing common skin conditions

Your treatment plan should address specific concerns common in the thirties:

Fine lines and wrinkles from facial expressions
Sun damage and pigmentation
Loss of skin elasticity
Enlarged pores
Uneven skin texture

Combining treatments for optimal results

Many patients achieve the best outcomes by combining treatments. BOTOX can address dynamic wrinkles while lasers target texture and pigmentation. CoolSculpting complements facial rejuvenation procedures.

“The magic happens when we create a comprehensive plan addressing multiple aging aspects simultaneously,” explains Dr. Daniel Schlessinger. “A patient might receive BOTOX for expression lines, Moxi for skin quality and BBL for pigmentation—each enhancing the others’ effects.”

Treatment expectations and timeline

Understanding realistic timelines helps set appropriate expectations:

BOTOX: Visible within three to seven days, peaks at two weeks
Laser treatments: Noticeable improvements after 1-2 weeks, with continued improvements over three to six months
CoolSculpting: Visible changes at one month, final results at four to five months
SkinTyte: Visible improvements lasting three to six months

Successful treatments require realistic expectations, understanding that maintenance is often necessary, proper post-treatment care, and patience as many treatments work gradually.

Always consult with a board-certified dermatologist to discuss your medical history and create a personalized treatment plan.

“The consultation process is where real expertise becomes apparent,” adds Dr. Joel Schlessinger. “A board-certified dermatologist assesses the overall facial architecture, understanding how treatments interact, and creating an appropriate timeline.”

Maintenance and long-term skin health

Aesthetic treatments work best with a comprehensive skin care routine including:

Daily broad-spectrum sunscreen
Quality moisturizer appropriate for your skin type
Gentle cleansing routine
Professional-grade skin care products
Regular dermatological check-ups

Frequently asked questions

How can one have wrinkle-free skin in their thirties? While completely wrinkle-free skin may not be realistic, combining preventative BOTOX, good skin care, sun protection and periodic laser treatments can significantly minimize signs of aging.

How to get beautiful skin after thirty? Focus on prevention through sun protection, maintain a consistent skin care routine, consider professional treatments like chemical peels or laser therapy, and address specific concerns with targeted procedures.

What is a good skin care regimen for a woman in her thirties? A comprehensive routine should include gentle cleansing, vitamin C serum, moisturizer and broad-spectrum SPF 30+ sunscreen daily, with retinoid products introduced gradually.

What can I do in my thirties to stop fine lines around my eyes? Preventative BOTOX is highly effective for dynamic lines around the eyes. Combine this with quality eye cream, sunglasses, and treatments like radiofrequency or laser therapy for comprehensive care.

Your path to confident, youthful skin

Your thirties are the perfect time to invest in your skin’s future. By combining evidence-based treatments with expert guidance from board-certified dermatologists, you can maintain healthy, youthful-looking skin for decades to come. The key is starting early, being consistent and working with qualified professionals who understand the unique needs of skin in this pivotal decade.

“The patients I see who age most gracefully are the ones who started thinking strategically about their skin in their thirties,” reflects Dr. Joel Schlessinger. “They understood that beautiful skin isn’t about chasing youth—it’s about maintaining health, vitality and confidence throughout every decade of life. When we approach aesthetic medicine as a long-term partnership between doctor and patient, the results speak for themselves.”

Ready to discover what your skin can look like with expert care? Contact Schlessinger MD to book your complimentary consultation.

Take advantage of these limited-time offers. Your future self will thank you!

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Bacne Treatments Tips From Board-Certified Dermatologists

Ashlei Johansen — Fri, 24 Oct 2025 17:30:56 +0000

Back acne, commonly known as “bacne,” affects millions of people and can be just as frustrating as facial breakouts. While it may seem stubborn and challenging to treat, board-certified dermatologists Dr. Joel Schlessinger and Dr. Daniel Schlessinger at Schlessinger MD have developed proven strategies to help achieve clearer, healthier skin on your back. With the right approach and consistency, back and shoulder acne is absolutely treatable.

Why back acne develops
Understanding different types of back acne
Recommended treatment approach
Addressing back acne scars
Final thoughts

Why back acne develops

The skin on your back is uniquely problematic when it comes to acne. It’s thicker than facial skin and contains numerous large sebaceous glands that produce sebum, a type of oil.

“Several factors contribute to back acne development,” explains Dr. Joel Schlessinger. “Hormonal fluctuations, including testosterone or creatine supplementation, affect sebaceous gland activity, while genetics determine your skin’s predisposition to acne. Environmental factors like excessive sweating and friction from clothing or sports equipment create the perfect conditions for breakouts to develop. Lastly, infections can arise when working out or touching mats or other equipment during yoga or floor-based exercises.”

Understanding different types of back acne

Not all back acne is the same, and this distinction is crucial for determining the proper treatment approach. Dr. Daniel Schlessinger notes: “In practice, I see patients with various forms of back acne, each requiring a tailored approach. Comedonal acne presents as those familiar blackheads and whiteheads, while inflammatory acne includes the red, tender papules and pustules that patients find most bothersome. The more severe cases develop nodular or cystic acne, which penetrates much deeper into the skin and often leads to permanent scarring if left untreated.”

The cases that concern dermatologists most are nodular and cystic acne lesions. These penetrate deep into the skin and almost always lead to permanent scarring if left untreated. Early intervention is crucial for these deeper lesions.

Sometimes, what patients think is acne is actually something entirely different. Dr. Joel Schlessinger notes that he has diagnosed everything from bacterial infections to hidradenitis suppurativa in patients who came in thinking they had severe back acne. This is why professional evaluation is so important when over-the-counter treatments aren’t working.

Recommended treatment approach

Starting with over-the-counter solutions

For mild to moderate back acne, dermatologists recommend starting with proven over-the-counter ingredients. Salicylic acid is excellent for unclogging pores and reducing inflammation, making it a top recommendation for comedonal acne.

“I always tell patients to start with a body wash from CLn, which contains Sodium Hypochlorite, a diluted component in bleach,” advises Dr. Daniel Schlessinger. “The key is proper application technique. Apply the cleanser to affected areas and let it sit for 3-5 minutes to allow the active ingredients to penetrate. Then, rinse thoroughly. Consistency is crucial for achieving results.”

Glycolic acid and lactic acid can also help exfoliate dead skin cells and prevent future breakouts. However, dermatologists caution patients about over-exfoliation, which can actually worsen acne by causing irritation.

When to consider professional treatment

Clinical experience has shown that timing is everything with back acne treatment. Dr. Daniel Schlessinger has a clear guideline for his patients: “My general rule is this: If you’ve been consistent with an over-the-counter routine for several weeks without seeing any improvement, it’s time to come in. What looks like acne could actually be a bacterial infection, such as Staph or pseudomonas folliculitis, which requires different treatment. It could also be yeast (pityrosporum) folliculitis, which also requires an oral treatment.”

Back Acne Treated at Schlessinger MD

Even for moderate to severe cases of acne, dermatologists often prescribe topical retinoids, which work by accelerating cellular turnover and preventing the formation of microcomedones, which are the precursors to all acne lesions. Oral medications like antibiotics or isotretinoin (Accutane) may be necessary for stubborn cases.

Addressing back acne scars

“When it comes to scaring, the importance of early intervention can’t be dismissed,” says Dr. Joel Schlessinger. “Once scars have formed, we can address them with certain treatment options, but completely getting rid of bacne scars completely is very difficult, if not impossible. Prevention is always preferable, which is why an early visit to your dermatologist is so important. Dermatologists have access to tools such as Accutane, a powerful derivative of vitamin A, that has been clinically proven to reduce or even put acne into remission. I frequently use it on my most challenging back acne patients. Lastly, I often see patients who have been misdiagnosed as having back acne, but instead have a condition called hidradenitis suppurativa, which is treatable with a variety of newer medications that are not commonly used for acne.”

For existing scars, several professional treatments are available. Professional treatments also include chemical peels and Diamond Glow microdermabrasion. These treatments utilize higher concentrations of active ingredients than what’s available over-the-counter and can penetrate deeper into the skin.

Due to the extended area of the back, these treatments can be expensive, so dermatologists always discuss realistic expectations and treatment timelines with patients.

The path forward

Successfully treating back acne requires patience, consistency and often a combination of approaches. Whether you’re dealing with occasional breakouts or persistent cystic acne, effective treatments exist for every severity level.

Most treatments require at least six to twelve weeks to show significant improvement. Dermatologists always remind patients that skin care is a marathon, not a sprint. Stay committed to your treatment plan, make necessary lifestyle adjustments, and celebrate small improvements along the way.

If your back acne is affecting your confidence or quality of life, don’t hesitate to seek professional help.

Ready to discover what your skin can look like with expert care? Contact Schlessinger MD to book a dermatology appointment today.

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What is microneedling? Results and recovery explained

Ashlei Johansen — Mon, 06 Oct 2025 16:44:41 +0000

Microneedling represents one of the most scientifically validated minimally invasive treatments for comprehensive skin rejuvenation. At Schlessinger MD in Omaha, Nebraska, board-certified dermatologists, cosmetic surgeons and Mohs surgeons, Drs. Joel and Daniel Schlessinger utilize this proven procedure to address multiple dermatological concerns through controlled collagen induction therapy. Here’s what you need to know:

What is microneedling good for?
EndyMed Intensif RF microneedling: Advanced technology for enhanced results
Recovery timeline and results
Essential microneedling aftercare
Professional vs. at-home microneedling
Combining microneedling with other treatments
Your path to healthier skin

What is microneedling good for?

Microneedling, clinically known as percutaneous collagen induction therapy, utilizes fine medical-grade needles to create controlled microchannels in the dermal layer of the skin. This precise prick of the skin triggers the body’s wound healing cascade, stimulating fibroblast activity and collagen synthesis.

“The beauty of microneedling is that it is an accessible and cost-effective approach to rejuvenation. While it isn’t the most dramatic of our procedures, it addresses a variety of concerns in a simple manner with little downtime,” explains Dr. Joel Schlessinger. “By creating these controlled micro-injuries, we’re essentially telling the skin to rebuild fresh, healthy collagen.”

The procedure addresses acne scarring, rhytides (wrinkles), striae distensae (stretch marks), traumatic scars and textural irregularities. The micro-channels also enhance transdermal delivery of topical therapeutic agents, increasing their penetration up to twenty times. When combined with platelet-rich plasma (PRP) or specialized growth factor serums, microneedling become even more effective at accelerating cellular regeneration.

EndyMed Intensif RF microneedling: Advanced technology for enhanced results

EndyMed Intensif RF microneedling combines traditional microneedling with controlled radiofrequency energy delivery, adding yet one other modality to the treatment regimen. This advanced modality delivers energy through the microneedles directly into the dermis, creating thermal zones that enhance collagen remodeling and dermal tightening.

“EndyMed Intensif allows us to treat at multiple tissue depths simultaneously,” Dr. Joel Schlessinger explains. “The mechanical needling addresses the upper and mid-dermis, while the radiofrequency energy creates heating and collagen stimulation of deeper tissue layers.”

The EndyMed Intensif system is effective at treating moderate skin laxity, wrinkles and acne scarring. It offers precise depth control and consistent energy delivery for optimal, predictable results at Schlessinger MD.

How long does it take to see results from microneedling?

Collagen synthesis and dermal remodeling occur gradually:

Initial improvements: One to two weeks post-treatment as inflammation resolves

Noticeable changes: Four to six weeks as Type I and Type III collagen production accelerates. Visible improvement in skin texture becomes apparent as new collagen begins to mature. Fine lines diminish, pore size appears reduced and overall skin tone improves.

Most patients notice a glowing effect as cellular turnover increases. Patients notice a visible improvement in skin texture, with fine lines diminishing, pore size appearing reduced, and overall skin tone improving.

Full clinical results: Three to six months as collagen continues to mature

Continued improvement: Up to twelve months as dermal remodeling continues

Dr. Daniel Schlessinger notes, “Patients may want immediate results, but microneedling works differently than treatments like fillers that deliver instant gratification. We’re stimulating your own skin to produce new collagen, and that’s a biological process that takes time.”

Essential microneedling aftercare

First 24 hours:

Avoid touching treated skin
Do not apply makeup
Cleanse gently with a mild, pH-balanced cleanser
Apply only physician-recommended post-procedure serums such as Alastin Nectar

Days two through seven:

Apply broad-spectrum SPF 30+ sunscreen (mineral-based preferred)
Avoid active ingredients including retinoids, alpha hydroxy acids and vitamin C along with the Alastin Nectar
Maintain adequate hydration
Avoid perspiration-inducing activities and direct sun exposure

Long-term maintenance:

Continue diligent sun protection
Resume regular skin care routine after one week
Follow recommended maintenance treatment schedule

“The aftercare period is not the time to experiment with aggressive skin care products,” Dr. Joel Schlessinger emphasizes. “Your skin’s barrier function is temporarily compromised, and it needs gentle, supportive care to heal optimally.”

Professional vs. at-home microneedling

While consumer-grade dermarollers are readily available, professional treatments offer substantially superior outcomes and much less likelihood of infections. At Schlessinger MD, we use sterile, medical-grade equipment with precise depth control under controlled, aseptic conditions that minimize infection risk.

“Having seen numerous cases of raging bacterial infection following at-home microneedling, I cannot recommend strongly enough that patients avoid at-home microneedling devices,” states Dr. Joel Schlessinger. “There is also the risk of causing scarring from improper technique, post-inflammatory hyperpigmentation or, at best, simply ineffective results. You should see a board-certified dermatologist if you are considering microneedling.”

Combining microneedling with other treatments

Microneedling can be strategically integrated with aesthetic procedures, including laser treatments, neurotoxins, fillers, biostimulators, platelet rich plasma (PRP), and prescription topical treatments.

Dr. Daniel Schlessinger frequently recommends combination approaches. “Many patients benefit from a multi-modal approach that addresses various aspects of skin aging simultaneously. For example, combining microneedling with BBL (BroadBand Light) therapy allows us to address both textural concerns and pigmentation irregularities in a coordinated treatment plan.”

Your path to healthier skin

Microneedling offers a scientifically validated approach to skin rejuvenation, characterized by minimal downtime and an excellent safety profile when performed by qualified medical professionals. At Schlessinger MD, our approach combines clinical expertise, state-of-the-art technology and individualized treatment planning to optimize outcomes.

“We’ve treated thousands of patients with microneedling over the years, and it remains one of our go-to procedures because it works with the body’s natural healing processes,” reflects Dr. Joel Schlessinger. “When performed correctly by experienced practitioners, microneedling offers significant improvements with minimal risk, and the results continue to improve for months after treatment.”

Ready to discover what professional microneedling can do for your skin? Contact Schlessinger MD to schedule your complimentary consultation with Drs. Joel or Daniel Schlessinger.

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What is baby BOTOX? Understanding preventive BOTOX treatments for natural results

Ashlei Johansen — Tue, 12 Aug 2025 16:55:42 +0000

Imagine being able to stop wrinkles before they start, rather than trying to erase them years later. That’s precisely what baby BOTOX aims to do, and it’s reshaping how we think about aging gracefully. This approach to injectable treatments is becoming more common, with savvy patients in their twenties and thirties choosing prevention over correction.

Gone are the days of waiting until deep lines appear before taking action. Today, patients are getting ahead of the aging process with subtle, natural-looking treatments that work behind the scenes to preserve their youthful appearance for decades to come.

At a Glance

Understanding baby BOTOX and microtox
The science behind preventative BOTOX
Baby BOTOX before and after: What to expect
Who is a good candidate for baby BOTOX?
Treatment considerations and maintenance
Choosing preventive BOTOX

Understanding baby BOTOX and microtox

What is baby BOTOX? The term refers to using smaller amounts of botulinum toxin in targeted areas to create subtle, natural-looking results rather than the more dramatic effect of traditional BOTOX treatments. This technique, sometimes called microtox or microdroplet BOTOX, involves injecting tiny amounts of the neuromodulator into specific facial muscles to prevent the formation of wrinkles while maintaining natural facial expressions.

“The goal with baby BOTOX isn’t to eliminate all movement. Instead, we’re looking to decrease stimuli just enough to prevent repetitive motions that end up leading to permanent lines at rest,” explains Dr. Joel Schlessinger, board-certified dermatologist and cosmetic surgeon.

Unlike traditional BOTOX treatments like you might get in your 40s or 50s, baby BOTOX typically uses fewer units or gentler BOTOX alternatives like Jeuveau, distributed strategically to maintain natural movement while preventing excessive muscle contractions that lead to wrinkle formation.

The science behind preventive BOTOX

Preventative BOTOX works to stop repetitive muscle movements before they create permanent creases in the skin, maintaining a smoother appearance for years to come. When we make facial expressions, our muscles contract, causing the overlying skin to fold. Over time, these repeated folding motions create permanent lines, even when our faces are at rest.

“Think of it like repeatedly folding a piece of paper in the same spot. Eventually, that crease becomes permanent. Preventative BOTOX prevents the folding before it ever happens so the permanent crease takes much longer to develop,” explains Dr. Daniel Schlessinger, board-certified dermatologist and cosmetic surgeon.

This approach is particularly effective in areas like the forehead, between the brows, and around the eyes (the so-called “crow’s feet”), where wrinkles typically first appear. By starting treatments in the mid-to-late twenties or early thirties, patients can significantly delay the onset of static wrinkles that remain visible even when the face is relaxed.

Baby BOTOX before and after: What to expect

Baby BOTOX before and after results are notably more subtle than traditional BOTOX outcomes, which is precisely the goal. Patients typically see a softening of expression lines rather than their complete elimination. The forehead retains natural movement and expression, but the deep furrows that can develop from repeated muscle contractions are minimized.

Results usually become apparent within three to seven days after treatment, with full effects visible at two weeks. The subtlety of baby BOTOX means that many people won’t notice you’ve had anything done, but they may comment that you look refreshed or well-rested.

“The best baby BOTOX results look completely natural. Friends and family might notice you look great, but they shouldn’t be able to pinpoint exactly what’s different,” Dr. Joel Schlessinger observes. “The most impressive result, however, comes years later, when your face is far smoother and more youthful than if you had waited all that time to start.”

Baby BOTOX treatments typically last three to four months, similar to traditional BOTOX. However, because the goal is prevention rather than correction, patients often find that their baseline appearance improves over time as the formation of new wrinkles is slowed or prevented.

Who is a good candidate for baby BOTOX?

The ideal candidate for preventative BOTOX is typically someone in their mid-twenties to early thirties who is beginning to notice wrinkles that appear with facial expressions but haven’t yet developed into static lines. These patients often have a family history of early aging or work in environments that promote frequent squinting or frowning.

“This treatment is most effective for patients who want to get ahead of the aging process rather than play catch-up with it,” Dr. Daniel Schlessinger explains.

Patients with very active facial expressions, those who spend significant time outdoors or individuals with strong facial muscles tend to benefit most from this preventive approach. The treatment is also ideal for patients who want to try BOTOX for the first time but are concerned about looking overdone or unnatural.

Treatment considerations and maintenance

BOTOX in any form requires a skilled injector who understands facial anatomy and can achieve the delicate balance between prevention and natural movement in an artistic manner. The technique involves the precise placement of small amounts of product, while baby BOTOX often uses more injection points than traditional BOTOX to ensure even distribution and natural-looking results.

The investment in preventative BOTOX is often more cost-effective in the long run than waiting to treat established wrinkles, which may require more product and additional treatments like fillers or resurfacing procedures.

“Starting with preventative treatments while the skin still has good elasticity and before deep wrinkles form gives us the best long-term results. It’s much easier to prevent lines than to erase them once they’re established,” Dr. Joel Schlessinger notes.

Choosing preventive BOTOX

The decision to begin baby BOTOX should be made in consultation with a board-certified dermatologist who can assess your unique facial anatomy, aging patterns and aesthetic goals.

During your consultation, your dermatologist will evaluate your facial expressions and help you understand whether preventative treatments align with your long-term skin care goals. This personalized approach ensures that any treatment plan serves your individual needs rather than following a one-size-fits-all approach.

Ready to learn more about whether baby BOTOX or other preventative treatments might be right for you? Schedule a consultation to discuss your skin care goals and explore personalized treatment options that can help you maintain a natural, youthful appearance for years to come.

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Can You Be Allergic to the Sun? Understanding PMLE and Sun Sensitivity

Ashlei Johansen — Tue, 29 Jul 2025 14:30:07 +0000

Summer days spent outdoors can be enjoyable for most people, but for those with sun allergies, exposure to the sun can trigger uncomfortable skin reactions. Can you be allergic to the sun, and how is it different than just a ‘sunburn’ or ‘heat rash’? The answer is yes—a sun allergy is a real medical condition that affects millions of people worldwide and there are definite differences between sun sensitivity and allergy.

Board-certified dermatologists, cosmetic surgeons, and Mohs surgeons, Drs. Joel and Daniel Schlessinger of Schlessinger MD have extensive experience diagnosing and treating various types of sun allergies, with polymorphic light eruption (PMLE) being the most common condition they encounter in their practice.

Understanding Sun Allergies and PMLE

A sun allergy occurs when your immune system reacts abnormally to UV radiation. Unlike most people, who may typically tan or burn with sun exposure, people with sun allergies may experience allergic reactions even with minimal sun exposure.

“Sun allergies are often misunderstood by patients. Many people think they just have sensitive skin, unexplained itching or hives from some other cause, but these are actual immune system responses to UV light that require proper diagnosis and treatment,” Dr. Joel Schlessinger explains.

Polymorphic light eruption (PMLE) is by far the most common type of sun allergy, affecting approximately 10-20% of the population. This condition typically develops in spring or early summer when people first increase their exposure to sunlight after the winter months. The term “polymorphic” refers to the various forms this condition can take, from minor bumps to larger blisters on sun-exposed areas.

“PMLE is particularly frustrating for patients because it often occurs when they’re trying to enjoy nice weather after a long winter. The good news is that, with proper prevention and treatment, many patients can build tolerance over time, but it is still a good idea to avoid the sun if at all possible,” Dr. Daniel Schlessinger says.

Sun allergy symptoms typically include red, itchy bumps that appear a few hours after sun exposure, small bumps or blisters on sun-exposed areas, and burning or stinging sensations. What distinguishes PMLE from regular sunburn is that these reactions occur with much less sun exposure than would cause a typical burn, and they often follow a distinct pattern, usually happening mostly in the spring and early summer as sun exposure is gradually ramped up after a winter without sun exposure.

“Sun allergy can develop at any point in your life, though it tends to appear in middle age more often, and it usually happens at the beginning of ‘sun season’ each year. This timing is actually a great diagnostic clue. Additionally, some ethnicities, such as those with Native American and Mediterranean ancestry, may be at higher risk of sun allergy,” Dr. Joel Schlessinger notes.

Sun Allergy Prevention and Treatment

The most effective approach to managing PMLE combines prevention with targeted treatment. Dr. Schlessinger and his team have found great success with a two-pronged approach: preventing reactions with a novel supplement called Heliocare Antioxidant Supplements and treating inflammation when it occurs with FixMySkin 1% Hydrocortisone Healing Balm or other, stronger, prescription topical corticosteroids.

Heliocare contains Polypodium leucotomos, a fern extract that has been used for centuries to address sun-related skin issues. “Heliocare has in several cases been life-changing for my patients with PMLE because it reduces the stress that UV radiation places on the skin and decreases the risk of getting any reaction in the sun,” Dr. Joel Schlessinger explains. “If you know you have sun allergy or PMLE, all you have to do is take two pills prior to being outside and that should help a great deal in decreasing your risk of flare-ups. For those who are allergic to the sun, I recommend taking this supplement on a year-round basis, but others with less severe symptoms often only take it in the summer months.”

When inflammation does occur, FixMySkin 1% Hydrocortisone Healing Balm is a potent anti-inflammatory balm that can be used anywhere on the body to reduce the inflammatory response and protect the skin during healing.

“My patients with PMLE love FixMySkin,” says Dr. Daniel Schlessinger. “Not only is it very effective at treating the rash, but it is also so easy to use and carry around in your pocket. It’s one of few medications that kids love using.”

Beyond these specific treatments, proper sun protection remains crucial. The best sunscreens for sun-sensitive skin are physical blockers containing zinc oxide or titanium dioxide, as these ingredients sit on top of the skin and physically block UV rays rather than absorbing them like chemical sunscreens.

“I prefer physical sunscreens for patients with sun allergies because they’re gentler on sensitive skin and provide reliable protection without causing additional irritation,” Dr. Joel Schlessinger advises.

Other important prevention strategies include seeking shade during peak UV hours (10 AM to 4 PM), wearing protective clothing including long sleeves and wide-brimmed hats, and gradually increasing sun exposure to build tolerance over time.

What is the difference between sun allergy versus sun sensitivity?

“Sun allergy and sun sensitivity are often used interchangeably by laypeople, but medically they are totally different things,” explains Dr. Daniel Schlessinger. “Sun allergy (or PMLE) is essentially an allergic reaction to UV, but sun sensitivity (or photosensitivity) is the state in which your skin burns more quickly or with less UV exposure than you normally would.”

As for photosensitivity, there are numerous causes, including certain medications, autoimmune disorders like lupus, and genetic causes. Determining the underlying cause can be complex and requires a dermatologist’s evaluation.

When to Seek Professional Care for Sun Allergy

Many people attempt to self-diagnose and treat what they believe is a sun allergy, but professional evaluation is crucial for proper management. “We often see patients who have been self-treating what they think is a sun allergy when it might actually be another condition entirely. A board-certified dermatologist knows the difference,” Dr. Daniel Schlessinger explains.

You should consult a dermatologist if you experience any rash that worsens with sun exposure, particularly if the reaction occurs with minimal sun exposure or interferes with your daily activities. Early intervention (and careful avoidance of the sun) often leads to better outcomes and can prevent the cycle of recurring reactions that many PMLE patients experience.

Living Comfortably with Sun Allergy

Managing PMLE requires some lifestyle adjustments, but patients can still enjoy outdoor activities safely with the right approach. The combination of Heliocare for prevention, FixMySkin for treatment when needed, and proper sun protection measures allows most patients to maintain active outdoor lifestyles.

“Many of our patients are surprised to learn they can still spend time outdoors even if they have sun allergies but still should be careful and thoughtful about the amount of time they do spend,” Dr. Daniel Schlessinger notes. “It’s all about being smart with prevention, being strategic in your sun exposure timing and having an effective treatment plan in place.”

Ready to address your sun allergy symptoms? Schedule a consultation to discuss your concerns and develop a personalized treatment plan that may include Heliocare prevention and targeted treatment options.

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Purifying back facials, explained

Aaron S — Mon, 07 Jul 2025 15:58:20 +0000

Out of sight and hard to reach, it’s easy to neglect the skin on your back. If you have skin issues you’d like to address—such as body acne or discoloration from sun damage—a purifying back facial at LovelySkin Spa in Omaha, Nebraska is a great place to start.

The LovelySkin Spa specializes in treatments for the face and body that combine medical-grade equipment and ingredients with a luxurious experience, so you walk away feeling pampered. Here, we’ll explore everything you’ll want to know about purifying back facials, including:

What is a back facial?
What are the benefits of a purifying back facial?
Is a back facial right for you?

What is a back facial?

A back facial is a series of skin care steps performed on your back by a licensed aesthetician. Depending on the type of back facial, those steps might include cleansing, exfoliation, massage and moisturizing. A mask or peel might also be included to clarify and renew skin. During a back facial at the LovelySkin Spa, your aesthetician will perform extractions as needed by using a sterile extraction tool to remove blackheads and release clogged pores that have resulted in acne.

What are the benefits of a purifying back facial?

A purifying back facial at the LovelySkin Spa helps clear clogged pores and buff away built-up dead skin cells that cause dullness and rough texture. After your treatment, you can expect an improvement in overall skin texture—the skin on your back will feel softer and smoother.

“I often send my ‘bacne’ patients for back facials or Diamond Glow treatments, as there is no better way to jumpstart improvements,” says Dr. Joel Schlessinger, board-certified dermatologist, Mohs surgeon and cosmetic surgeon, and Director of LovelySkin Spa.

Joey Lasher, Med Spa Team Lead at the LovelySkin Spa, often performs back facials on clients who are preparing for special occasions. “Back facials are a wonderful spa treatment for brides who plan to wear a backless dress at their wedding and want to make sure their skin is smooth and glowing,” she says. Even if you don’t have plans to bare your back, a back facial is a luxurious experience that will leave you feeling relaxed, refreshed and well taken care of.

Is a back facial right for you?

The LovelySkin Spa offers several different types of back facials, so you can find just the right treatment to meet your skin care goals. Now, let’s find out which facial has your back.

Purifying Back Treatment

This back facial includes an antibacterial mask to help reduce acne-causing bacteria. Extractions performed if needed.

Benefits: Soothe irritation, combat acne
Key active ingredients: Salicylic acid or glycolic acid

Salicylic Back Peel

This back acne treatment centers on a peel with salicylic acid, which helps existing acne resolve as well as prevent future breakouts from forming. Extractions are also performed if needed.

Benefits: Fights acne, clears pores and reduces surface oils.

Key active ingredients: Salicylic acid

afa^Ⓡ Clay Peel

This luxurious clay mask provides deep exfoliation to help clear clogged pores and target discoloration. “The afa^Ⓡ Clay Peel works fabulously to loosen congestion in pores and smooth rough texture,” Lasher says. “This is great for acne-prone skin as well as clients who have scarring from previous acne lesions.”

Benefits: Smooths and brightens the complexion, deep exfoliation, reduces the appearance of pigmentation, clarifies and purifies pores, reduces surface oils

Key active ingredients: Bentonite clay and afaLUXE, a dermatologist-developed blend of filaggrin-based antioxidants, vitamin C and Dead Sea salt.

DiamondGlow^Ⓡ Treatment

This resurfacing face treatment is also available for the back, neck and chest. Your aesthetician will use the DiamondGlow^Ⓡ diamond-tip resurfacing wand to deeply cleanse and exfoliate your skin while infusing it with a specialty serum.

Benefits: Deep exfoliation and revitalization

Key ingredients: Your aesthetician will customize your treatment by choosing a professional-grade serum from SkinMedica that best meets your skin care needs. There are options to improve uneven skin tone with tranexamic acid, acne with salicylic acid and dehydration with hyaluronic acid. “DiamondGlow^Ⓡ treatments for the face or body are a very popular resurfacing treatment for people who aren’t quite ready to try laser resurfacing but are still looking for some deep exfoliation benefits,” Dr. Daniel Schlessinger says.

Custom treatments

The LovelySkin Spa can also customize a back facial treatment for you based on your specific skin needs. “For clients who want a relaxing back treatment but have no back acne or discoloration issues, we use gentle exfoliation, such as the Natura Bisse glycolic serums,” Lasher says.

She continues, “These serums gently exfoliate, smooth and brighten skin. After exfoliation, we will do any necessary extractions, followed by a customized mask. At the end of the back facial, we apply a suitable moisturizer or sunscreen.”Are you ready to schedule your first back facial? You can speak to a spa patient coordinator directly to learn more about back facials by calling 402-334-1226. If your back acne is more severe, you can schedule a medical consultation with Drs. Joel or Daniel Schlessinger using our online booking tool or by calling 402-685-8262.

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How skin boosters and biostimulators can help you achieve healthy, radiant skin

Amanda D — Tue, 01 Jul 2025 14:46:13 +0000

If your skin appears dull, feels dehydrated, or is starting to show premature signs of aging, you may want to consider using skin boosters and biostimulators for a smoother, more youthful-looking complexion. Unlike traditional hyaluronic acid fillers that add volume to specific areas, these treatments work to improve the overall quality, texture and radiance of your skin over time.

At Schlessinger MD, we offer cutting-edge skin rejuvenation treatments, including SKINVIVE by JUVÉDERM®, Sculptra and other biostimulatory injectables, that promote collagen production and enhance hydration for long-term skin health. Read on to learn:

What are skin boosters and biostimulators?
SKINVIVE by JUVÉDERM®: A breakthrough skin booster
Sculptra: Long-lasting collagen stimulation
What to expect during treatment

What are skin boosters and biostimulators?

Skin boosters and biostimulators are injectable treatments designed to hydrate, smooth and improve skin structure from within. Unlike hyaluronic acid (HA) gels that contour or volumize with depots of filler, these treatments subtly rejuvenate skin by promoting collagen and elastin production and by deeply hydrating skin, resulting in a naturally plumper, brighter appearance.

Dr. Joel Schlessinger, board-certified dermatologist, Mohs surgeon and cosmetic surgeon, explains, “Skin boosters and biostimulators are an excellent option for patients who want to improve the look and feel of their skin but don’t want to look overdone.”

“As we age, our skin becomes drier and collagen naturally declines, leading to signs of aging like wrinkles and diminished youthfulness. These treatments work to counteract the effects of collagen loss and dehydration by stimulating your skin to produce and rejuvenate its own natural collagen,” he adds.

Skin boosters and biostimulators are typically placed more superficially in the skin and gradually enhance your complexion, leaving you with a more youthful and glowing appearance over time.

SKINVIVE by JUVÉDERM®: A breakthrough skin booster

One of the newest and most exciting advancements in skin boosters is SKINVIVE by JUVÉDERM®—the first and only FDA-approved HA-based microdroplet injectable designed to improve skin smoothness and hydration.

Unlike traditional fillers that lift or add volume, SKINVIVE works by dispersing tiny amounts of hyaluronic acid just beneath the skin’s surface, where it draws in moisture and improves skin texture for a firmer appearance.

Dr. Daniel Schlessinger, board-certified dermatologist, Mohs surgeon and cosmetic surgeon, explains, “Patients love SKINVIVE because it gives them a hydrated, dewy look. Few, if any other injectable products can achieve that. It’s an especially popular treatment option among patients looking for a subtle, easy refresh.”

SKINVIVE has minimal to no downtime, and the full benefits develop over a period of a few weeks to a few months as the hyaluronic acid works to improve skin quality, texture and tone. These results usually last several months, with many patients experiencing the effects for six months or longer after treatment.

Sculptra: Long-lasting collagen stimulation

Sculptra is another standout treatment in the category of biostimulators. Made from poly-L-lactic acid, Sculptra works to regenerate your skin’s natural collagen production, improving firmness, elasticity and volume loss over time.

While traditional fillers offer instant results, Sculptra’s improvements build gradually over the course of a few months. These results can last up to two years.

“Unlike many fillers that are made with hyaluronic acid to add instant volume, Sculptra stimulates the skin’s natural collagen production to build it sustainably over time. Its thinner consistency allows it to be distributed more evenly across broader areas, such as the cheeks, temples or jawline,” shares Dr. Daniel Schlessinger.

“This makes Sculptra an ideal option for individuals with naturally thinner facial structures or those experiencing significant volume loss, such as patients taking GP1 medications like Ozempic or Mounjaro.”

At Schlessinger MD, we use Sculptra on the face to diminish wrinkles, treat volume loss and improve skin laxity, helping patients achieve visibly smoother skin over time.

What to expect during treatment

Skin booster and biostimulator treatments are quick and require little to no downtime. Most patients experience minimal discomfort during their treatment, and the results for treatments such as SKINVIVE by JUVÉDERM® and Sculptra gradually develop over several weeks.

Immediately after your treatment, you may notice improved hydration, a healthy-looking glow and visibly smoother skin. For best results, we may recommend a series of sessions based on your individual skin goals.

After receiving Sculptra, we recommend following the “five-five-five” protocol for massaging the skin so the Sculptra spreads out evenly. This means gently massaging the facial skin where the injections happened for five minutes at a time, five times a day, for five days.

Whether you’re just starting your skin care journey or looking to enhance your professional results with the latest injectable technology, skin boosters and biostimulators can be a powerful part of your anti-aging routine.

If you’re interested in achieving smoother, more youthful-looking skin with skin boosters and biostimulators, you can book a one-on-one aesthetic consultation with Drs. Joel or Daniel Schlessinger online. During this consultation, our team will discuss your concerns, answer any questions you may have and develop a treatment plan. If you’d like to speak to an aesthetic patient coordinator directly, you can call us at (402) 685-8262.

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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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Ultherapy Prime or Sofwave: Which treatment delivers better lifting results?

How do these treatments work?

What to expect during treatment

The results you can expect

Why Ultherapy Prime stands out

Is Ultherapy Prime right for you?

A guide to aesthetic treatments in your thirties

Understanding your skin in your thirties

The science behind aging skin

The window of opportunity

BOTOX: Your first line of defense against dynamic wrinkles

Advanced laser treatments for skin rejuvenation

Body contouring with CoolSculpting

SkinTyte: non-surgical skin tightening

Creating your personalized treatment plan

Maintenance and long-term skin health

Frequently asked questions

Your path to confident, youthful skin

Bacne Treatments Tips From Board-Certified Dermatologists

Why back acne develops

Understanding different types of back acne

Recommended treatment approach

Starting with over-the-counter solutions

When to consider professional treatment

Addressing back acne scars

The path forward

What is microneedling? Results and recovery explained

What is microneedling good for?

EndyMed Intensif RF microneedling: Advanced technology for enhanced results

How long does it take to see results from microneedling?

Essential microneedling aftercare

Professional vs. at-home microneedling

Combining microneedling with other treatments

Your path to healthier skin

What is baby BOTOX? Understanding preventive BOTOX treatments for natural results

At a Glance

Understanding baby BOTOX and microtox

The science behind preventive BOTOX

Baby BOTOX before and after: What to expect

Who is a good candidate for baby BOTOX?

Treatment considerations and maintenance

Choosing preventive BOTOX

Can You Be Allergic to the Sun? Understanding PMLE and Sun Sensitivity

Understanding Sun Allergies and PMLE

Sun Allergy Prevention and Treatment

What is the difference between sun allergy versus sun sensitivity?

When to Seek Professional Care for Sun Allergy

Living Comfortably with Sun Allergy

Purifying back facials, explained

What is a back facial?

What are the benefits of a purifying back facial?

Is a back facial right for you?

Purifying Back Treatment

Salicylic Back Peel

afaⓇ Clay Peel

DiamondGlowⓇ Treatment

Custom treatments

How skin boosters and biostimulators can help you achieve healthy, radiant skin

What are skin boosters and biostimulators?

SKINVIVE by JUVÉDERM®: A breakthrough skin booster

Sculptra: Long-lasting collagen stimulation

What to expect during treatment

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

afa^Ⓡ Clay Peel

DiamondGlow^Ⓡ Treatment