Twitter Q&A Transcript April 18, 2017


On April 18, 2017, Gary Goldenberg, MD, took over the @CutisJournal Twitter account for 1 hour to answer reader questions about updates in cosmetic dermatology. Below is a transcript of the Twitter Q&A session (#AskCutisJournal).

What can help #hyperpigmentation from prior #HIV related #prurigo in darker pts since this is a stigma of disease? #AskCutisJournal
@carriekovarik Aside from lightening agents & moisturizers, success with #microneedling. Go low & slow 2 prevent more hyperpigmentation.

Microneedling Therapy With and Without Platelet-Rich Plasma

What's new for treatment of melasma?

@NailDoc12 I recommend combo of prevention, sunscreen & lightening cream w/ microneedling w/ PRP or ktp laser such as #Cutera #ExcelV.

Dermatologists Weigh in on Skin-Lightening Agents

Is there good evidence for use of PRP for skin aging?

@NailDoc12 Pts swear by #PRP. Use after fillers/Botox & microneedling or laser. Pts say it improves skin quality, gives it a "glow" (1/2)
@NailDoc12 Growth factors in PRP improve tissue vascularity & help cells regenerate & normalize. Helps w/wound healing post procedure (2/2)

Microneedling With Platelet-Rich Plasma

@CutisJournal #AskCutisJournal What is your approach to global facial rejuvenation? Do you like to start with injectables or laser?

@anthonymrossi Total rejuvenation is just that. I rec combo tx 2 improve skin quality (laser and/or microneedling with PRP) (1/2)
@anthonymrossi Plus wrinkle relaxers for dynamic wrinkles, & fillers to address volume loss and deep wrinkles & lines (2/2)

Facial Rejuvenation With Fractional Laser Resurfacing

@CutisJournal #AskCutisJournal Whats your favorite filler for cheek lifting?

@SkindocDLCC Filler naive pts: #RestylaneLyft or #JuvedermVoluma. Experienced pts: #Radiesse or #Bellafill

@CutisJournal @Goldenberg_Derm What filler do you like for a sharper jawline? #AskCutisJournal

@SkindocDLCC I prefer long-lasting fillers, such as #Radiesse or #Bellafill. This is true for both male & female pts

Efficacy and Safety of New Dermal Fillers

@CutisJournal @Goldenberg_Derm How do you get a smooth forehead with neurotoxin without a heavy brow? #AskCutisJournal

@SkindocDLCC Precise placement of product is important. Some pts may require more product to completely smooth out forehead (1/2)
@SkindocDLCC Those pts may need a combo tx with laser such as #CO2 or #microneedling with #PRP (2/2)

@CutisJournal @Goldenberg_Derm How do you combine PRP and fillers? #AskCutisJournal

@SkindocDLCC I regularly use #PRP with fillers 2 enhance the effect (1/3)
@SkindocDLCC PRP helps stimulate collagen & increase vascularity needed for collagen production (2/3)
@SkindocDLCC I use a mesotherapy needle to inject #PRP after injecting filler and/or neurotoxins (3/3)

@CutisJournal @Goldenberg_Derm What is your favorite filler for tear troughs?

@MilitelloDerm I prefer Restylane or Juvederm Ultra. These fillers give the best volume effect & last longer than other options in my hands

Periocular Fillers and Related Anatomy

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