Cosmetic Dermatology: A Complete Guide

Los Angeles is the world’s glamour capital. All the biggest stars are here, and their exquisiteness is simply inspiring.

 Glass skin… Fuller lips… An hourglass figure… You can have them all along with your other gifts if you wish.

Modern science has an answer to nearly every beauty flaw. You just need to find a spectacular medical genie to do it. And we got the best ones right here at BHSkin Dermatology.

What Is Cosmetic Dermatology?

If you’ve tried different diets, workouts, and products but still cannot get the look you want, perhaps it’s time to visit a cosmetic dermatologist at one of our LA clinics.

Cosmetic dermatology is a specialty focused on enhancing one’s appearance using medical treatments or minimally invasive surgical procedures. Usually, the body part that a patient wants transformed is not dysfunctional, but the way it looks can strike up feelings of dissatisfaction.

Cosmetic dermatologists are physicians. Specifically, they are board-certified skin doctors who have chosen to devote their practice to patients’ physical enhancement. As in all other medical fields, finding the right specialist increases the chances of getting the results you want. But picking the wrong one can aggravate the problem or cause serious injuries.

Insurers usually do not cover cosmetic dermatology treatments because they are not medically necessary. Some of them can be pretty pricey, but rest assured that you’ll get every penny’s worth when you entrust your skin care to the best.

Why Would Someone Get a Cosmetic Procedure?

Aesthetically enhancing treatments have skyrocketed in the last couple of decades. If you’ve come to the point of mulling a trip to the cosmetic dermatologist’s office, psychologists will tell you that it doesn’t make you different from a lot of people. The following reasons motivate most patients to get an aesthetic procedure:

• They want to keep up with the beauty standards of their time. The media plays a huge role in shaping their views.

• They have increasing confidence in the treatments.

• Some want to feel more accepted by their peers. Anyone who survived adolescence must have felt this way at some point.

• Others would like to recapture their youthful look.

• Those with higher disposable incomes are looking for ways to love themselves more.

• Cosmetic enhancement has helped some patients overcome their shyness.

People who feel good about their looks find themselves doing better at their jobs, having better relationships and feeling positive overall. Additionally, letting a professional take care of your aesthetic needs saves you from the potential risks of DIY concoctions. 

What Procedures Do Cosmetic Dermatologists Perform?

Cosmetic dermatologists get rid of problems that prevent you from looking your best. The following procedures help them do this:

Laser Treatment

 Laser surgery uses powerful light beams to correct skin flaws. It introduces controlled injury into the skin, inducing inflammation. The healing process improves the treated site’s appearance. 

 Various laser types are available to address both medical and cosmetic concerns, such as the following:

• Aging skin
• Sun damage
• Scars
• Unwanted hair
• Tattoos
• Acne
• Spider veins, rosacea and other vascular lesions
• Brown spots and other pigmentation problems
• Benign moles
• Psoriasis, vitiligo, atopic dermatitis and other immune-driven skin disorders
• Loose skin
• Stretch marks

 Skin of color is more sensitive to lasers than fair skin. A good cosmetic dermatologist recognizes the special needs of individuals with a dark skin tone.  

Chemical Peel 

Chemical peeling uses substances that remove the skin’s top layers and stimulate tissue renewal. Examples of exfoliating agents are alpha-hydroxy acids, tretinoin and trichloroacetic acid. Chemical peels work at different depths and treat skin problems like: 

• Fine lines
• Coarse wrinkles
• Pigmentation problems
• Acne
• Acne scars
• Rough skin texture
• Sun damage

 The doctor may combine different exfoliating agents depending on the skin condition and its severity.

Dermabrasion

 This cosmetic procedure involves the mechanical removal of the skin’s outer layers, revealing the younger, healthier cells within. It remedies the same problems as chemical peels.

 Dermabrasion performed by a cosmetic dermatologist has a deeper approach than microdermabrasion done by an aesthetician. Numbing medication is given to patients with a low pain threshold. Dermabrasion may not be the right procedure for you if you’re keloid-prone.

Body Contouring

 Not loving that double chin or muffin top? Body contouring may help. These procedures remove subcutaneous fat unyielding to diet and exercise. Liposuction is an example, and it is one of the most commonly done aesthetic treatments worldwide.

Liposuction vacuums out fat tissue and is performed under anesthesia. It may produce areas of sagging skin, which can take months to resolve on their own. However, procedures like laser surgery and radiofrequency can help tighten the skin faster.

Cosmetic dermatologists may also use less invasive technologies to deal with stubborn fat. These treatments loosen up the tissues in the target area and rely on the body’s natural lipid-clearing mechanisms.

• Cryolipolysis or “coolsculpting” damages fat tissue using cold injury.
• Laser, infrared and radiofrequency burn fat cells with the aid of high-energy electromagnetic waves. 
• Ultrasound involves high-frequency sound vibrations.
• Diathermy converts electric or electromagnetic energy into fat-liquefying heat.
• Mesotherapy, explained further below, entails the injection of fat-dissolving drugs.

Their body-sculpting effects are modest by comparison, but combining them with conventional liposuction enhances their efficacy.

Body contouring is not a substitute for long-term weight reduction strategies, but a healthy lifestyle can make the results last for years.

Soft Tissue Augmentation

Subcutaneous fat disappears over time. It will be hard to hide one’s age if it occurs fast enough in the face. But injectable fillers can help restore the skin’s youthful fullness and smooth out wrinkles.

Collagen, hyaluronic acid and silicone are examples of soft tissue fillers, but they can induce hypersensitivity in allergy-prone individuals. An autologous fat transfer spares patients from severe allergies as it uses their own body fat to plump up the skin.

Botox Injections

 Botulinum toxin is a nerve paralyzer that improves wrinkles formed by muscle movement. “Botox” is a brand name of botulinum toxin that is FDA-approved to treat frown lines, forehead wrinkles and crow’s feet. Botox injection likewise reduces oil and sweat gland activity, so dermatologists may also use it to relieve acne and excessive sweating.

 “Dysport” is another brand name for this toxin. It works pretty much like Botox, although the FDA recommends it only for treating glabellar lines and severe neck and limb spasms.

 Botulinum toxin may be given for other wrinkle types, such as those forming around the lips, and dermatologic applications not licensed by the FDA. However, such “off-label” use is only safe in the hands of a skin care specialist.

 Hair Restoration Surgery

 Hair loss can make people look older than their years. Hair restoration surgery is a minor procedure that transplants hair follicles from a lush scalp area to a balding one. Individuals who don’t respond to medical remedies can benefit from this treatment.

 Choosing the right “donor” area is crucial to the success of hair restoration surgery. The wrong choice can lead to further hair loss, so the procedure requires the cosmetic dermatologist’s specialized knowledge of the hair and scalp. 

PRP Injection

 Blood platelets contain growth factors and other substances vital to tissue repair. When injected into the skin, they can stimulate cell renewal, correcting issues like: 

• Hair loss
• Scars
• Wrinkles
• Stretch marks

 “PRP” stands for “platelet-rich plasma.” Plasma is the blood’s watery fluid.

 During a PRP procedure, the dermatologist takes a small sample of the patient’s blood, separates the platelet-rich portion and injects it into the problem area. If it is done on the face, it is known as a “vampire facial,” which is very popular among entertainment artists. Hypersensitivity is not a problem with this treatment as it does not use artificial chemicals.

Mesotherapy

 If you’re looking for a cellulite-shrinking fix but don’t want liposuction, you may ask your dermatologist about mesotherapy. With this cosmetic treatment, the doctor can spot-reduce cellulite by injecting fat-dissolving substances like L-carnitine and isoproterenol. No anesthesia or suctioning is needed.

 Mesotherapy is also an alternative to other skin rejuvenation therapies. Instead of chemicals that break down fat, the dermatologist injects complexion-enhancing substances into the problem area. Hyaluronic acid, growth factors and other bioactives are used.

Microneedling

Medical microneedling passes rows of ultra-fine needles on the skin. The resulting micro-injuries stimulate inflammatory processes that enhance skin renewal and collagen production. That’s why it’s also called “collagen induction therapy.”

Cosmetic dermatologists use microneedling to treat the following skin concerns: 

• Acne
• Unwanted pigment
• Stretch marks
• Aging and sun-damaged skin
• Loose skin
• Hair loss
• Some forms of autoimmune skin disease

 Your doctor may combine microneedling with other procedures depending on the outcome you want to achieve.

Photodynamic Therapy

 In the US, photodynamic therapy involves applying a photosensitizing agent, usually aminolevulinic acid, and subsequent exposure to blue light. In other countries, the combination of methyl aminolevulinate and red light is a common alternative.

 Photodynamic therapy is primarily indicated for actinic keratosis and early skin cancer. But cosmetic dermatologists also use it for various benign conditions, such as: 

• Pigmented lesions
• Acne
• Aging and sun-damaged skin
• Stubborn infections such as warts and nail fungal disease
• Psoriasis
• Unwanted hair

 And many others. Some patients may be sensitive to the treatment and require pain medication during the session.

Cosmetic Cryotherapy 

Cryotherapy uses liquid nitrogen’s subzero temperature to destroy lesions and stimulate the skin’s inflammatory and repair mechanisms. This essentially painless procedure can treat pigmentation problems and benign growths like:

• Melasma
• Tattoos
• Warts
• Moles
• Vascular birthmarks
• Cysts
• Skin tags
• Keloids

It is also an inexpensive skin cancer treatment option, though it has a lower cure rate than Mohs surgery. Good aftercare significantly reduces the odds of scar formation after cryotherapy. 

Here’s a table summarizing the indications for cosmetic dermatology treatments:

Cosmetic Dermatology Procedures and Their Indications

Note that patients respond variably to these procedures. While some observe a significant difference after only one treatment, others need multiple sessions to see some results. Trust that the cosmetic dermatologist will help you figure out the safest and most efficient way to reach your goals. 

How Do You Choose a Cosmetic Dermatologist?

Finding a cosmetic dermatologist is like picking an outfit for an exclusive event—the artist’s work speaks volumes about your personal standards. You want only positive feedback, and maybe a little envy, from people looking at your next filter-free profile picture. So there’s no room for compromise.

Here’s what we suggest you do:

• Pick the one with the best credentials.

Cosmetic dermatologists are board-certified physicians who went through a medical internship, dermatology residency and a rigorous certification process given by the American Board of Dermatology.

 Some pursue clinical fellowships in cosmetic dermatology after board certification. Others go on to join organizations specializing in the field, like the American Academy of Dermatology, where they can access updated evidence-based medical information.

 Other providers can offer to give you the above treatments at a lower price. However, only cosmetic dermatologists have advanced skills in performing aesthetic enhancement procedures and can guarantee their success and safety.

 Besides, some patients coming in with suspicious lesions don’t know if they already have skin cancer. Board-certified dermatologists are trained to identify early-stage tumors and treat them in a timely fashion. 

• Ask how long they have been practicing and how many procedures they have done.

Most reputable cosmetic dermatologists have years of experience in a hospital setting or private practice. Each patient encounter, whether simple or complicated, sharpens their skills. So the greater the numbers, the more confident you should be in their abilities.

 At BHSkin Dermatology, our skin care specialists have years of training and experience. Patients are happy with the high-quality care they get from our doctors. 

• Ask a friend or another medical professional to refer a cosmetic dermatologist to you.

Ask someone who has had good results with a cosmetic procedure if they would recommend their dermatologist to you. Find out their reasons for choosing their doctor and if they are happy with their service. Chances are, that friend must have also done some research before paying good money for the treatment. 

Meanwhile, a colleague’s endorsement says a lot about a dermatologist’s professionalism and skill. So ask your primary physician or doctor friends to give you a name they trust. 

For more information, you may read our detailed article on finding an excellent skin care expert.

When You’d Rather Be a Legend than a Cautionary Tale

Cosmetic dermatology’s popularity continues to rise because of the increasing safety and effectiveness of its procedures, thanks to evidence-based medicine and the improving standard of care. Still, social media is fraught with stories of failed aesthetic treatments done by unlicensed individuals.  

You want to make sure that your cosmetic procedure makes you look and feel wonderful. A legend, not a cautionary tale. So get no one else but a highly trained, board-certified professional to do it. 

Get a Beauty Boost from LA’s Award-Winning Skin Care Experts  

In Encino and Glendale, BHSkin Dermatology is a bankable name in cosmetic dermatology. Patient satisfaction is our priority, and you can tell by the number of patients spreading the word about us. 

Think you need laser hair removal? A dermal filler? Or skin tightening? Whatever skin issue you have, you can trust our specialists to solve it. Visit us at one of our clinics or consult remotely through our telederm portal.  

Book your appointment today!

Author: Don Mehrabi

Don Mehrabi, MD, FAAD, is LA’s leading board-certified dermatologist who treats patients, builds the BHSkin clinics, and raises three kids. This blog builds on medical studies combined with Dr. Mehrabi's first-hand experiences from practicing in Encino-Tarzana, Glendale, and online