Cosmetic Dermatology



Our skin changes as we age naturally in addition to how we take care of it. We know that depending on our genetics and amount of sun exposure, early signs of aging are fine lines , wrinkles, skin discolorations, broken blood vessels and a general sallowness of skin tone. Even with the best of sun protection, we lose adipose tissue in our face and our skin collagen and elastic tissue break down gradually. When we add years of gravity, we start to see hollowness in areas of the face, looser skin and a perceived drooping of the facial skin ( in jawline and under eyes).

It is up to us to take care of our skin with daily sun moisturizers and appropriate clothing for protection from the UV rays.
Please see Dr. Kay’s own line of skincare products which he has helped formulate for his patients’ skin protection and treatment.

Our office has the very best non-surgical treatments to reverse and correct the ravages of time, sun damage and scarring on the face. There are light and medium peels, injectable fillers to replace lost fullness, light therapies for pigment correction and laser treatments to restore  a more youthful appearance.


Chemical Peels

Chemical peeling done in the dermatologist’s office improves your skin by peeling off layers of skin and depending on the strength (depth of peel) of the peeling agent, the new skin will be smoother, less wrinkled and more even in color. The results from chemical peeling should be permanent.

Light chemical peeling – Using various types of “fruit derived” (or alpha hydroxyl acid) agents, the dermatology staff can reduce fine lines around the eyes and mouth as well as the cheek area. Sunspots, liver spots, age spots, freckles and blotchiness of the facial skin can be removed as well. This technique can be used by itself or added to another procedure, such as Botox or light laser treatments. Beta hydroxy , or Jessner’s peels, are used for slightly more sun damaged skin or darker colored skin patients. Do not be fooled by marketed other named peels, as they are only variations (essentially the same) as the ones just mentioned.

Medium chemical peeling – These chemical peels usually involve different strengths of Trichloroacetic acid applied to the skin. Many Dermatologists still use variations of this peel instead of laser treatments for deeper wrinkles, sagging skin and more difficult pigmentation problems.The physicians themselves usually perform these peels as these peels are more aggressive and require much expertise.

Deep chemical peeling – This technique is not used much these days in the US due to the availability of many types of resurfacing lasers. However, in experienced Dermatologists’ hands, these peeling techniques can erase deep lines around the mouth and cheeks and tighten facial skin.

After a chemical peel there may be a mild to severe sunburn like reaction. Light peels usually just make the skin red for a couple of days and might cause faint peeling of the skin for a few days. Medium and deep peels can cause swelling and blisters and healing can take 7-10 days but the results are more dramatic and long lasting.





Spider and varicose veins of the legs, hands  and even the face can be removed or reduced safely and painlessly with injecting Ethoxysclerol using a very tiny needle. Dermatologists around the world have been the developers and experts in all aspects of varicose vein treatments for over 100 years. The solution injected irritates the inside of the small vein causing it to gradually be removed by the body (it usually takes a few weeks to see the results) and it may take a few treatments depending on the size of the vein treated. Side effects are usually minimal and temporary.
Spider and varicose veins can also be treated with laser therapy without anesthesia. Different lasers are used to treat veins and the Dermatologist will recommend which one to use based on size of the veins and color of the skin ( see below for laser treatments of blood vessels).
When dealing with very large varicose veins, a mini-surgical procedure called Ambulatory Phlebotomy is often used. Developed by a Dermatologist in Europe, small segments of the varicose vein are removed under local anesthesia and healing occurs over a few weeks while wearing firm pressure socks or stockings. Minimal to no scarring is seen after this procedure. For even larger varicose veins , referral for endovenous laser treatment might be recommended.



Latisse is a proven eyelash lengthening medication sold in Dermatologist’s offices which needs medical supervision. Be careful with non-physicians dispensing this product.


Skin Enhancement Lasers

The first skin laser was developed by a physician, Dr. Goldman, many years ago and in the last 30-40 years, Dermatologist researchers have invented a myriad of ways to improve the appearance of skin with laser technology. It can be very confusing for the non-physician and even the non-Dermatologist physician to discuss which laser is best for which problem of the skin as there are dozens of different names for lasers that do the same thing. It is much easier to identify the problem a person is having with their skin and to then recommend the correct type of laser for that problem.

Vascular Lasers

These are used mostly for reddish birthmarks, reddish scars, rosacea redness and warts. Many other uses have been developed over the years as well.

VBeam Laser 

Intense Pulsed Light Device

Sometimes used in conjunction with, or instead of, the VBeam laser 

Pigmented Lesions and Tattoos

These lasers penetrated deep enough to reach tattoo ink and brown discoloration in the skin.

Vbeam and IPL Devices can also be used to remove brown pigmented skin lesions in addition to the reddish skin mentioned above.
Tattoo lasers can also be used to remove brown skin pigmentation in addition to the tattoo metallic ink.
Removing Tattoos with Alexandrite, Yag or Ruby Lasers.

Laser Hair Removal

Laser hair removal was first discovered in patients undergoing tattoo removal. The same types of lasers still used for tattoo removal , but modified, are used for effective and often painless hair removal ( Alexandrite  and Yag lasers). In certain patients with darker skin, it is important to use longer wavelength lasers such as Diode and Yag. With laser hair removal it is very important to remember that no two lasers are the same for everyone’s skin type.


Skin Tightening and Overall Rejuvenation Laser Treatments

Over the last 20 years there have been many attempts to safely and effectively reverse the sign of sun damage and aging  of our skin ( thinning skin, discolored skin, broken blood vessels and wrinkling) using laser technology. In 1994, the carbon dioxide laser was made safer for the face by pulsing the beam and thousands of people all over the world had their wrinkles removed with this pulsed CO2 laser technology. Unfortunately, the healing time could be many weeks and the laser was not safe when used below the neck on skin.
Today we have light , medium and strong skin rejuvenating lasers which are safe to use anywhere on the skin and the healing time can be chosen by the patient. it may take a few more laser treatments with a lighter laser to reach the same result as one treatment with the stronger laser but, now, one could fit the treatments into one’s schedule more easily. The treatments below are in increasing strength and effectiveness in correcting these skin problems.

Matrix RF Laser
Matrix IRT Laser
Triniti Laser Treatment
Fraxel Laser
Fractional CO2 laser



Needling is a relatively new skin rejuvenation technique used for acne scars, wrinkles and sun damage. Originally invented by one of our cosmetic surgical colleagues as a large metal pin roller for the skin, there are now many smaller and more easily used devices. Essentially, this technique damage the dermal skin with hundreds of tiny pin pricks to a certain depth and in the healing process, the collagen remodels some and you see smoother and less scarred skin. Using numbing cream before the procedure and a cooling device during the procedure, this method is very comfortable. Results are seen gradually but are permanent. A series of treatments are needed with this technique but the healing time is very fast, as the surface of the skin is almost untouched.

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