Our Blog
  • Eyelid Blepharoplasty

    Eyelid blepharoplasty is a surgical procedure designed to remove excess skin or fat deposits from around the upper or lower eyelids. The procedure is often used in combination with laser resurfacing and other cosmetic procedures to improve the contour of the eye and to create a more rested, youthful appearance. Blepharoplasty may also be used to remove excess skin around the eyes that is interfering with vision.

    Who Is a Candidate for Eyelid Blepharoplasty?

    Patients undergoing blepharoplasty typically have significant sagging of the upper eyelids, pouches of fat in the upper or lower eyelids that contribute to an aged or tired appearance, or peripheral vision problems caused by excessive eyelid skin. The skill of the surgeon is essential since removing too much skin or fat tissue can lead to an overly tight, unnatural look or even make it difficult to close the eyes fully. To ensure the most natural looking results, it is important to consult an experienced Orange County surgeon and board-certified dermatologist like Dr. Tony Nakhla.

    Upper Eyelid Blepharoplasty:

    An upper eyelid blepharoplasty involves making an incision along the crease of the upper eyelid in order to excise the excess skin. The surgeon must be careful not to remove too much fat from the area in order to preserve a natural, youthful appearance.

    Lower Eyelid Blepharoplasty:

    With a lower eyelid blepharoplasty, an incision is made inside the lower eyelid or just under the lash line to allow the surgeon to remove excess skin and fatty tissue leading to unsightly bags under the eyes. A lower eyelid blepharoplasty may also be combined with a canthopexy if the eyelid needs to be tightened further.

    What to Expect:

    Upper and lower eyelid blepharoplasties are performed as outpatient procedures using local anesthesia with oral or intravenous sedation. It is normal to experience some minor bruising or swelling immediately following the surgery; however, this should resolve within approximately 10 days. A follow-up visit is normally scheduled a week following the procedure to remove the stitches. Because of the location of the incisions, there should be no visible scarring. Most patients resume their normal activities a week after the surgery.

  • Skin Cancer Removal

    Once diagnosed with skin cancer, individuals living in Orange County should contact a skin cancer specialist as soon as possible to discuss options for treating and removing the lesion. The specific removal and reconstruction techniques vary based on the location, size, and type of lesion; however, there are certain steps involved in almost every skin cancer removal surgery.

    Anesthesia:

    Regardless of the type of surgery, patients are given some form of anesthesia or sedation before the procedure to minimize pain and help them relax. The dermatological surgeon will recommend the most appropriate type of anesthesia based on the type of procedure to be performed. The most common options include intravenous sedation, a local anesthetic, or general anesthesia.

    Lesion Removal:

    If the lesion is small, localized, and well defined, a simple excision followed by closure may be sufficient to remove all of the cancerous tissue. In the case of larger lesions or lesions with poorly defined borders, skin cancer surgeon Dr. Tony Nakhla, will typically send sections of the tissue to a pathologist to determine if the margins of the sample are free of cancer cells until the procedure is repeated until there is a sample with clean margins.

    An alternative technique, called Mohs surgery allows the doctor to remove thin sections of cancerous tissue, which are then frozen and examined during the procedure to determine if the margins are clear of cancer cells. If the margins are not clear, the surgeon continues to remove thin sections of tissue until the entire sample has a clear margin. The Mohs technique has the advantage of preserving as much healthy tissue as possible and limiting the need for repeat surgeries.

    Reconstruction:

    Depending on the size of the lesion, the location, and the type of procedure used, reconstruction may be necessary to limit any scarring and disfigurement. One method is to reposition a small flap of healthy skin over the wound and securing it with sutures hidden in the natural curves and creases of the face. If the wound is particularly large, the surgeon may graft a small section of skin from elsewhere on the body over the wound.

    Surgery Risks:

    As with any surgery, skin cancer removal poses some risks, including excessive bleeding, post-surgical infection, and recurrence or spread of the cancer.

    Dr. Nakhla provides skin cancer treatment services to those living in OC and surrounding areas with offices located in Santa Ana and San Clemente. Call today to arrange for a consultation.

  • Adult Acne Symptoms and Treatment

    Acne is the most common skin problem in America. As a result, there is much information regarding acne available. However, not all of this information is accurate. Those who wish to have clearer skin should visit Calabasas dermatologist Dr. Tony Nakhla for professional treatment, instead of self help methods at home. Some people think you should let acne run its course. Dermatologists know that waiting is not always the best choice. Those who fail to seek treatment may develop dark spots and permanent scars.

    The Forms and Signs of Acne

    People often assume that acne simply means that a person has pimples on his or her face. In reality, acne can form anywhere on the body. For example, people commonly develop acne on their back, chest, upper arms and buttocks. Acne can be more than just pimples. Those who have acne can also develop blackheads, whiteheads, cysts, nodules and papules.

    Some skin conditions resemble acne but are actually different. There are different four different grades of acne. Grade 4 is the most severe. Those who have acne should seek cosmetic and medical dermatology treatment.

    Individuals with acne may struggle with self-confidence issues if they feel their acne is overwhelmingly present or visible. People tend to hide from what discomforts them. Fear not, there are cosmetic dermatological treatment options that significantly reduce the appearance of acne. The dermatologist may start by giving the patient a topical cream or by prescribing antibiotics to help reduce inflammation. The patient can also select a cosmetic treatment like laser therapy or a chemical peel.

    Who Develops Acne?

    Acne is the most common skin condition in the country. In fact, 40 to 50 million Americans develop it each year. Teenagers and young adults are the most likely to develop acne. With that said, people can develop acne at any age. For example, middle-aged women and newborn babies can also develop acne.

    What Causes Acne, and How Do Doctors Treat It?

    Acne forms when the pores on your skin get clogged through blockage. Clogged pores keep dead skin cells from rising to the surface. When dead skin cells remain trapped inside of a pore, acne develops. Sometimes, bacteria can even enter a clogged pore. When this occurs, the pore becomes inflamed. This is also how cysts and nodules occur.

    To treat acne, an adult and pediatric dermatologist starts by examining the patient’s skin. There are several options available in terms of treatment. A patient can opt for a chemical peel if the acne is predominantly on the face. There is also microdermabrasion and laser treatments. The Fractional C02 laser treats acne effectively. It works by resurfacing the skin and increasing collagen production.

    Contact OC Skin Institute to schedule a consultation if you suffer from adult acne.

  • Causes and Treatments for Leg Veins

    Varicose veins are tortuous, enlarged veins that bulge above the skin’s surface while spider veins are spindly, small veins that branch like spider webs. Both are undesirable. Both chronic venous diseases may appear blue, purple or red and feel uncomfortable, itchy or painful. People who have varicose or spider veins have a higher risk of suffering from open sores or blood clots. OC board-certified dermatologist Dr. Tony Nakhla can reduce the appearance, pain and likelihood of complications that accompany these venous conditions.

    Causes and Risk Factors for Varicose Veins

    When the venous valves that help blood travel to the heart become weak, some of the blood regresses and accumulates in the vein. In turn, the pooled blood puts pressure on the vein’s wall, which causes the vein to bulge and weaken. Those who are pregnant, sit or stand for prolonged periods or have a family history of varicose veins are more likely to suffer from varicose or spider veins. In some cases, injuries, hormonal changes and sunlight may cause spider veins.

    Self-Care Tips

    As the least invasive treatment option, self-care is designed to improve blood circulation through a series of patient-applied instructions. Self-care does not eliminate existing varicose veins. However, those who follow these tips can prevent the formation of new spider and varicose veins:

    • Avoid hot baths.
    • Exercise on a regular basis.
    • Elevate the legs.
    • Take short walks every 30 minutes when sitting for long periods.
    • Sit down every 30 minutes when standing for long periods.
    • Wear compression stockings to lessen swelling and facilitate blood flow.

    The Effective Treatment Method Known As Sclerotherapy

    Sclerotherapy is a safe cosmetic treatment that drastically reduces the appearance of small varicose veins in 3 to 4 months and spider veins in 3 to 6 weeks. A sclerotherapy treatment opens the affected vein’s walls, reducing swelling and improving circulation. During this procedure in our Orange County office, the dermatologist injects a sclerosant into the vein. Before a compression stocking is placed on the leg, the dermatologist will massage the treated area for the injected substance to dissolve. After a short observation period, the patient can recuperate at home and return to most activities the following day. Often, patients need 2 to 3 treatments to get the desired results.

    Contact OC Skin Institute today to schedule a consultation regarding how you can get rid of spider veins, varicose veins or both.

  • What to Do About Diaper Rashes

    A baby is likely to develop a diaper rash during infancy despite how carefully caregivers attend to his hygiene. Antibiotics taken by a baby or his breastfeeding mother increase the likelihood of the baby developing a diaper rash. Other risk factors include having diarrhea, sleeping in a soiled diaper and starting solid foods.

    Mild Diaper Rashes

    To prevent the occurrence of a diaper rash or treat a mild rash, caregivers should check the baby’s diaper often and always wash their hands before and after a diaper change. When changing the diaper, they should only use plain water with or without a mild cleanser. Alternatively, they may use a clean washcloth or fragrance-free, alcohol-free moist wipes. Before putting on a new diaper, caregivers should gently pat the area dry.

    Severe Diaper Rashes

    In some cases, a yeast infection, bacterial infection, allergic reaction to the diaper or seborrheic dermatitis can cause diaper rashes. When rashes are severe, the child’s dermatologist may recommend that caregivers use a squirt bottle to cleanse the area. To facilitate healing, the baby should go without a diaper as much as possible until the rash clears. If an allergic reaction is suspected, a change in diaper brand or laundry detergent is also recommended. Caregivers may use creams, powders or ointments to soothe and protect the affected area:

    Cornstarch and talc powders keep the diaper area dry; however, caregivers should avoid creating puffs of powder near the baby’s face to prevent respiratory problems from inhalation. Hydrocortisone and other over-the-counter steroid creams should only be used after speaking to a dermatologist as these creams may aggravate the affected area. Ointments that contain petroleum jelly or zinc oxide can provide the infant relief and create a protective barrier.

    Certain signs and symptoms require a visit to a board-certified Orange County dermatologist like Dr. Tony Nakhla. If the rash worsens or does not improve in 3 days, caregivers should call a dermatologist. These are other signs that doctor-intervention is necessary:

    • Crusty patches.
    • Fever.
    • Lethargy.
    • Lesions or white scales.
    • Pustules or crusty patches.
    • Small red pimples.
    • Redness in skin folds.
  • Types of Rashes

    Many people believe that all rashes are the same, so they tend to treat them with hydrocortisone cream or oral antihistamines. However, a dermatologist knows that rashes differ in terms of clinical manifestation. Some rashes are concentrated in one area while others occur on all parts of the body. There are rashes that disappear after a period of time and others that linger. In addition, rashes may emerge as blisters, blotches or welts, and they may feel dry, itchy or scaly.

    While rashes are usually not a serious health threat, they may be signs of an underlying medical condition. Those who have certain symptoms accompanying their rash should either visit the emergency room or a board-certified OC dermatologist. These are some different types of rashes and their possible causes:

    • A blistered rash with or without open sores may be an allergic reaction, medication allergy or internal disease; immediate medical attention is needed if the blistered rash is located around the eyes, mouth or genitals.
    • A painful rash necessitates a visit to the dermatologist.
    • A rash and a fever could be caused by an allergic reaction, shingles, mononucleosis, measles or streptococcal bacteria.
    • A sudden, rapidly spreading rash may be due to a medication allergy, which is a potentially life-threatening emergency.
    • A widespread rash can be an indication of an allergic reaction or infection.
    • An itchy rash may become infected when the sufferer scratches it; common signs of an infected rash are a red streak near the site of the rash as well as crusting, pain, green or yellow fluid and warmth.

    There are multiple forms of rashes including blistered, painful, sudden and itchy, each of which have varying signs and symptoms. Rashes may take up to several weeks to heal, depending on the issue that causes them. In order to receive the proper skin treatment for a rash, patients should schedule an appointment with board-certified dermatologist Dr. Tony Nakhla who can diagnose and treat such rashes.

  • Global Facial Rejuvenation & Smile Correction with Botox and Fillers

    From male smile correction to lower eyelid rejuvenation, the proof is in the pudding. Botox and fillers have been effective cosmetic treatments for our patients at Orange County Skin Institute. We specialize in lower face rejuvenation, eye rejuvenation and global facial rejuvenation as well.

    Case studies and before and after photographs demonstrate how exactly cosmetic improvements are made. Specifically, Dr. Tony Nakhla and our team perform each procedure with the utmost diligence and care. Fillers and botox can be applied to various areas of the face, whether it is below the eyes or around the lips and other areas of the face, there is a proper technique implemented. From the selection of the filler to the amount of units necessary, there is sophistication and judgment in the skill and expertise of our prestigious board-certified dermatologists.

    For instance, the first Case Study demonstrates a female patient who opted for global facial rejuvenation. This patient had Juvederm applied for her lower eyelid tear troughs. Radiesse was applied for bilateral cheek enhancement. Juvederm was applied for marionette lines, smile lines and lip rejuvenation. Botox was applied for frown lines, crow’s feet and forehead lines.

    For every patient, there is a correct method depending on the desired goal and treatment area. With the help of our trained professionals, OC Skin Institute is at your servive for all your cosmetic needs.

  • A Patient’s Guide to Fractional CO2 Laser Treatments

    Fractional carbon dioxide lasers go beyond the abilities of other laser treatments to improve the skin’s texture. Dermatologists in Orange County utilize this technology because it emits longer wavelengths, allowing it to penetrate deep into the skin. In turn, the light scatters into small shafts and replace damaged skin with new skin. The heat produced by fractional CO2 lasers also shrinks collagen, which tightens the skin.

    Candidates for Fractional CO2 Laser Treatments

    Ideal candidates for fractional CO2 laser treatments are patients who range in age from 40 years old to 70 years old. This technology is well-suited for to treat those who have moderate or deep wrinkles, significant sun damage, severe acne, blotchy skin and scars on the arms, chest, legs and neck. Fractional CO2 lasers can even safely treat damage to darker skin. Those who have precancerous growths or lines around the mouth and eyes also benefit from this type of laser therapy. A board-certified dermatologist like Dr. Tony Nakhla can improve most of these conditions in one or two rounds of treatment.

    People who take certain anticoagulants, chemotherapy, isotretinoin and certain photosensitizing medications should not receive fractional CO2 resurfacing. Additionally, patients who have a history of scarring, healing difficulties or bleeding disorders are not good candidates for this type of laser therapy. Pregnant women should not receive fractional CO2 treatments.

    Recovery and Downtime

    Patients may feel like the affected skin is sunburned the first day after a fractional CO2 treatment. For two to seven days, the skin will peel. Afterward, the pinkness of the skin will last from three to six weeks, but patients can mask this sign of healing with makeup one week after treatment. In the rare event that bruising occurs, the bruises will fade in two weeks. Patients who receive fractional CO2 treatment on the eyelids should expect to have redness and swelling from two to four days. The total recovery time for facial, neck and chest treatments lasts up to four weeks. The arms and legs may take longer to heal.

    Results From Fractional CO2 Treatments

    Although some improvement is immediately noticeable, patients will experience the full results anywhere from three to six months. During the first six weeks, the skin will appear smoother. After the pinkness subsides, patients’ skin will have fewer lines and a healthy glow. Those who are vigilant about wearing sunscreen and taking care of their general health can expect these results to last for several years.

  • IPL Photorejuvenation – A Guide for Patients

    IPL photorejuvenation emits a concentrated pulsed light from a laser device to fragment melanin and hemoglobin. The body absorbs the broken pigment and vessels, making them less noticeable. IPL laser treatments are effective at lightening sun spots and brown blotches, enhancing skin texture, reducing pore size and decreasing skin oiliness. In addition, IPL photorejuvenation can minimize the appearance of rosacea, skin redness, wrinkles and dilated blood vessels. This technology even facilitates collagen growth by heating the body’s fibroblast cells, which are responsible for collagen production.

    The IPL Photorejuvenation Procedure

    A board-certified dermatologist at OC Skin Institute, Dr. Tony Nakhla, can provide an in-office IPL photorejuvenation treatment. During the intense pulsed light laser procedure, the patient is given a special cover to protect the eyes. Next, the dermatologist applies a cool gel on the patient’s affected skin. Finally, light pulses are directed toward the skin from a hand-held device that the dermatologist carefully places on the targeted area. Some patients may feel a mild sting.

    Afterward, the area is cleaned, and the patient is given a sunscreen-infused moisturizer. If mild swelling occurs, the patient can apply a cold compress for 10 minutes. The entire treatment can take as little as 30 minutes. Photorejuvenation is an excellent option for many people; however, pregnant patients should avoid this treatment due to the lack of testing on gestating women.

    Additional Treatments

    IPL photorejuvenation typically requires three to five treatments, which are given at approximately one-month intervals. The total number of treatments depends on the severity of the patient’s condition. Patients can expect to see improvement after each treatment. Those who properly care for their skin often only need one maintenance treatment every year. However, two treatments per year may be necessary for people who want to control redness or retain collagen growth.

    The Recovery Period

    Minor swelling, skin redness and brown-spot darkening commonly occur after a patient’s first treatment. These issues usually subside anywhere from a few hours to one week. Slight bruising is another side effect; however, this symptom is rare, and it usually takes up to two weeks for the bruises to disappear. Patients who have sun spots may notice crusting, which can last a little over one week. If desired, patients can carefully apply makeup to cover the signs of healing. It is crucial for patients to habitually use sunscreen and wear protective clothing in order to maintain their treatment results.

  • The Causes and Treatment for Wrinkles

    For many people, wrinkles are a serious skin concern. In order to effectively treat wrinkles, it is important for patients to know the causes of wrinkles. There are four main facilitators of wrinkles. Regular long-term muscle action that occurs in the same area can eventually create wrinkles like vertical frown lines. Environmental damage to the epidermis is another contributor to wrinkles. Also, the loss of age-related elastin and collagen can result in wrinkles. Finally, decreased fat, muscle and bone volumes can lead to a sagging jawline.

    Cosmetic Treatments for Wrinkles

    Board-certified dermatologist and dermatologic surgeon Dr. Tony Nakhla, at OC Skin Institute will suggest a treatment plan based on the depth of the patient’s wrinkles. Resurfacing lasers or light peels are effective at addressing superficial lines. Some patients who have fine lines around the eyes may be candidates for cosmetic injectables that relax the muscles and minimize wrinkles, such as Dysport or Botox.

    Since one cause of deep folds and wrinkles is the loss of bone, muscle and fat, treatment for severe wrinkles must add volume and provide support to the area. Therefore, grooves and deep lines tend to respond better to two-part treatments that include injectables and facial fillers, which are designed to support and plump wrinkles. Facial fillers commonly used by dermatologists include Perlane, Radiesse and Sculptra.

    If sun damage also contributed to the patient’s deep wrinkles, the dermatologist may use Juvederm or Restylane to provide additional support. CO2 lasers or Fraxel lasers can be utilized as part of the patient’s treatment plan in order to enhance the epidermis’ color and texture and improve the patient’s general complexion.

    Although cosmetic injections and fillers are effective at addressing lines, wrinkles and folds, they are not able to regenerate bone, fat or muscle. These products are also unable to restore the dermis’ collagen levels. However, cosmetic injections can improve the appearance of fine lines and deep wrinkles overall without the need for surgical intervention.