Skin treatments

Binds retinoic-acid receptors to regulate keratinocyte turnover and calm inflammation, preventing the microcomedones that start acne. Effects build over 8-12 weeks; an initial purge and dryness are common.

Sessions: Apply a pea-sized amount to clean, dry skin once daily at night; always pair with moisturizer and daily SPF.

Adapalene 0.1% is an FDA OTC monograph drug (US) and available without prescription in Canada; higher strengths and fixed-dose combinations (e.g., with benzoyl peroxide) remain prescription. Avoid in pregnancy.

Binds retinoic-acid receptors directly (no conversion needed) to accelerate skin-cell turnover, normalize follicular keratinization, calm inflammation, and — over months — stimulate dermal collagen. Effects build over 8-12 weeks for acne and several months for photoaging; an initial purge and 'retinization' dryness are common.

Sessions: Self-applied at home: a clinician prescribes the strength/vehicle, then you apply a pea-sized amount to clean, dry skin in the evening (often started 2-3 nights per week and increased as tolerated). Tretinoin is degraded by UV light, so it is used at night; pair with moisturizer and daily broad-spectrum SPF.

Tretinoin is a prescription topical retinoid in the US (Rx, FDA-approved) and Canada; contraindicated in pregnancy. Sold under many generic and brand names (e.g. Retin-A, Retin-A Micro, Renova, Altreno in the US; Stieva-A in Canada; Retacnyl in parts of the EU; ReTrieve in Australia/New Zealand), with brand availability varying by country. Available via a clinician where prescribable in your region.

Selectively activates RAR-gamma — the dominant retinoic-acid receptor in skin — to normalize follicular keratinization and reduce inflammation, with large surface-area use validated for the trunk.

Sessions: Self-applied at home: a clinician prescribes it, then you apply a thin layer once daily in the evening to affected areas of the face and/or trunk; use moisturizer and daily SPF.

Trifarotene (Aklief) is an FDA-approved prescription topical retinoid (US) and prescription in Canada; contraindicated in pregnancy. Available via a clinician where prescribable in your region.

An applicator draws or rests on the target area and exposes the tissue to precisely controlled cooling. Fat cells (adipocytes) are more vulnerable to cold than surrounding skin, nerves, and muscle. The cooling induces apoptosis (programmed cell death) of fat cells without damaging overlying tissue. Over the following weeks to months, the body's lymphatic and immune systems gradually clear the dead fat cells, reducing the thickness of the fat layer in the treated area.

Sessions: Each applicator cycle takes roughly 35-60 minutes. Many areas need 1-3 sessions per area, spaced several weeks apart. Results develop gradually, with noticeable change in about 1-3 months and full results by ~2-4 months.

FDA-cleared (e.g., CoolSculpting) for non-invasive fat reduction in specific body areas; licensed in Canada. Performed by trained providers in med-spa or physician settings; medical oversight is recommended given device-related risks. The FDA and manufacturers have warned about Paradoxical Adipose Hyperplasia (PAH), a side effect in which treated fat enlarges rather than shrinks and may require liposuction to correct.

Holding the blade at roughly a 45-degree angle, the provider makes light, feathery strokes that physically scrape away the stratum corneum and fine hair. Removing this dead layer creates an immediately smoother, brighter surface and a clean canvas for products and makeup. It is purely a surface treatment — it does not stimulate dermal collagen or treat pigment, scars, or wrinkles at depth. It is often paired with a chemical peel, hydrating facial, or other treatment for enhanced product penetration.

Sessions: Typically every 3 to 4 weeks, roughly aligned with the skin's natural cell-turnover cycle. Each session takes about 20 to 45 minutes. No anesthesia is needed.

A cosmetic exfoliation procedure; not a prescription or physician-only treatment. Scope of practice for using a scalpel blade varies by US state and Canadian province, so it should be performed by a trained, licensed provider with proper sterile technique.

A hair-thin probe is slid into the natural opening of each follicle. One of three modalities is applied: galvanic (a direct current produces sodium hydroxide/lye that chemically destroys the follicle), thermolysis (high-frequency alternating current generates heat that coagulates the follicle), or blend (both combined). Destroying the follicle's regenerative cells prevents that hair from regrowing. Because each follicle is treated individually and hairs must be in the active growth (anagen) phase, multiple sessions are required to catch all follicles across growth cycles.

Sessions: Treatment is done one follicle at a time, so sessions are scheduled by area and hair density. A full course typically requires a series of regular appointments (often weekly or biweekly) over roughly 12-18+ months until clearance is achieved; small areas (e.g., upper lip, chin, eyebrows) need fewer/shorter sessions than larger areas.

The US FDA recognizes electrolysis as a permanent hair-removal method (laser is cleared only for 'permanent hair reduction'). Practitioner licensing/certification is regulated at the state level in the US and provincially in Canada; choose a licensed electrologist using sterile, single-use or autoclaved probes.

A spiral handpiece combines a chemical exfoliant (typically a mild glycolic/salicylic blend) with simultaneous vacuum suction. The suction dislodges and removes dead skin cells and pore debris while serums (hyaluronic acid, antioxidants, peptides) are vortexed onto the skin surface. Effects are largely surface-level hydration and exfoliation; there is no controlled wounding or significant dermal remodeling.

Sessions: Single session takes roughly 30-45 minutes. For maintenance, monthly sessions are commonly recommended; benefits from any single session are temporary (typically days to a few weeks).

Based on selective photothermolysis: the laser emits a specific wavelength of light preferentially absorbed by melanin in the hair shaft and follicle. Absorbed light converts to heat, damaging the follicle (especially actively growing/anagen follicles) and the bulge stem cells, which impairs or delays regrowth. Because only hairs in the active growth phase respond well at any given time, multiple sessions are needed to treat follicles as they cycle into anagen. Skin cooling and wavelength selection protect surrounding skin; longer wavelengths (Nd:YAG) reduce melanin absorption in the epidermis, making them safer for darker skin.

Sessions: Typically a series of about 6 to 8 sessions spaced roughly 4 to 8 weeks apart (closer for the face, longer for the body), followed by periodic maintenance sessions as some regrowth or finer hair may occur over time.

Laser hair removal devices are FDA-cleared (US) and Health Canada-licensed medical devices, cleared for long-term 'permanent hair reduction' rather than permanent removal (electrolysis remains the only FDA-recognized method of permanent hair removal). It is a medical device procedure: operator licensing and physician-supervision requirements vary widely by US state and Canadian province, with some jurisdictions requiring on-site or remote physician supervision. Caution is advised over tanned skin and near the eyes.

Different wavelengths penetrate to different depths and are absorbed by cellular chromophores. Red (~630-660 nm) and near-infrared (~830 nm+) light are absorbed by mitochondria (cytochrome c oxidase), boosting ATP production and stimulating fibroblast activity and collagen synthesis (photobiomodulation). Blue light (~405-420 nm) is absorbed by porphyrins produced by Cutibacterium acnes (formerly P. acnes), generating reactive oxygen species that kill the bacteria and reduce acne-causing inflammation. Unlike lasers, LED light is non-thermal and does not ablate tissue.

Sessions: Professional treatments are typically short (10-30 minutes) and most effective in a series (e.g., 1-3 times per week for several weeks), with maintenance sessions. At-home masks are used in shorter, frequent sessions per device instructions; results are gradual and require consistency.

Many LED devices (both professional and at-home) are FDA-cleared for acne treatment, wrinkles, or pain relief; at-home consumer masks are widely available without prescription. Eye protection is recommended, and proper wavelength/intensity matters. Photosensitizing medications (e.g., isotretinoin, certain antibiotics) and a few skin conditions are relative cautions; check device labeling and FDA safety communications, as some at-home masks have been recalled for thermal/eye-safety concerns.

A handpiece either sprays aluminum oxide or sodium bicarbonate crystals across the skin or passes an abrasive diamond tip over it while a vacuum suctions away crystals and exfoliated cells. By removing the stratum corneum, it stimulates cell turnover and gives a smoother, brighter surface; the mild suction may transiently boost circulation. Effects are superficial and cumulative — it does not reach the dermis, so it does not meaningfully remodel collagen or treat deep wrinkles, scars, or pigment in the deeper skin.

Sessions: Best as a series, commonly 5 to 12 sessions spaced 1 to 4 weeks apart, then maintenance monthly. Each treatment takes about 30 to 60 minutes and is often combined with a hydrating mask or serum afterward.

Considered a low-risk cosmetic procedure. Devices are regulated as FDA Class I medical devices (US); it is not a prescription or physician-restricted treatment and is widely offered by licensed estheticians.

The acid solution lowers skin pH and breaks the bonds (desmosomes) holding dead surface cells together, causing controlled exfoliation of the epidermis. Glycolic acid (an AHA) is water-soluble and works on surface tone/texture; salicylic acid (a BHA) is lipid-soluble and penetrates into oily pores, making it useful for acne. This stimulates cell turnover and a modest, superficial wound-healing response.

Sessions: Each treatment takes about 15-30 minutes. Best results typically come from a series of 4-6 sessions spaced roughly 2-4 weeks apart, with periodic maintenance.

Botulinum toxin type A blocks the release of acetylcholine at the neuromuscular junction by cleaving the SNARE protein SNAP-25. This temporarily prevents the treated muscle from contracting. When injected into specific facial muscles, it reduces the repeated movements that create dynamic wrinkles, softening their appearance. The effect is reversible: nerve terminals sprout and function returns over time, so results are temporary.

Sessions: A brief in-office injection appointment with no anesthesia required. Cosmetic results typically begin in 3 to 7 days, peak around 2 weeks, and last about 3 to 4 months (newer formulations such as Daxxify may last longer for some patients), so treatments are repeated a few times per year to maintain effect.

Botulinum toxin is an FDA-approved prescription drug (US) and a prescription product in Canada; it must be prescribed and administered by, or under the direct supervision of, a licensed medical professional. US labeling carries a boxed warning about the potential for the toxin effect to spread beyond the injection site. Cosmetic dosing of facial areas beyond specific approved indications is often off-label. Not for use during pregnancy or breastfeeding.

The 2,940 nm wavelength is strongly absorbed by water in the skin. Each pulse rapidly heats and vaporizes (ablates) micron-thin layers of epidermis and superficial dermis. Controlled removal and the limited residual thermal injury trigger wound healing, re-epithelialization, and neocollagenesis, producing smoother, more even, and tighter skin as new collagen forms over weeks to months. Fractional Er:YAG treats only a fraction of the skin surface per pass, leaving intact skin between micro-columns to speed healing.

Sessions: Fully ablative treatments are often a single session with optional touch-ups; fractional or lighter resurfacing is typically a series of 2 to 4 sessions spaced roughly 4 to 8 weeks apart, depending on depth and indication.

Er:YAG resurfacing lasers are FDA-cleared (US) and licensed by Health Canada as medical devices; this is a medical procedure that should be performed by, or under the supervision of, a qualified physician (dermatologist or plastic surgeon). Antiviral and sometimes antibiotic prophylaxis is commonly prescribed around the procedure.

The CO2 laser's 10,600 nm wavelength is strongly absorbed by water in skin cells. In fractional mode it creates an array of microscopic ablative columns (microthermal treatment zones), vaporizing tissue in those columns and delivering residual heat that contracts collagen. Sparing the intervening skin leaves reservoirs of healthy tissue that drive rapid re-epithelialization, while the wound-healing response stimulates robust new collagen and elastin over months. Treatment depth and density are tunable, trading more dramatic results against longer downtime and higher risk; conservative settings reduce — but do not eliminate — adverse events.

Sessions: Often a single aggressive session for major resurfacing, or 2 to 3 lighter sessions spaced several weeks to months apart. Performed under topical and/or local anesthesia (sometimes nerve blocks or sedation for full-face deep treatment). Antiviral and sometimes antibiotic prophylaxis is commonly prescribed around the procedure. Each session takes roughly 30 to 90 minutes.

Performed with FDA-cleared (US) / Health Canada-licensed (Canada) ablative laser devices; it is a physician-performed or physician-supervised medical procedure. Adjunctive antiviral (HSV) prophylaxis and sometimes antibiotics are prescription medications ordered by the treating physician. Provider scope of practice varies by US state and Canadian province.

Hyaluronic acid is a hydrophilic (water-attracting) molecule; cross-linked HA gel adds physical volume beneath the skin and draws in water to plump and hydrate the treated area. Placed at specific depths and tissue planes, it fills lines and folds, restores lost volume, and recontours features. The body gradually breaks the HA down over months. Because the material is reversible, the enzyme hyaluronidase can be injected to dissolve unwanted or misplaced product or to manage certain complications.

Sessions: An in-office injection session, often with topical or built-in local anesthetic (lidocaine). Results are immediate and typically last about 6 to 18 months depending on the product and area; periodic touch-up or repeat treatments maintain results.

HA dermal fillers are FDA-approved and Health Canada-licensed prescription medical devices that must be administered by, or under the supervision of, a licensed medical professional. FDA warns against unapproved needle-free 'filler pens' and against fillers for large-scale body contouring (e.g., breasts, buttocks). Tear-trough and some other uses are off-label. Not for use during pregnancy or breastfeeding.

Pulses of broadband light are absorbed by chromophores in the skin — melanin in brown spots and hemoglobin in blood vessels (selective photothermolysis). The absorbed energy heats and breaks down excess pigment, which darkens and then flakes off, and coagulates dilated vessels, which the body clears. Because IPL is polychromatic and not a true laser, it treats multiple targets in one pass but is less precise; correct filter selection and skin typing are essential to avoid burning melanin-rich skin. It does little for deep wrinkles or significant laxity.

Sessions: Usually a series of 3 to 5 sessions spaced about 3 to 4 weeks apart, with periodic maintenance (e.g., 1 to 2 times per year). Each session takes roughly 20 to 45 minutes; a cooling gel and eye shields are used.

Performed with FDA-cleared (US) / Health Canada-licensed (Canada) energy-based light devices. Not a prescription drug, but it is an energy-based procedure with burn and pigment risks; physician supervision and proper skin typing are strongly recommended. Provider scope of practice varies by US state and Canadian province.

TCA coagulates surface proteins and creates controlled chemical injury down to the papillary dermis (a visible 'frost' indicates depth). Jessner's solution (salicylic acid, lactic acid, resorcinol) is often applied first to break down the stratum corneum so the TCA penetrates more evenly. The controlled wound triggers re-epithelialization and dermal collagen remodeling, yielding firmer, more even skin.

Sessions: Usually a single treatment for a given course, with results developing over weeks; it may be repeated after several months. Procedure time is about 30-60 minutes.

Multiple tiny needle punctures create controlled micro-channels in the epidermis and dermis. The resulting micro-injuries activate the wound-healing cascade, prompting fibroblasts to lay down new collagen and elastin (neocollagenesis) and remodeling existing tissue. The micro-channels can also transiently enhance topical product penetration. Depth is adjusted to the indication.

Sessions: Each session takes about 30-60 minutes (including numbing cream). A series of 3-6 sessions spaced roughly 4-6 weeks apart is typical, with results building over months as collagen forms.

Ultra-short pulses concentrate energy into pigment particles faster than the heat can dissipate (photoacoustic/photomechanical effect), generating rapid pressure waves that fracture ink or melanin into tiny fragments. These fragments are then cleared by the body's immune cells (macrophages) and lymphatic system over the weeks following each session. Selective photothermolysis principles allow the laser to target chromophores (ink or melanin) while sparing surrounding tissue; picosecond pulse durations increase the photomechanical effect and can improve clearance of stubborn ink colors.

Sessions: Tattoo removal typically requires multiple sessions (often about 5 to 10 or more) spaced roughly 6 to 8 weeks apart, depending on ink colors, density, depth, and skin type. Benign pigmented lesions may clear in 1 to 3 sessions; melasma toning is done as a longer maintenance-style series.

Q-switched and picosecond lasers are FDA-cleared (US) and Health Canada-licensed medical devices. These are medical procedures; operator licensing and supervision requirements vary by US state and Canadian province. Treatment of pigmented lesions should include evaluation to rule out malignancy before lasering, which is a physician responsibility.

PLLA microparticles are injected into the deep dermis or subcutaneous plane. Once placed, the particles trigger a controlled, low-grade foreign-body inflammatory response. Fibroblasts respond by depositing new type I collagen around the particles. The PLLA is gradually broken down into lactic acid and metabolized to CO2 and water over roughly 9-24 months, while the newly formed collagen provides progressive, longer-lasting volume and firmness. Results build slowly and are not immediate.

Sessions: Typically a series of 2-3 sessions spaced about 4-6 weeks apart. Visible collagen-driven improvement develops over 6-12 weeks, with results lasting up to ~2 years. Diligent post-injection massage (commonly the '5-5-5' rule: 5 minutes, 5 times a day, for 5 days) is often advised to reduce nodule risk.

FDA-approved (Sculptra Aesthetic) for correction of nasolabial fold contour deficiencies and other facial wrinkles, and originally for HIV-associated facial lipoatrophy; authorized by Health Canada. A prescription medical device administered by a licensed, trained physician injector (or qualified supervised provider per state/provincial scope). Proper depth, dilution, and hydration/reconstitution timing are critical to reduce nodule and granuloma risk.

Blood is drawn from the patient and centrifuged to concentrate platelets into plasma. Microneedling creates thousands of controlled micro-channels in the skin, triggering the wound-healing cascade and stimulating fibroblasts to produce new collagen and elastin. PRP, rich in growth factors (e.g., PDGF, TGF-beta, VEGF), is delivered into these channels to potentially amplify the regenerative and angiogenic response, supporting tissue repair and collagen remodeling.

Sessions: Usually a series of about 3 sessions spaced roughly 4-6 weeks apart, with periodic maintenance. Collagen remodeling continues for weeks to months after the final session.

Microneedling devices are FDA-cleared as medical devices; PRP itself is not FDA-approved for cosmetic skin rejuvenation and its aesthetic use is generally off-label. Because PRP involves drawing, handling, and re-introducing blood, strict sterile technique and single-patient device/tube use are essential. Serious infection outbreaks (including HIV and hepatitis transmission) have been linked to unlicensed 'vampire facial' providers using improper blood-handling practices. Best performed by or under a licensed medical professional in a regulated, sterile setting.

Needles penetrate to a programmed depth and emit radiofrequency current from their tips, generating focused heat (roughly 40 to 70 C in target zones) in the deep dermis while largely sparing the epidermis. The combined micro-wounding and thermal coagulation trigger a wound-healing cascade that stimulates neocollagenesis, elastin production, and dermal remodeling over weeks to months. Insulated needles concentrate energy at the tip for deeper, more selective heating; this makes the technology comparatively safer for darker skin tones because it bypasses melanin-rich epidermis, though risk is not zero.

Sessions: Typically a series of 3 to 4 sessions spaced about 4 to 6 weeks apart, with maintenance every 6 to 12 months. A topical anesthetic is applied beforehand. Each session takes roughly 30 to 90 minutes including numbing.

Performed with FDA-cleared (US) / Health Canada-licensed (Canada) energy devices. Not a prescription drug, but it is an energy-based medical procedure typically requiring physician oversight; provider scope of practice varies by US state and Canadian province.

A fine needle delivers a sclerosing agent (e.g., a detergent such as polidocanol or sodium tetradecyl sulfate, or hypertonic saline) into the lumen of the targeted vein. The solution irritates and damages the inner vessel lining (endothelium), causing the vein to spasm, clot off, and become fibrotic. The collapsed vein is gradually reabsorbed by the body and blood is rerouted through healthier veins, so the treated vessel fades from view. Foam sclerotherapy (agent mixed with air/gas) is used for larger vessels to increase contact with the vein wall.

Sessions: Each session lasts about 15-45 minutes. Multiple treatments (often 2-4 sessions) several weeks apart may be needed for full clearance. Compression stockings are typically worn for days to weeks afterward, and improvement continues over several weeks to a few months.

Sclerosing agents (e.g., polidocanol/Asclera, sodium tetradecyl sulfate/Sotradecol) are FDA-approved prescription drugs administered by a physician or qualified medical provider; authorized in Canada. A medical evaluation (sometimes including ultrasound to assess underlying venous reflux) is performed first. Not recommended during pregnancy, and individuals with a history of blood clots require careful assessment.

Hydroquinone inhibits tyrosinase, the key enzyme melanocytes use to produce melanin. By blocking this step in melanin synthesis (and affecting melanocyte activity), it gradually reduces the formation of new pigment, allowing existing pigmented cells to slough off and the treated area to lighten toward surrounding skin tone. It is usually applied for a limited, defined course rather than indefinitely.

Sessions: Applied at home to the affected areas, typically once or twice daily for a limited course (commonly up to a few months, often in cycles with treatment breaks rather than continuous long-term use). Strict daily broad-spectrum sunscreen is essential because UV exposure both worsens pigment and can reduce efficacy. Periodic dermatologist follow-up is used to assess response and watch for side effects.

Prescription-supervised. Under the US CARES Act (2020), the FDA withdrew OTC hydroquinone products; prescription hydroquinone (e.g., 4%, or triple-combination creams) should be used under dermatologist supervision for a limited duration. Health Canada limits OTC concentrations and treats higher-strength products as prescription/regulated. Long-term continuous use is discouraged due to the risk of exogenous ochronosis.

Isotretinoin dramatically shrinks the sebaceous (oil) glands and reduces sebum production, normalizes the shedding of skin cells lining the follicle (reducing comedone formation), and lowers populations of acne-causing Cutibacterium acnes while reducing inflammation. By addressing all four major drivers of acne simultaneously, it can clear severe disease and frequently induces durable remission.

Sessions: Taken as daily oral capsules over a typical 4-6 month (15-20 week) course, usually dosed by body weight to reach a cumulative target dose. Requires baseline and periodic follow-up visits with lab monitoring; in the US, monthly visits, pregnancy testing for those who can become pregnant, and iPLEDGE compliance are required throughout.

FDA-approved; dispensed in the US only through the mandatory iPLEDGE REMS program, which requires prescriber/pharmacy/patient registration, two forms of contraception and regular pregnancy testing for people who can become pregnant, and monthly check-ins. Canada manages it under Health Canada-required Pregnancy Prevention Programs. Routine lipid and liver function monitoring is standard. Do not co-prescribe with tetracycline-class antibiotics or vitamin A supplements.

Tretinoin binds retinoic acid receptors in skin cells and accelerates skin-cell turnover, which unclogs and prevents follicle plugging (comedones), normalizes keratinization, and reduces inflammation in acne. For aging skin, it stimulates collagen production, increases epidermal thickness over time, promotes more even melanin distribution (fading dark spots), and smooths texture. Benefits accrue gradually over weeks to months of consistent use.

Sessions: Applied at home as a pea-sized amount to clean, dry skin, usually nightly (often started 2-3 nights per week and increased as tolerated). It is degraded by UV light, so it is used in the evening. Visible results typically take 8-12 weeks for acne and several months for anti-aging effects; follow-up with the prescriber helps titrate strength and frequency.

Prescription-only (Rx) in both the US (FDA-approved for acne and, for certain formulations, photoaging) and Canada. Topical retinoids are generally advised to be avoided during pregnancy/breastfeeding; use under physician guidance. Not the same as OTC retinol/retinaldehyde, which do not require a prescription.

Phenol produces a deep, controlled chemical burn extending into the reticular dermis, destroying damaged tissue and prompting extensive collagen and elastin remodeling during healing. The depth and the croton oil concentration determine intensity. Because phenol is systemically absorbed and can be cardiotoxic, the face is typically treated in sections over time with continuous cardiac monitoring and IV fluids.

Sessions: Generally a once-in-a-lifetime or rarely repeated procedure for a given area because of its depth; full-face treatment may be staged. The procedure and monitoring can take 1-2+ hours.

Highest-risk peel; requires physician administration, often with intraoperative cardiac monitoring and IV hydration due to phenol cardiotoxicity. Not appropriate for darker skin tones in most cases due to permanent pigment change.