Skin Care:

It is always good to give a little historic perspective because it allows you to see how valid a procedure or a product is. If that product or procedure has been used for a long time, it probably means that the results have been good and there were very few side effects.  I personally never like to use a drug which has just entered the market.  How many times have we heard that a drug has been pulled off the market by the FDA due to safety concerns after a few years of use.  I usually wait a few years and attend meetings to hear others talk about a new procedure or product.  Sometimes when the dust settles, I find that it was not worth offering that service or product and rarely do I find that I should adopt it into my practice.

In the early 1990s, no plastic surgeon used skin care in their practice and the results of peels were very radical.   The common peel was the phenol peel that left patients with white faces, stripping off all the melanine pigment in their skin.

I heard that there was a doctor in California who had devised a system of products followed by a control depth TCA.  He was offering a course for about $30,000 for whoever wanted to learn how to use his method.  I was very intrigued, but I waited a few years to make sure the results were as good as they were promised to be.  Years later, I was at the plastic surgery meeting in Colorado where one of the guest speakers, Dr Obagi, presented his method and products in a couple of hours.

This was what had happened: One of the well known plastic surgeons had gone to him as a patient, had great results and convinced Dr Obagi to present this technique to the plastic surgery community. Dr Obagi had lowered the price of the course to a more reasonable $5000 and was offering it around the country.

I took his course in Baltimore; I am not sure what year it was, but I think it  was in 1994. I saw him do live peels on patients who had been pre-treated for six weeks with creams.  He showed us how to judge the depth of TCA action by touching, pinching and observing the frost on the skin.

I started to use the products on my patients ever since with satisfying results. We then introduced another line of products for a few years, but I found that nothing made as big of a difference.  Today we are only offering the Obagi Medical products.  I still use the products according to Doctor Obagi’s original teachings with Retin A for 4 to 6 weeks with a moderately aggressive approach.  This makes a significant difference and jump starts the skin into a better level of activity. However, the patients have to be ready to accept some discomfort and peeling.  The system can be used in a milder way in which there is less peeling and discomfort, but the benefits will take longer to show. The Obagi Medical offers a comprehensive line of products from skin cleansers to  vitamin c to light TCA peels (Blue Peel).