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If you have deep lines between your eyebrows, sometimes called the elevens, and you’ve had Botox injections and you still have a hint of a line or even a deep line what can you do about it? In my office I first inject Botox and see how much of an effect it will have. I have my patient return 10 days to two weeks later for the full effect. Then if there is still a line and the patient would prefer further correction I take a very fine line filler and inject the line with hyaluronic acid. This usually fills the entire line. So it does require two procedures and an added expense but that’s what happens when the lines are deeper. At least there is a solution!

In the last few years, I started to notice that younger and younger people were asking me for Botox. The reason is that many people don’t want to see the lines appear on their face in the first place. So imagine you have a smooth forehead with no wrinkles or an unfurrowed brow. You just want to keep it this way. So you can have what’s called preventative Botox. Some people in their 20s have Botox injected in the frown, the forehead, or even the crows feet. They never develop wrinkles at all. They have perfectly smooth skin and I inject the muscles so that they can’t frown or wrinkle their forehead or squint their eyes. The Botox relaxes the muscles and the skin overlying it is smoothed out so wrinkles never form. For other young individuals they have very dynamic muscles with deep lines forming early so they may need Botox early and it’s not preventative it’s more of a necessity. So if you are young it’s certainly something to think about.

It’s an easy habit to get into, just like brushing your teeth. Up to 80 percent of the sun’s UV rays can pass through clouds. This is the reason people often end up with serious sunburns on overcast days if they’ve spent time outside with no sun protection. Sun damage is cumulative. So even if you only spend 15 minutes per day outside this adds up over the course of a lifetime. Take a few minutes every day to apply your sunscreen and you will prevent uneven color, broken blood vessels and wrinkles. You can even prevent skin cancer.

Seborrheic dermatitis is a common skin condition that I see in my practice weekly. For most people it’s a nuisance that shows up as red, peeling skin around the nose, on the eyebrows and on the scalp. The most common treatment for the face is topical steroids. My concern with this treatment is that over time it thins the skin, and can cause broken blood vessels and stretch marks. Topical antifungals are also used, but they don’t always work. So I decided to try a novel approach. Elidel cream (pimecrolimus) is used for eczema but it has very few known side effects, other than occasional burning. One study found that Elidel was slower to work than other treatments, but more effective for seborrheic dermatitis and had longer-lasting results. I have started using it on some patients, with very good results.