If you have tried standard acne kits without success, consider creating your own customized regimen of OTC acne products with these tips from a dermatologist.

Here is your AM Plan using OTC acne products:
  • Step 1 – the first OTC acne product to consider is a cleanser. I suggest looking for an AM cleanser for early morning care. Salicylic acid products are ideal for oily skin.  For adult acne, try cleansers with glycolic acid which is milder  ( I recommend the Societe AHA cleanser shown below- available online and at some dermatology offices for adults with acne)
  • Step 2 am – spot treat breakouts with a  topical antibacterial gel  such as benzoyl peroxide 5%
  • Step 3-Apply Oil free sunscreen
Here is your PM plan using OTC acne products
  • Step 1- Use gentler cleanser, glycolic acid or any product labeled gentle cleanser
  • Step 2 – Apply a pm treatment product with topical vitamin A  ( Differin Gel is recently available over the counter. Until recently it was by prescription)
  • Step 3 – Apply a pm oil free moisturizer ( the pm treatment product may cause some dryness or peeling so don’t skip this step)

Optional additional products –

  • Try a weekly masque for stubborn blackheads. I love Societe Deep Thermal with clay and sea salt. Skip the Differin on the night you use this.
  • For acne on the back and chest, use a benzoyl peroxide wash in the shower
AM wash for teens $10 at drugstores

AM wash for teens < $10 at drugstores

OTC acne products

AHA Cleanser For Adult Acne

OTC acne products

BP wash for back acne < $15

OTC Acne Products

Oil free, non-chemical sunscreen for all skin types.

OTC Acne Products

Differin – Spot treatment in PM, like prescription strength

OTC Acne Products

1-2x/week masque. Great exfoliator. Buy online or in derm offices.

OTC Acne Products

Oil free PM moisturizer. Ideal for use after Differn.

OTC Acne Products

CA Skin Kit for adult acne

As difficult as it is to wait when you want to see fast results, keep in mind that patience is key – optimal results for any acne program typically take 12 weeks. If you don’t succeed, schedule an appointment with a dermatologist to see if oral medication is needed.


Posted by & filed under Acne, Anti-Aging Treatments, FAQ's, General, Women's skin conditions.

Menopause causes a number of changes to the skin, hair and nails. The hormonal changes cause the body to make less new collagen. There is also atrophy or thinning of the facial bones and the fat layer under the skin. As a result, there may be sagging around the neck, jawline and cheeks. The reduction in estrogen during menopause causes dry skin.  All of these changes combined make fine lines and wrinkles more visible.  Thinner hair and more brittle nails are other common concerns.  Here are some answers to your FAQ regarding menopausal skin.

Can menopause cause itchy skin?

As estrogen production diminishes around the time of menopause, dry, itchy skin becomes a very common symptom. The decline in skin thickness and collagen production appears to be most rapid in the few years immediately preceding menopause.
Lowered estrogen levels also decrease the body’s ability to retain moisture and slow down the body’s production of natural skin oils, which also contributes to itchy skin.

Menopausal skin solution for itching :

The itchy skin can be treated naturally by applying OTC moisturizers daily after showers on damp skin. Moisturizers containing ceramides, naturally occurring skin lipids that prevent water loss, may have enhanced results.  Options include Cerave, a pharmacy brand and Avene Xeracalm, sold in dermatology offices.

How does menopause affect your hair?

Menopause causes androgen or male hormone levels to increase, which can trigger thinning of scalp hair as well as excess facial hair. Initially, androgens reduce the length and thickness of scalp hair; later on there may be recession of the hairline                            Platelet-rich plasma for Hair Loss Torrance

Solution to hair changes during menopause:

Hormone replacement therapy, if recommended by your doctor, will help minimize both scalp hair thinning and excess facial hair. Rogaine 5% or Minoxidil 5% (generic) , available OTC can be  used once daily, to improve hair thinning. If hair thinning persists, consider augmenting this program with Platelet Rich Plasma (PRP) treatments done in a dermatology office.  While still in the investigational stage, smaller studies have shown that  this treatment delivers  growth factors to the hair root. The result is thickening of  existing hair and stimulation of  new growth.

Excessive facial hair can be treated temporarily with waxing, epilation or home depilatories. Laser hair removal   can achieve  80% permanent reduction after a series of treatments . For facial hair that is not easily treated at home, it is a safe option.

Does menopause cause acne?

The hormone changes during menopause include a rise in female testosterone.  This can cause increased oil production in the skin, one of the causes of adult acne.

Solutions for menopausal acne:

Menopausal acne typically responds to topical therapy.  Skin care products and medications need to be customized for dry, more sensitive skin of adult acne patients. When topical medications are not 100% effective, a testosterone blocker , spironolactone is often used.  See a dermatologist for a program tailored to your specific skin needs before investing in OTC products that may irritate rather than improve your skin.

What are the best anti-aging options for menopausal skin?

  •  Skin care for menopausal skin:

Take care to prevent dry skin by using gentle cleansers. Moisturize nightly and consider using a product with active ingredients such as antioxidants. Most dermatologists agree that prescription strength tretinoin cream used nightly is top rated for skin smoothing and wrinkle reduction. For best results combine with a daytime serum with Vitamin C such as our Societe C or a serum with growth factors. And, don’t forget fanatic sun protection.  Use sunscreen daily, reapply and wear hats and protective clothing. Your skin will show it!

Use a body moisturizer on damp skin after showers. For extra dry or peeling skin, consider an exfoliating product such as Glycolic acid lotion or Amlactin.

  • Top non–surgical procedures for anti-aging post menopause:

If you have significant sun damage and wrinkles, Fractional CO2 laser will provide the best results with 7-8 days of healing time.   anti-aging treatment for menopausal skin with Fractional CO2 laser

Not ready for a facelift, but concerned about early signs of sagging skin? Ultherapy is a non-invasive option that can provide skin tightening and help regenerate new collagen

For patients with volume loss, especially in the mid-face, volume enhancing fillers such as Sculptra, Radiesse or Volume can add facial volume and stimulate new collagen.

If you are already using Botox, keep it up as a preventative. If you have not tried it, consider combining Botox with some of the treatments above.

And don’t forget, 50 may be the new 40 with what we now know about aging! Schedule a cosmetic consultation with Dr. Goodlerner at Ca Skin Institute Torrance to learn more



toenail fungus

Posted by & filed under General.

Summer is here! Time to wear sandals and go barefoot at the beach. But, your toenails have white spots, yellow discoloration, are lifted at the ends or thickened. Chances are you have toenail fungus. Here are some tips on how to treat and prevent toenail fungus.

 What causes toenail fungus?

Nail fungus is caused by an overgrowth of a fungus called a dermatophyte that thrives in warm, moist locations. The same type of fungus can also cause athlete’s foot and jock itch. If you have nail fungus, check between the toes for redness or cracks in the skin.   toenail fungus

Is nail fungus contagious?

Yes. It can be acquired in nail salons, gyms, and community showers in swimming pools. It also can be spread from skin to skin contact and frequently develops in young men who participate in wrestling. You may also get it from a family member if you use the same shower.

How can nail fungus be prevented?

  • Be careful in gyms and public showers. Wear shower shoes and dry your feet carefully after workouts
  • If you are active in athletics, wear absorbent socks and make sure shoes dry out. Use an antifungal foot powder before and after workouts.
  • Take care at nail salons: bring your own mani-pedi tools and nail files. Avoid foot baths. And consider bringing your own polish ( many salons use wet sterilization which may not remove fungus from instruments and nail files are re used)
  • Avoid constant use of nail polish, give your nails a chance to breathe. If you have fungus, polish can trap moisture and cause fungus to spread.


Is toenail fungus dangerous to your health?

Nail fungus does not spread internally or cause serious disease. Delaying treatment can result in spread to all toenails, the feet and the groin. In addition, the nails eventually can become thickened, ingrown or painful.

Are there natural treatments for toenail fungus?

Toenail fungus is very difficult to treat, even with FDA approved medications. There are a multitude of home remedies reported as a “fungus cure”.  Most of these remedies do not have any scientific studies to support their benefit. Here are some of the remedies that are reported to work. There may be some benefit for superficial fungus –the type that appears as a white or yellow discoloration of the nails without thickening of the nails. It is unlikely that these natural methods will work for nail fungus that has been present for more than a year.

  • White vinegar or bleach diluted 1 part to 2 parts water applied directly to the nail or as a foot soak
  • Tea tree oil or oregano oil applied directly to the nail once or twice daily for months
  • Vick’s Vaporub applied directly to the nail once or twice daily

Medical treatment  for toenail fungus

If home remedies used over a month or more fail to cure the fungus, see a dermatologist for one of these FDA approved medications:

  • Oral antifungal medications: The most effective is terbinafine. The medication is typically prescribed for a 3 month course. But you won’t see the final result until the new nail grows in which can take up to a year. Treatment success rate is up to 70% but may be lower in patients over 65. There are rare (<1%) cases of elevation of liver enzymes due to terbenifine. The changes resolve when the medication is stopped.  Monitoring with a one or two lab tests is recommended. The medication is not recommended for patients with liver disease or patients taking certain other medications.
  • Medicated nail polish: Ciclopirox (AKA Penlac) is an antifungal nail polish painted on the infected nails once a day. It is removed once weekly with polish remover. It can be effective resolving nail fungus with 1 year of continuous use. While using it, it is necessary to stay away from cosmetic nail polishes. Clinical studies have shown about 35-40% of patients get completely clear nails after 1 year.
  • Medicated nail solution: Efincinazole ( AKA Jublia) is a clear nail solution applied to the nails and surrounding skin once daily for a year. It is reported to have better nail penetration than other topicals, however clinical trials show results similar to Ciclopirox. This new medication may not be covered under all health plans

Surgical treatment for nail fungus

  • Nail removal: Painful fungus nails can be surgically removed. When combined with oral or topical antifungal medication, this procedure can aid in clearing the fungus. Be aware that regrowth of the nail may take up to a year.
  • Laser surgery: Various laser treatments to evaporate fungus nails have recently been developed. To date there are no large scale clinical studies proving that these treatments work in the long term. And, there are no studies comparing laser treatment to oral or topical antifungal medications. Treatment with lasers is costly and there may be risk of nail deformity. Until further studies prove improved results over standard treatments I cannot recommend it.

Try the tips above to prevent nail fungus. If you already have toenail fungus, it is too late to cure if for this summer! Try to cover with polish until summer is done, then embark on a cure in September for healthy nails next summer.


top 5 cosmetic treatments for men Torrance

Posted by & filed under Botox, cosmetic surgery, General, men's skin care, V-Beam, wrinkle treatments.

Cosmetic procedures for men are increasing in popularity.  There are many reasons for this, but primarily it seems to be a way to stay competitive in the workplace.  Non-surgical or minimally invasive procedures such as Botox or fillers are the preferred treatments for men looking to fight ageism. The share of people over 65 in the workplace has increased dramatically from 12% in 2000 to almost 19% in 2016. Simultaneously, there has been a 20% jump in all cosmetic procedures for men. It is not clear if there is a cause and effect, but I suspect it is connected.

According to the American Society for Plastic Surgery’s Statistics the top 5 non-surgical cosmetic procedures for men are: Botox, injectable wrinkle fillers, laser hair removal, photo rejuvenation,  (treatment for brown spots or facial redness) and non-surgical skin tightening.  Gentlemen, if you are considering cosmetic treatment options,  read on to see what treatments may be right for you.

Cosmetic procedures for men Botox, #1 in non-surgical cosmetic procedures for men:  Botox works equally well for men and for women, although men may require slightly more Botox to achieve the same results. Botox functions to smooth out lines in the upper face. The most common areas of treatment are frown lines on the forehead, between the eyebrows and “crow’s feet”.  Botox can help get rid of a scowling look and can make you look younger in a subtle way.  The part most men like is that the procedure takes 15 min and there is no “downtime”.  Treatment needs to be repeated every 4 months to maintain results. Cost varies depending on the number of treatment areas or units of Botox used as well as the zip code – range is $300-$600 per session.

Wrinkle Fillers or Soft Tissue Fillers:  Injectable filler treatments for men have increased in popularity from 2015-2016. There are specific fillers for improving the “sunken cheeks” in athletic men with low body fat, and there are fillers designed to improve the folds between the nose and corner of the mouth.  These treatments take 15-20 minutes in the office and are considered to have “no downtime”. Occasionally there may be temporary bruising or swelling at the treatment site. Cost is $600-$900 per vial of injectable filler depending on the product used.

cosmetic treatments for menLaser Hair Removal:  In the past, men did not remove hair on the back and chest unless they were bodybuilders or competitive swimmers. Not so now; more and more men are opting for thinning out hair on the chest, back and shoulders.  Laser hair removal  can accomplish this with a focused light beam that targets the pigment in the hair root and destroys the follicle. Treatment duration is 30-60 minutes depending on the treatment area. Six or more treatments are needed for permanent hair reduction. Best results are obtained with light skin and dark hair.  Laser hair removal does not work on blond or white hair.  African American skin types are successfully treated with the Nd:Yag laser.

Laser or Intense Pulsed Light (IPL) treatment for brown spots or redness:  Men with concerns about facial redness, broken blood vessels around the nose or brown age spots can opt for a laser or light treatment to improve their appearance.  Either the pulsed dye laser  or the IPL can gradually remove dilated blood vessels or brown spots over the course of a 4-6 treatments. Each treatment takes 15-20 minutes. There will be increased redness post treatment and possibly temporary darkening of brown spots for 7-10 days. Typically patients go to work the next day. Cost of treatment is $250-$400 per session.

Non-surgical skin tightening: This procedure is done using radiofrequency heat, ultrasound or lasers. It is growing in popularity for men and women and is now the 5th most popular non-surgical cosmetic procedure for men.While a facelift is the “gold standard” for improving a sagging neck, for those not ready for surgery there is now an effective option.  Ultherapy uses ultrasound to stimulate new collagen and repair the skin’s foundation. The result can be a more defined jawline, elevation of the eyebrows or reduced sagging in the neck. The procedure takes 1-1 ½ hours and costs in the range of $3000 depending on the area treated. We are pleased to offer this treatment at California Skin Institute Torrance within the next few weeks.

cosmetic treatments for men

Men want to look their best, too! To celebrate Men’s Health Month (and Father’s Day), we are offering specials on all of these procedures for first timers. Schedule your consultation now to learn which option is right for you.

For a limited time, get 15% off any of these 5 top procedures that you have not previously received at CSI Torrance.