Long-term Shingles: Prevent and Treat | As Seen in Glamour

Shingles can leave long-term effects on your skin, ranging from changes in the overall texture to hyperpigmentation. Using the right products and treatment practices, can decrease the amount of discoloration and patches. Dr. Alexandra Bowles thoroughly provides the best tips and tricks, as well as product recommendation to protect your skin throughout its natural healing process, featured in Glamour.

What is the typical timeline and progression of a shingles rash?

Shingles typically follows a fairly predictable progression, although it can vary somewhat from person to person. It often starts with a tingling, burning, or sensitive feeling in a specific area of the skin, usually on one side of the body. Within a few days, a red rash begins to appear, followed by clusters of small, fluid-filled blisters. These blisters can become painful and may continue to develop over several days before they eventually begin to dry out and form scabs. Over time, the scabs heal, although the skin may still appear discolored or sensitive for a period afterward. I usually think of it as moving from nerve-related symptoms to visible skin changes and then into a healing phase.

While progression is often similar, it doesn’t look exactly the same for everyone. Some people may have a milder rash, while others experience more extensive blistering or discomfort. Catching shingles early is important because starting antiviral treatment can help reduce inflammation and limit how severe the rash becomes. From a skin perspective, this can lower the risk of prolonged discoloration, scarring, and ongoing sensitivity. I usually emphasize that earlier treatment tends to lead to better overall outcomes, both for the skin and for symptom control.

What are the possible short and long-term risks from an episode of shingles?

In the short term, shingles can cause significant inflammation, redness, and discomfort in the affected area. As the skin heals, some patients may experience post-inflammatory hyperpigmentation or changes in skin tone. This is particularly seen if the rash was more severe. In some cases, there can also be textural changes or mild scarring, especially if the blisters were disrupted. One of the more well-known long-term complications is postherpetic neuralgia, which involves lingering nerve pain even after the skin has healed. I also see patients who notice ongoing sensitivity or dryness in the affected area. The degree of these changes can vary depending on how early the condition is treated and how the skin is cared for during the healing process.

Furthermore, if an individual were to get a secondary bacterial infection from a shingles rash, it could increase the risk of both scarring and long-term discoloration. When the skin barrier becomes more disrupted and inflamed, there is a greater chance of deeper skin injury. As a result, it can make post-inflammatory hyperpigmentation, hypopigmentation, or textural scarring more noticeable and difficult to treat. From a medical standpoint, bacterial infections are important because they can worsen pain, delay healing, and occasionally require antibiotics. That’s one reason why I emphasize avoiding picking or scratching the area and keeping the skin clean during healing.

What are the best practices for maintaining the health of your skin during each phase?

During the early tingling phase, the most important step is seeking medical evaluation, as antiviral treatment can help reduce the severity and duration of the outbreak. Once the rash appears, I usually recommend keeping the area clean, avoiding friction, and using gentle, non-irritating skincare. During the blister phase, it’s important not to pick or pop the lesions, as this can increase the risk of infection and scarring. As the skin begins to scab and heal, keeping the area lightly moisturized can help support the skin barrier. Sun protection is also very important once the rash has healed, since the skin can be more prone to discoloration at that stage. Overall, gentle care and avoiding unnecessary irritation are key throughout the process.

What are common, but avoidable mistakes people make dealing with long-term shingles?

One of the most common mistakes is picking or scratching the affected area, which can increase the risk of infection and scarring. I also see patients use overly harsh products or try to “treat” the rash with strong active ingredients, which can further irritate already inflamed skin. Another issue is not keeping the area clean and protected, especially if blisters are present. It’s also important to avoid excessive sun exposure during healing, as this can worsen discoloration. In general, I recommend keeping the routine simple and focused on supporting the skin rather than aggressively treating it.

Are there specific products, ingredients, or items recommended during a shingles outbreak?

I usually recommend focusing on gentle, soothing products that support the skin barrier during an outbreak. A simple, fragrance-free moisturizer can be very helpful, especially as the skin begins to dry out or scab. For example, I often suggest something like CeraVe Moisturizing Cream because it contains ceramides and hydrating ingredients that help maintain the skin barrier without adding unnecessary irritation. For cleansing, I recommend using a very gentle, non-stripping cleanser that won’t disrupt the skin while it’s healing. A product like Vanicream Gentle Facial Cleanser is a good option because it effectively removes debris on sensitive or inflamed skin. Adding on, it can be used on both the face and body due to its mild and non-irritating composition. For larger body areas, I recommend gentle fragrance-free body washes such as Dove Sensitive Skin Body Wash or Vanicream Body Wash.

In addition to basic skincare, cool compresses can help relieve discomfort during more active stages of the rash. I also recommend avoiding strong active ingredients such as exfoliants or retinoids until the skin has fully recovered. The goal is to keep the routine simple and supportive while the skin heals. The recommendations to avoid harsh active ingredients such as retinoids, exfoliating acids, or scrubs apply specifically to the area affected by shingles. If someone has shingles on their back, for example, there is generally no reason they cannot continue using their normal skincare routine on unaffected areas like the face, assuming the skin there is otherwise healthy and tolerating those products well.

What advice is there for individuals with more melanated or fair skin?

While shingles is often described as causing a “red” rash, the appearance can vary significantly depending on skin tone. In lighter skin tones, the rash may appear bright red or pink, while in deeper skin tones it can look more violaceous, grayish, dark brown, or subtly inflamed rather than obviously red. That variation is important because shingles can sometimes be more difficult to recognize early in more melanated skin if people are only expecting a classic bright red appearance.

For individuals with more melanated skin, I pay particular attention to the risk of post-inflammatory hyperpigmentation, which can persist after the rash has healed. I usually emphasize strict sun protection and gentle skincare to help minimize long-term discoloration. For those with very fair skin, redness and irritation may be more visible, and the skin can be more prone to sensitivity during healing. In both cases, avoiding picking, minimizing irritation, and supporting the skin barrier are key. I also remind patients that healing can take time, and gradual improvement is expected. Tailoring care to the individual’s skin type can help improve overall outcomes.

How do you deal specifically with the hyper- and hypo- pigmentation from long-term shingles?

Hypopigmentation after shingles is often related to inflammation disrupting normal pigment production during healing. In many cases, some repigmentation can gradually occur over time, although it may take several months. I usually recommend focusing on gentle skincare, avoiding additional irritation, and maintaining good sun protection while the skin recovers. If pigment changes are persistent, it’s reasonable to see a dermatologist. There you can discuss whether treatments such as topical anti-inflammatory medications, light-based therapies, or other targeted approaches may be appropriate.

Additionally, SPF is especially important to minimize and prevent worsening of post-inflammatory hyperpigmentation. It can also be helpful towards the overall healing process. UV exposure can make uneven pigmentation more noticeable in general. While sunscreen will not directly “fix” hypopigmentation, reduced sun exposure can help decrease contrast between lighter and surrounding skin of long-term shingles.

What type of scarring appears during healing, and how do you treat them?

The most common changes I see after shingles are post-inflammatory pigmentation changes and mild textural irregularities.. Some patients can develop shallow atrophic scarring if the inflammation was deeper, the lesions were picked at, or became secondarily infected. In certain cases, especially with prolonged inflammation, there can also be persistent discoloration or areas of altered skin texture.

Many of the same recommendations mentioned above are important for minimizing scarring. More specifically, avoiding picking, minimizing friction, gentle moisturizers, and protecting the area from sun exposure. Sunscreen is especially helpful for reducing worsening pigmentation changes associated with scars and helping scars heal with less noticeable discoloration. It is particularly important for post-inflammatory hyperpigmentation, although it will not necessarily change scar texture itself. Preventing additional inflammation during healing is one of the biggest factors in reducing more noticeable scarring overall.

What are in-office treatments for stubborn discoloration and scars?

Treatment really depends on whether the primary issue is pigmentation, redness, or textural scarring, as well as the patient’s skin tone and sensitivity. For persistent hyperpigmentation, I may consider topical lightening agents, chemical peels, or certain lasers. However, caution is important in more melanated skin tones because aggressive treatments can worsen pigmentation. For redness, vascular lasers may sometimes help. For textural scarring, treatments such as microneedling, fractional laser resurfacing, or radiofrequency-based procedures can sometimes improve skin texture over time. I usually recommend a personalized approach because the safest and most effective treatment can vary significantly. This depends on the patient’s skin type, healing pattern, and the severity of the residual changes.

What are signals that the skin barrier is healed?

In general, I consider the skin barrier more fully healed once there are no longer any open lesions, crusting, active blisters, or significant tenderness in the area. The skin should feel more intact and less reactive overall. If the area is still stinging easily, irritated with simple products, or showing active inflammation, I usually recommend continuing a gentle, barrier-focused approach.

The Evolution of Botox: Science, Safety, and Staying Power | As Seen in Cincinnati Magazine

Jessica Watkins, PA-C, shares how the world’s most popular cosmetic treatment, Botox, was discovered by accident, and why it has continued to be a provider and patient favorite over two decades later, featured in Cincinnati Magazine.

How was it discovered?

The history is quite interesting. The effects of botulinum were first noted in the late 1800s by a German scientist after a small outbreak of foodborne illness. While noting that the poison in high enough doses can prove fatal via its weakening actions on the nervous system, Dr. Justinus Kerner also recognized its paradox. Perhaps there exists a therapeutic potential for treating muscle hyperactivity. Over the years, scientists eventually isolated the causative bacterial strains, Clostridium botulinum. They learned to purify the toxin produced by the bacteria so that it could be more closely studied. By the 1970s, the toxin was first used in humans during experimental treatments for eye muscle disorders.

The results were amazing. Using just a tiny amount, the target muscle was affected with good duration and no adverse side effects. By 1989, the FDA possessed enough data from 240 investigators to approve Botox for blepharospasm (eye twitching) and strabismus (crossed eyes).

How did it become a cosmetic treatment?

Dr. Jean Carruthers, an ophthalmologist using Botox on her blepharospasm patients in the early 1990s, noticed the cosmetic potential of the treatment. Her patients had (gasp!) decreased frown lines! She worked with her late husband, dermatologist Alistair Carruthers, to research the cosmetic use of Botox. By 2002, the world’s most popular cosmetic treatment was born. It is now used by over 2.5 million people per year and has remained the top non-surgical treatment for over two decades.

What can Botox treat?

Botox Cosmetic has four FDA-approved treatment areas: Glabellar (frown) lines, crow’s feet, forehead lines, and the latest indication, jawline and neck lines. There are also 12 medical FDA-approved indications that help people every day for debilitating conditions. This includes chronic migraines, excessive sweating, severe muscle spasms, and urinary incontinence. Now that we have robust clinical research, data, safety, and clinical experience in the real world, health care professionals across many cosmetic and medical specialties use Botox for a myriad of other “off-label” uses. I regularly treat the chin, D.A.O., bunny lines, masseter, lips, and gummy smile.

What trends do you anticipate in the future?

As a cosmetic dermatology PA who has been treating patients with Botox for 10+ years, I can say without a doubt that Botox is here to stay. Researchers have described Botox Cosmetic in more than 792 peer-reviewed articles in scientific and medical journals. This puts it in a league of its own, especially compared to other cosmetic treatments. With Botox paving the way, we have also seen an expansion of the toxin market. Other competing brands include Dysport, Daxxify, Xeomin, and more.

A typical appointment by an expert injector takes less than 10 minutes, has no downtime, and produces rapid, natural-looking results. It’s no wonder that neurotoxin patients are repeat customers regardless of age demographic. Pairing that with ever-expanding medical uses, the Botox demand will certainly continue on its meteoric rise! A new fast-acting Botox is even on the horizon and will hopefully make its appearance in late 2026. Jawline and neck Botox has boomed since its 2024 FDA approval and will only continue to grow in popularity. Botox is also increasingly being used as part of other treatments. For example, mixing with hyaluronic acid serums in AquaGold facials. Using concentrated Botox injected into post-surgical scars has interesting utility. I think we will be seeing more of this in the future.

Is Filler In or Out for 2026? | As Seen in Cincinnati Magazine

It’s no secret that there’s a lot of negative coverage of cosmetic filler treatments in the media. Dr. Alexandra Bowles, shares her perspective in Cincinnati Magazine, on the growing concerns around dermal fillers and what to consider if you’re thinking about getting treated.

If you’ve been scrolling through social media lately, you’ve probably noticed a shift in how people talk about fillers. What was once celebrated as the go-to anti-aging treatment now comes with a side of skepticism. That being said, it’s still one of the most popular cosmetic treatments. One that I perform and recommend to my patients daily! These are some of the most common concerns my patients bring up, and the advice I share so that they can make an informed decision.

Overfilled Features:

Looking overly plump or overfilled is a natural and common fear, and, to be fair, it’s probably the number one reason my patients are second-guessing getting filler altogether. However, it is important to note that when this happens, an inexperienced injector has usually placed the product in the wrong area or used the wrong technique. The goal of filler should never be to change your face. Rather, it’s a helpful tool to enhance your natural features and restore volume that you’ve lost over time.

Looking Unnatural:

Some of my patients come in concerned that they won’t look like themselves. I understand this, especially if they’ve had a friend or family member with this experience. But not all injectors are created equal. Filler requires an in-depth understanding of facial anatomy, an artistic eye, and years of experience to get it right. It is important to listen to your patient and consider their individual characteristics and not use a “one size fits all” approach.

Migration:

One of the hottest topics right now is filler migration. The idea that filler can move from where it was originally placed and end up somewhere else. While migration can happen, skilled injectors rarely see it when they perform the procedure correctly. Migration typically occurs when an injector uses too much product, places it in the wrong plane, or selects the wrong type of filler for a specific area. The right technique and appropriate product selection keep your filler exactly where it’s supposed to stay.

Your Guide to Filler Success

Find a Qualified, Experienced Injector:

This is a non-negotiable. Your injector should be a board-certified dermatologist, plastic surgeon, or highly trained medical professional with extensive experience in facial aesthetics. Don’t be swayed by cheap deals or convenience. Your face deserves an expert. Ask about their training, how long they’ve been injecting, and request before-and-after photos of their work. Look for results that appear natural and balanced, not overfilled or dramatic.

Ask For a Full-Face Assessment:

Cookie-cutter approaches don’t work when it comes to your face. A great injector will take time to understand your concerns, assess your facial structure, and create a personalized plan that enhances your unique features.

It’s OK To Start Small:

If you’re concerned, ask to start with less. I always start conservatively, because it’s much easier to add more filler later than to correct an overfilled result. I’d rather see you back in a few weeks for a touch-up than have you leave with too much product. That being said, a treatment may require multiple syringes of product. This may depend on the area we are treating.

Communicate Your Goals:

Be honest with your injector about what you want—and what you don’t want. I love when my patients share photos with me and are honest about their goals as well as concerns.

Trust the Process (and the Timeline):

Great results don’t always happen in one session. Building volume gradually over time often leads to the most natural-looking outcomes. Be patient with the process. Trust your provider’s expertise on how to best use filler to give you the most natural results.

Other Options:

If you are still wary of filler treatments, consider PRF Ez Gel, which uses your own platelet-rich plasma as an alternative to traditional filler. Although results may be more subtle and won’t last as long, it’s a nice option as well.

The Bottom Line

Concerns around filler are real, but that doesn’t mean filler is the problem. It’s how it’s being used and who is injecting it. When placed thoughtfully by a skilled injector who understands facial anatomy and prioritizes natural results, dermal fillers can be an incredible tool for looking like the best version of yourself. My goal is always for my patients to feel confident and beautiful in their own skin! Filler should enhance who you are, not change you into someone else.

To learn more about filler or book a cosmetic consultation.

A Guide to Final Touches After Taking a Weight Loss Medication | As Seen in Cincinnati Magazine

There are many people in the United States and overseas who have recently experienced significant weight loss. If you are using one of these medications, you may experience unexpected changes to your face and body as the pounds come off. Board-certified dermatologist and anti-aging expert Dr. Mona S. Foad shares how to address and prevent some of the most common skin and body concerns that people face while on these medications, and how to feel more confident in your new body.

Restoring Facial Volume

People don’t expect to lose fat in their face when they start losing weight. While seeing that number on the scale go down is exciting, facial volume loss can actually make you look older. Sometimes, up to five years older than you are. When fat or muscle disappears from your face, you might notice new lines and wrinkles, a hollowed-out look around your cheeks or temples. Also, skin can appear looser than before. The good news? There are several ways to restore that youthful fullness.

Dr. Mona’s Recommendations:

Hyaluronic acid fillers: Help restore lost volume from fat loss with immediate results that can last up to 12-18 months.
Biostimulators: Such as Sculptra, help to build your own collagen within the skin gradually, with best results seen 3-6 months after treatment.
Platelet Rich Plasma (PRP): Harness your body’s ability to build collagen using the growth factors in your blood’s platelet-rich plasma.

Building Muscle Strength & Tone

Did you know that up to 40% of the weight you lose might actually come from muscle, not just fat? While many of us focus on the muscle loss that can occur on the body, our face can actually lose that same muscle mass, creating premature signs of aging. Muscle, in addition to fat, is an important support structure for the skin. The first line of defense? Healthy lifestyle changes like eating more lean protein and incorporating strength training into your routine. But if you’re experiencing weakened muscle function or want an extra boost, electromagnetic stimulation treatments can help restore lost muscle on both the face and body.

Dr. Mona’s Recommendations:

EmFace: Consider muscle stimulation for the face. EmFace uses HIFES (high-frequency electrical stimulation) technology paired with radiofrequency energy to tighten skin and noninvasively improve muscle tone on the forehead, eyes, cheek, and submentum to build back that lost support with no downtime.
EmSculpt Neo: While EmFace focuses on the face, EmSculpt Neo targets muscle on the body to build back lost muscle and burn fat on the abdomen, flanks, buttocks, thighs, biceps, triceps, and calves with no downtime.

Improving Skin Quality

Significant weight loss can change how your skin looks and feels. That’s because losing weight doesn’t just affect fat—it also impacts the essential building blocks that keep skin looking youthful, like elastin, collagen, and other key nutrients. You might notice your skin looking saggy, dull, or less firm than it used to. The good news is that there are plenty of options to visibly tighten, smooth, and enhance your skin’s appearance.

Dr. Mona’s Recommendations:

Skincare: Growth Factors and peptides (such as TNS Advanced+ Serum) help the skin “act young” again and slow down aging. Adding a retinoid, such as Retin-A (tretinoin), or a retinol for more sensitive skin, can improve cellular turnover and increase skin radiance. Consider skin care for the neck and body. Our favorites are SkinMedica’s Firm and Tone for the body and Neck Correct for the neck.
Tightening: Ultrasound and radiofrequency are great, no-downtime ways to tighten skin on and off the face. We love Sofwave ultrasound tightening, Thermage radiofrequency, and Radiofrequency microneedling.
Lasers and Lights: If you have some downtime, a laser can help improve overall skin quality and help address fine lines. We love Fraxel Dual, Halo, Erbium, and CO2 for skin resurfacing.

Tackling Stubborn Fat

You’ve done the hard work and lost the weight—but you might still notice stubborn pockets of fat that won’t budge, no matter what you do. Stubborn fat is that layer beneath your skin that’s resistant to diet and exercise. If you’re at or near your ideal weight but are still bothered by specific areas, noninvasive body contouring treatments could be the final touch you need.

Dr. Mona’s Recommendations:

Kybella: Deoxycholic acid, a substance produced by the gallbladder to break down fat, can be injected to target unwanted fullness under the chin or along the jowls. It can also be used in small pockets of stubborn fat on the body, such as bra fat.
CoolSculpting Elite: This treatment uses freezing technology, also known as cryolypolisis, to permanently destroy fat cells. CoolSculpting is a great option for targeting a focused area of stubborn fat, such as on the abdomen, thighs, bra fat, or arms.

Not sure what’s right for you? Book online or call 513.984.4800 to schedule a consultation at Mona Dermatology to discuss which products and treatments are right for you

IPL vs. BBL: Which is Right For Me?

IPL vs BBL: Which Light-Based Treatment Is Right for Your Skin?

If you’ve been exploring options for clearer, more even-toned skin, you’ve likely come across IPL and BBL. While these light-based treatments are often mentioned in the same breath, they’re not interchangeable, and understanding the difference can help you make the best choice for your skin concerns.

What Is IPL?

IPL, or Intense Pulse Light, uses broad-spectrum light energy to target common skin issues like sun damage, brown spots, redness, and uneven tone. It’s a versatile treatment that’s been around for years and has helped countless patients achieve more radiant skin.

IPL is particularly well-suited for patients dealing with mild to moderate discoloration who are looking for gradual improvement over time.

What Is BBL?

BBL, or BroadBand Light, takes light therapy to the next level. This advanced technology delivers energy more precisely and consistently than traditional IPL, allowing it to address more stubborn or deep-seated concerns.

BBL can effectively treat deeper sun damage, persistent redness, broken capillaries, and even improve overall skin texture and quality. Beyond correction, BBL is also recognized for its rejuvenating and anti-aging benefits by stimulating collagen production and supporting long-term skin health, making it a favorite among patients focused on prevention and maintenance. There is also a customization specifically to target acne. The BBL acne protocol can reduce acne-causing bacteria, calm inflammation, and improve overall skin clarity.

So Which Treatment Is Right for You?

Choosing between IPL and BBL really comes down to your specific skin goals and concerns.

IPL may be ideal if you:

Are new to laser or light-based treatments
Have mild sun spots or redness
Prefer subtle, progressive results
Are looking for ongoing maintenance treatments

BBL may be the better choice if you:

Have more significant sun damage or redness
Want faster, more noticeable results
Are focused on anti-aging and improving overall skin quality
Are committed to long-term corrective treatments

The Bottom Line

Both IPL and BBL are proven, effective treatments, there’s no one-size-fits-all answer. The right choice depends on your unique skin type, concerns, and aesthetic goals. That’s why a personalized consultation is so important. During your visit, we can assess your skin, discuss your expectations, and recommend the treatment that will deliver the best, safest results for you.

Microneedling vs Chemical Peels | As Seen in Women’s Health

Microneedling and chemical peels have become go-to treatments for patients seeking healthier, more radiant skin without the downtime of invasive procedures. Board-certified dermatologist Dr. Mona Foad explains that these treatments work by stimulating collagen production and encouraging skin cell renewal, helping improve texture, tone, and overall glow. Be sure to check out the full article in Women’s Health!

Why are treatments like microneedling and chemical peels so popular right now?

These treatments are popular because they deliver visible results with minimal downtime compared to more invasive procedures. Both microneedling and chemical peels improve skin texture, tone, and overall radiance by stimulating cell renewal and collagen production. Patients love that they can target multiple concerns such as fine lines, acne scars, pigmentation, and dullness in a natural way that helps the skin rejuvenate itself. In an age where people want healthy, glowing skin without drastic interventions, these treatments strike the perfect balance between effectiveness and recovery.

What is microneedling and how does it work? What are its main benefits?

Microneedling, also known as collagen induction therapy, uses fine sterile needles to create controlled micro-injuries in the skin. This process triggers the body’s natural healing response, which stimulates new collagen and elastin production. The result is smoother, firmer, and more youthful-looking skin. Microneedling can improve fine lines, acne scars, enlarged pores, and overall texture without significantly disrupting the surface of the skin. It is highly customizable and can be adjusted for different skin types and concerns, making it a versatile and effective treatment.

What is a chemical peel, and how does it work? What are its main benefits?

A chemical peel uses a carefully selected acid solution such as glycolic, lactic, salicylic or trichloroacetic acid to exfoliate the outer layers of the skin. The depth of the peel can vary from light to deep depending on the product used, the concentration and desired result. By removing dull or damaged skin cells, chemical peels reveal smoother, brighter, and more even-toned skin beneath. They can help fade sun damage, help acne and acne scarring, and help with unwanted superficial pigmentation while promoting healthy cell turnover. With consistent use, chemical peels can dramatically improve skin clarity and texture over time.

What are the similarities and differences between microneedling and chemical peels?

Both treatments rejuvenate the skin by encouraging new cell growth and collagen production. They target similar concerns such as fine lines, uneven tone, acne scars, and dullness. The main difference lies in their approach and how they work. Microneedling stimulates the skin from within by triggering a healing response, while chemical peels resurface the skin from the outside by removing the top layer of skin cells. Microneedling is often better for deeper textural issues, while chemical peels are ideal for surface brightness and tone. Chemical peels are better for treating brown spots and can be better at treating acne and superficial acne scarring, whereas microneedling would be better for slightly deeper scars and for overall skin rejuvenation and collagen stimulation.

What add-ons often accompany microneedling, and what benefits do these offer?

Microneedling can be enhanced with add-ons like platelet-rich plasma, exosome therapy, or targeted serums that contain growth factors or peptides. These add-ons take advantage of the microchannels created during treatment, allowing active ingredients to penetrate more deeply. Platelet-rich plasma uses the body’s own growth factors to accelerate healing and boost collagen, while exosomes and peptides can enhance cell repair and radiance. These combinations maximize results and often shorten recovery time, leaving the skin smoother and more luminous. But it is important to only add approved products and not just add anything. Certain products can cause irritation or can cause foreign body reactions under the skin.

What add-ons often accompany a chemical peel, and what benefits do these offer?

Popular add-ons for chemical peels include brightening boosters, hydrating serums, and soothing post-peel recovery masks. Some practitioners also incorporate LED light therapy to calm the skin and speed up healing. These additions help replenish moisture, reduce irritation, and enhance the peel’s brightening effects. They also make the overall experience more comfortable and help patients maintain hydration and glow as the skin renews.

Why does skin type and skin tone matter when deciding between a peel and microneedling?

Skin type and tone are key factors when deciding which treatment is most appropriate. For patients with sensitive or darker skin tones, deeper chemical peels can sometimes cause irritation or post-inflammatory hyperpigmentation.For darker skin types, consider a salicylic acid peel which may be safer than a glycolic or a TCA peels and always let patients know to avoid sun exposure and retinoid use before and right after a peel. In those cases, microneedling is often a safer choice because it does not rely on acids to achieve results. On the other hand, lighter skin types with sun damage or uneven tone may benefit more from a series of light chemical peels. The best treatment depends on the individual’s goals, skin history, and level of sensitivity.

Since both treatments increase collagen, how do they work, and how much growth can patients usually see?

Microneedling increases collagen by triggering the body’s natural wound-healing process. As the skin repairs itself, fibroblast activity increases, which leads to new collagen and elastin production. Chemical peels stimulate collagen by removing damaged surface layers and prompting the skin to regenerate. The amount of collagen production varies for each person, but studies suggest microneedling can increase collagen by up to several hundred percent over a series of treatments. Chemical peels typically provide gradual collagen stimulation that builds with consistent use. Both treatments strengthen and rejuvenate the skin over time, although microneedling will stimulate more collagen growth.

Is microneedling or a chemical peel better for skin cell renewal? Why?

Both treatments encourage cell turnover but in different ways. Chemical peels directly accelerate exfoliation by removing dead surface cells, leading to faster visible renewal. Microneedling works deeper within the skin, stimulating new cell growth over several weeks as collagen remodels. If the goal is instant brightness and smoother texture, a chemical peel provides quicker results. For more structural and long-term renewal, microneedling offers deeper benefits. Many patients use both treatments in rotation for comprehensive rejuvenation.

Is microneedling or a chemical peel better for improved texture and tone? Why?

Microneedling is excellent for improving texture because it remodels the skin from within, helping to smooth scarring, fine lines, and enlarged pores. Chemical peels are ideal for improving tone, texture, pore size, brightness, and pigmentation on the surface. The best treatment depends on whether the main concern is texture or discoloration. Combining both in a customized treatment plan often provides the most balanced results for smoother, more even skin.

How does the pain of a chemical peel compare to microneedling?

Both treatments are well tolerated, though they feel different. Microneedling typically causes a mild prickling or pressure sensation such as a strong cat’s tongue. A numbing cream is applied beforehand to minimize discomfort. Chemical peels may create a temporary tingling or stinging sensation as the acid interacts with the skin, but this usually subsides quickly. Most patients find both treatments comfortable and manageable, and any mild discomfort is short-lived compared to the long-term improvement in skin quality.

What is the downtime and recovery of microneedling vs. a chemical peel?

Recovery time depends on the intensity of the treatment. After microneedling, patients usually experience mild redness and sensitivity for one to two days, similar to a light sunburn, but can have a couple more days of redness if the depth of the microneedles is increased. Makeup can typically be applied after 48 hours. With a chemical peel, downtime varies more widely. A light peel may cause minor flaking for a few days, while a deeper peel can require about a week of recovery with visible peeling. Both treatments benefit from diligent sun protection and gentle skincare afterward to maintain results and support healing.

How are the results of both treatments maintained?

Results from both treatments last longer when paired with a consistent skincare routine and sun protection. Using daily SPF, antioxidants, and gentle exfoliating or collagen-boosting products helps extend results. Most patients start with a series of treatments and then move to maintenance sessions every few months. Hydration, a balanced diet, and regular skincare all play important roles in preserving the glow and firmness that follow either treatment.

How do you help patients decide if a peel or microneedling is right for them?

I start by assessing each patient’s skin type, main concerns, and comfort level with downtime. For patients looking to refine brightness, tone, and superficial pigmentation, a chemical peel is often the best choice. For those focused on texture, acne scars, or fine lines, microneedling tends to deliver better results. Many patients benefit from a combination of both, used at different times for complementary effects. The right choice always depends on the individual’s goals, skin condition, and how their skin responds over time.

Anti-Aging Treatments | As Seen on The Wealthy Healthy Life Podcast

With so many anti-aging options available today, it can be hard to know what really works. In a recent episode of the Wellthy Healthy Life Podcast by Nicole Johnson, our own Dr. Alexandra Bowles shares her expert perspective on treatments that can make the biggest impact, why combination therapy matters, and how patients can start building a long-term plan for healthy, youthful skin. Be sure to check out the full podcast episode!

What are some of the most effective anti-aging treatments?

The treatments I reach for most often are Botox, retinoids, platelet-rich plasma (PRP), and laser resurfacing.

Botox softens lines caused by repeated facial movements. By relaxing those muscles, it prevents deeper wrinkles from forming over time.
Retinoids are one of the most well-studied topical anti-aging options in dermatology. They improve cell turnover, boost collagen, and help smooth the skin gradually with consistent use.
PRP (platelet-rich plasma) is an exciting treatment because it uses your own natural growth factors to stimulate collagen and elastin. This makes it a great option for patients who want something regenerative.
Lasers are powerful for resurfacing — they not only smooth fine lines but also brighten skin tone and improve overall texture.

Each of these treatments works in a different way, but when you use them together, the results are much more impactful.

Why is combination therapy so effective?

No single treatment can address all of the changes we see with aging. For example, Botox is incredible for softening expression lines, but it won’t improve sun damage or skin texture. Lasers are excellent for resurfacing, but they don’t restore lost volume. Retinoids are foundational, but they take time and consistency. That’s why I often recommend layering treatments. Using Botox for movement lines, pairing it with a laser to refresh texture, and keeping retinoids in your daily routine creates a more natural, balanced outcome. It’s not about looking “different” — it’s about maintaining healthy, youthful skin over time.

How do lasers fit into anti-aging care?

Lasers are one of my favorite tools because of how versatile they are. They stimulate collagen remodeling, so the benefits continue long after the procedure. With resurfacing, we can smooth fine lines, even out texture, and brighten overall tone. One of the most popular treatments we offer is the BBL (BroadBand Light). Patients love it because it targets discoloration and sun damage while also giving the skin an overall refreshed, even look. It’s a go-to option for many people who want visible results without a lot of downtime. What makes lasers and light treatments so powerful is that patients often see improvement right away, and the results continue to build as new collagen forms. That’s what makes them such an effective long-term investment in skin health.

When should patients start thinking about anti-aging treatments?

It’s never too early to think about prevention. In your 20s, starting with something as simple as a retinoid and daily sunscreen can set the stage for healthier skin later. As you move into your 30s and 40s, I may recommend adding Botox to soften early expression lines or lasers and PRP for texture and collagen support. Everyone ages differently, so it’s really about tailoring treatments to your specific skin, your lifestyle, and your goals.

How can someone get started?

The best first step is a consultation. I work with patients to create personalized plans — whether that means beginning with skincare basics or layering in more advanced treatments. My approach is always about enhancing natural features, not changing them, so results feel subtle, effective, and confidence-boosting.

Get started on your anti-aging journey by scheduling a consultation today!

Ice Water Facials | As Seen in Glamour

Like many other beauty and wellness trends, ice water facials have become increasingly popular via social media platforms. But is dunking your face in a bowl of ice water actually effective? Listen to all the logistics and tips provided by Dr. Alexandra Bowles before you dive into this trend. Be sure to check out the full article in Glamour!

Is it safe to dunk your face in ice water?

Dunking your face in ice water can feel refreshing and invigorating, but it’s important to consider your skin type and exposure time. Sensitive or dry skin may react with redness, irritation, or temporary dryness, and prolonged exposure can be harmful. Short dips of 10–30 seconds, a few times a week, are usually enough to enjoy the experience safely. Following up with gentle hydration and sunscreen afterward helps protect your skin from environmental stressors. Keep in mind, though, that listening to your skin is key. If it feels uncomfortable, it’s best to skip it. Done thoughtfully, this practice can be a fun, refreshing addition to your self-care routine.

What are the benefits of ice water facials?

Dipping your face in ice water can energize both skin and mind. The cold helps firm the skin, tighten pores, and improve tone, leaving your complexion looking fresh and smooth. It also stimulates lymphatic flow, supporting the body’s natural detoxification processes and promoting overall skin health. On a systemic level, the brief cold exposure can increase alertness and provide a gentle stress-lowering effect by activating endorphin release. Many people find it a refreshing ritual that leaves them feeling invigorated and ready for the day.

What are the disadvantages of ice water facials?

While ice water facials can feel refreshing, they aren’t without drawbacks. For some people, the cold can strip the skin of natural oils, leading to dryness or irritation, especially in already dry or sensitive skin. Direct contact with ice, particularly for prolonged periods, can even cause frostbite, ice burns, or broken capillaries. In certain cases, extreme cold may trigger increased oil production in acne-prone skin, potentially leading to breakouts. The visible effects, like tightened pores or reduced puffiness, are also temporary and don’t replace consistent skincare practices. Individuals with conditions like rosacea, eczema, or other inflammatory skin issues may find that ice worsens their symptoms rather than improving them.

How long should you dunk your face in the ice water?

When it comes to ice water facials, shorter is better. Usually, 10 to 30 seconds is enough to get the refreshing benefits without stressing the skin. Staying in longer can increase the risk of dryness, irritation, or even frostbite, especially for sensitive skin. It’s always best to listen to your skin and stop if it feels uncomfortable.

Is there anyone who shouldn’t participate in the ice water facial trend?

Certain people should skip ice water facials altogether. Individuals with fragile capillaries or a history of broken blood vessels may notice increased redness or visible damage from the cold. Those prone to skin inflammation or flare-ups, such as in rosacea or eczema, may experience worsening symptoms. Even people with extremely sensitive skin might find the sudden temperature shift uncomfortable or stressful to the skin barrier. For anyone in these categories, it’s safer to explore gentler ways to refresh the skin rather than using ice water directly on the face. Some options can be splashing the face with cool water, using a chilled facial mist, applying a cold compress wrapped in a soft cloth, or storing hydrating gels and sheet masks in the fridge for a soothing effect. These methods provide a refreshing sensation without stressing the skin barrier or triggering inflammation.

When do you start seeing the benefits of ice water facials?

The benefits of ice water facials are usually noticeable almost immediately, though they are mostly temporary. Many people see a quick reduction in puffiness, slight tightening of the skin, and a refreshed feeling right after the first session. Over time, with occasional and consistent use, some may notice a more energized appearance or improved skin tone, but these effects aren’t long-lasting on their own. It’s important to view ice water facials as a short-term pick-me-up rather than a replacement for regular skincare. Combining them with hydration and gentle skincare routines will help maintain healthier-looking skin overall.

Liquid Microneedling: How Does it Work? | As Seen in Byrdie

Here at Mona Dermatology, we offer microneedling treatments that help stimulate collagen and elastin in the skin and reduce fine lines, wrinkles, and scarring. For those who may prefer an at-home option to maintain and boost your results, liquid microneedling could be a great option. It’s important to note, though, that at-home treatments will not create the same results as professional in-office procedures. Listen to board-certified Dr. Alexandra Bowles explain how these products work and give some helpful recommendations. Be sure to check out the full article in Byrdie!

What is liquid microneedling?

Liquid microneedling is a non-invasive skin treatment that uses microscopic, naturally derived “needles” suspended in a serum or cream to gently exfoliate and stimulate the skin. These tiny needles, often called spicules, are small enough to be applied topically but still create a mild, temporary sensation that triggers the skin’s natural repair process.

What’s the difference between liquid microneedling products and professional microneedling treatments?

Liquid microneedling products use spicules or similar microscopic structures to create very small, superficial channels in the skin. When massaged in, the spicules prompt cell turnover, boost circulation, and improve absorption of active ingredients. Professional microneedling treatments use a device with fine needles to penetrate deeper into the skin, stimulating more collagen and elastin production. In my experience, at-home liquid versions are gentler, offer more subtle results, and can be used regularly without downtime.

How do the results of these two microneedling methods differ?

Both encourage renewal and collagen production, but traditional microneedling generally produces more dramatic and longer-lasting results because it reaches deeper layers of the skin. Liquid microneedling is less intense, making it safer for at-home use and easier to incorporate into a regular routine. While you may not see the same degree of wrinkle softening or scar improvement, you can still achieve smoother texture, brighter tone, and a refreshed look with consistent use.

Who are liquid microneedling products for? Is there anyone who should avoid them?

Liquid microneedling can be a good choice for people who want to brighten a dull complexion, smooth rough patches, or boost radiance without visiting a clinic. However, it is not suitable for those with very sensitive skin, eczema, rosacea, active acne, or open wounds, as it can cause irritation. I always recommend that anyone who is pregnant, breastfeeding, or being treated for a skin condition check with their dermatologist before trying these products.

What are some of the key ingredients in liquid microneedling products?

The main ingredient is the spicules themselves, which are microscopic needle-like structures often derived from freshwater sponges or marine plants. Many formulas also include brightening agents like vitamin C or niacinamide, and hydrating ingredients like hyaluronic acid. Soothing botanicals like aloe or centella asiatica to help balance stimulation with skin-calming benefits.

How do the spicules work?

Spicules are the microscopic structures that give liquid microneedling its name and effect. They act as both a mechanical exfoliant and a delivery system for active ingredients. When massaged into the skin, they create a mild prickling sensation and lodge temporarily in the upper layers. This prompts gentle exfoliation and encourages better absorption of active ingredients. They are typically derived from freshwater sponges or marine plants and can remain in the skin for 24 to 72 hours before naturally shedding. While they can be very effective, overuse may cause redness or dryness. It’s important to follow product directions and avoid combining with other strong exfoliants on the same day.

Any other recommendations regarding liquid microneedling?

Liquid microneedling can be a valuable addition to a skincare routine, but results are gradual and build over time. For best outcomes, use the product consistently and avoid pairing it with other strong exfoliants on the same day. Be sure to protect your skin daily with sunscreen, as exfoliated skin can be more sensitive to UV exposure. It works best as part of an overall healthy skin regimen that also includes hydration, balanced nutrition, and sun protection.

Platysma Botox: New Non-Surgical Neck Rejuvenation

In a new advancement for aesthetic medicine, the FDA has approved Botox for the vertical bands connecting the jaw and neck. This area is more commonly known as the platysma bands. Announced in October 2024, this is Botox’s first approved use beyond the face, expanding its application to the neck area.

The platysma is a thin, superficial muscle that extends from the chest up to the lower face. Over time, repetitive muscle activity and aging can cause this muscle to become more prominent. This can lead to visible vertical bands on the neck and a less defined jawline.

This breakthrough allows providers to offer a non-surgical, injectable option for patients concerned about neck aging and looking for a treatment to fight the signs. “With the neck being in the top 3 areas that age you most, this is a great tool in our toolbox to continue to help with a natural, graceful aging approach,” adds Anna Lunning, CNP.

The treatment involves precise injections to the vertical bands on the neck. This temporarily relaxes the underlying muscles to reduce their appearance. Depending on the patient, the amount of units ranges from 8-16, which equates to around 4 units per band. Patients typically see improvements within two weeks, with results lasting approximately three months.

This development provides patients with more comprehensive options for addressing signs of aging. It also extends the benefits of Botox treatments beyond the face to include the neck and jawline.

If you’re ready to explore this exciting new treatment and achieve a smoother, more youthful neckline, schedule your appointment today! We’re here to help you age gracefully, from face to neck.