BOTOX® vs. Dermal Fillers: How Long Do They Last?

There are many factors that set BOTOX® and dermal fillers apart—including how they work and what they treat—but a question patients frequently ask at Ironwood Dermatology is “How long will it last?”

Keeping in mind that BOTOX® Cosmetic is for inhibiting muscle activity and that dermal fillers come in a wide variety of volume-adding formulas, it can be wise to track which effects last the shortest and longest, especially for patients who want to maintain a more youthful-looking face for the long term. Scheduling maintenance visits is easier when you have a good idea of how long your forehead will appear smooth or jawline should have extra definition.

First, BOTOX®. Tucson-area women and men regularly choose this treatment for their forehead and frown lines, as well as their crow’s feet. After a brief session with one of our injectors, you can expect three to four months of smooth skin, worry-free. After that time, the targeted muscles will start moving again, leading to visible furrows and wrinkles whenever you frown or make similar facial expressions.

Dermal fillers, on the other hand, tend to be longer lasting. Juvederm®, for example, has several gel fillers that go the distance, including Volbella (which enhances lips and smooths out vertical lip lines for up to a year), Vollure (which reduces the appearance of nasolabial folds and more for up to 18 months), and Voluma (which adds volume to the midface and lasts up to two years).

With this in mind, you may have several BOTOX® sessions between visits for dermal filler injections.

A member of the Ironwood Dermatology team can work with you to ensure your schedule is as seamless as possible, which means you can enjoy an overall youthful-looking face with no interruption to the smooth look in just one area.

To learn more about dermal fillers, BOTOX®, and more, contact the Tucson-based Ironwood Dermatology online or call 520.618.1630.

Four Ways to Rejuvenate the Skin

The saying goes that beauty is only skin deep, but it should be updated to note that many times imperfections are similarly shallow. The fine lines and clogged pores that can make a face look older are often easily addressed by simply getting rid of the skin where they are found. The dermatologists at Tucson’s Ironwood Dermatology offer numerous treatments that do just that. Here is a brief look at four of them:

Chemical Peels

Within this category alone there are several variations, but all of them work the same way: A strong, acid-based solution is applied directly to the skin and left to work for a set amount of time. The outer layer will later peel away. This accomplishes two things: It gets dead cells and debris off of the face, and it promotes natural rejuvenation.


As opposed to covering the entire face at once in a peeling solution, microdermabrasion involves buffing the dead skin cells away from top to bottom, cheek to cheek. The ultimate result is much the same, in that healthier-looking, younger skin is revealed and collagen rejuvenation is kick-started.


Similar to microdermabrasion, dermaplaning is a treatment that mechanically removes dead skin cells, but it involves manual action from a cosmetic professional. Working directly on the skin with a special tool, the dermaplaner will exfoliate to remove unwanted cells and encourage healing.

Laser Skin Resurfacing

Short pulses of energy from a specially designed laser make this a non-invasive treatment that promotes collagen production without ablating—or removing—the skin. The resulting rejuvenated collagen can improve the look of everything from fine lines to visible scars and marks.

Patients are not expected to know which of these treatments would work best for their own skin. The Ironwood Dermatology team can suggest an ideal plan after a consultation tailored to the individual. Learn more by reaching out online or calling 520.618.1630.

CoolSculpting® vs. Kybella

When choosing between Kybella® and CoolSculpting® treatments, Tucson-area men and women who want to address a double chin may find themselves wondering which option is best. Since every case is unique, the ideal treatment depends on the patient, with deciding factors that include body type, desired levels of results, and more.

That said, it can be helpful to compare the available options in order to get a better idea of what it possible.

Both CoolSculpting® and Kybella® are nonsurgical fat-reduction treatments, but the similarities pretty much end there. CoolSculpting® works by chilling unwanted fat cells so that they rupture. The process does not break the skin, but does involve suction pulling the targeted tissue between two cooling plates. Kybella®, on the other hand, works via a series of injections that introduce a modified form of a digestive chemical—deoxycholic acid—into the fat cells marked for destruction. This acid causes them to no longer be able to maintain their integrity.

At this point, the treatment begin to resemble each other again. Whether destroyed by cold or acid, the fat cells are no longer viable, which means the body works to get rid of them efficiently. In the days and weeks after a treatment, volume in the area reduces, leading to new contours.

Neither treatment requires post-treatment downtime, as neither treatment involves incisions or sutures, which need time to heal.

Perhaps the best way to determine which fat-reduction strategy is best is to schedule a consultation with a professional experienced in both options and with a range of body types. A dermatologist can assess a double chin, learn more about the patient, answer questions as necessary, and recommend the best course from there.

To learn more about CoolSculpting® and Kybella® and determine which one is right for you, contact the Tucson-based Ironwood Dermatology online or call 520.618.1630.

Stay Aware of Skin Cancer All Year Long

With Skin Cancer Awareness Month having ended months ago, the Ironwood Dermatology team wanted to be sure that this important topic doesn’t get lost amid early fall plans—especially since there’s no start or end date for skin cancer. Arizona residents are used to sunny days, so it stands to reason that they also should be used to properly applying sunscreen, but “should be” and “are” can be miles apart.

There’s no shame in admitting you need a refresher on proper sunscreen use.

Use Enough: The American Academy of Dermatology recommends using an ounce of sunscreen to cover all exposed skin. That’s a shot glass full. Obviously some people are larger and some are smaller, so the amount should be adjusted accordingly. Just know that many people use less sunscreen than is required to be effective.

Start Early: This tip has two meanings. First, you’re never too young to start wearing an age-appropriate sunscreen. One risk factor for skin cancer later in life is frequent sunburns—especially those that blister—in childhood. Develop good skincare habits young, and encourage those around you to do the same. Second, sunscreen requires a little time on the skin before it’s effective at protecting against UV rays, so apply a layer roughly 20 to 30 minutes before going outdoors.

Double Up: One layer for your day is almost certainly not enough, especially if you’re outdoors and active. Apply a new layer of sunscreen every two hours, but be prepared to slather it on sooner if your first application is washed off by the ocean or pool, or if you sweat a lot.

Don’t Skip It: Ultraviolet rays can get to you even if you aren’t exposed under a clear blue sky. Vehicular travel (riding in a car, truck, or van) is a significant source of cumulative sun exposure, and even overcast days don’t protect you from damage. Make it a rule: If you’re going outside, wear sunscreen.

Get it Everywhere: If your skin can see the sun, the sun can damage your skin. It’s easy to remember your nose and arms—or your bare back, if you’re at the beach—but don’t forget the tops of your feet, the tops of your ears, and your scalp, especially if you’ve got thin (or no) hair.

If you’re experiencing the results of a lifetime of poor sunscreen habits, don’t kick yourself. The team at Ironwood Dermatology offers skin cancer screenings, as well as treatments for a range of sun-caused medical and cosmetic problems. Find out more by calling 520.618.1630 or visit

Discover 2017’s Top Five Cosmetic Treatments

When it comes to nonsurgical cosmetic treatments, from microdermabrasion to BOTOX®, Tucson’s Ironwood Dermatology team noted with interest the recently released results of an annual report compiled by the American Society of Plastic Surgeons. Published at the start of March 2018, the report details statistics from 2017, taken from medical databases and doctor surveys. Among the many items of interest is the overarching fact that nonsurgical cosmetic treatments on the whole are growing in popularity. The entire field grew by 2 percent from 2016 to 2017, with more than 15.7 million treatments performed on men and women across the United States.

That also represents a 186-percent jump from the year 2000.

Topping the list is—as usual—BOTOX® and its fellow injectables based on botulinum toxin type A, which collectively made up almost half of the total treatments performed. With 7.2 million treatments reported, this option is unquestionably the most frequently chosen cosmetic option in the country—surgeries included.

Next on the list, with more than 2.6 million applications, is soft tissue fillers, which includes the entire Juvederm® line. There are formulas for reducing the appearance of nasolabial folds, for adding youthful roundness to the apple of the cheeks, and for subtly boosting lip contours.

Chemical peels came in third with 1.3 million applied. Though they all accomplish the same thing—removing the outermost layers of dead skin for a brighter, fresher look—they come in a variety of compounds with different strengths. This treatment also makes the skin more receptive to revitalizing serums.

Fourth is laser hair removal, a versatile treatment that can be applied virtually head to toe. Statistics show that just more than a million laser hair removals were performed in 2017, proving that bare skin made smooth without the hassle of razors or waxing remains a popular choice.

Rounding out the top five is microdermabrasion, which essentially buffs or polishes away dead skin cells in the outermost layer. Though the mechanics are different, the results are similar to a chemical peel.

Learn more about any of these treatments by reading about them on the main Ironwood Dermatology website, contacting the practice online, or calling 520.618.1630 to arrange a consultation.

Why “Targeted Fat Loss” or “Spot Reduction” Cannot Be Achieved with Diet & Exercise

The internet is rife with certain “fitness gurus” touting claims of reducing fat on the arms, thighs, or belly through various kinds of focused exercises. Unfortunately, this is not how the body functions.

While eating a nutritious diet and exercising regularly can yield significant physical and mental health benefits, and are key to maintaining a healthy weight, all they ultimately do are reduce the size of fat cells – they do not get rid of them.

As for focused exercises, the most they might do is improve muscle tone and definition in those areas to make fat look less obvious. While overall slimming down of the body is possible, it generally does not yield the extent of reduction we would like in specific areas.

This is part of what makes medical-grade, non-invasive fat reduction treatments so popular. CoolSculpting® offers Tucson, AZ, patients a pain-free alternative to surgery that is much more effective than diet or exercise at reducing fat in specific areas of the body.

The FDA-cleared device comes with a variety of applicators, each uniquely shaped and sized to accommodate almost any type of fat pocket on the body. The device cools down the area the applicator is attached to, causing fat cells to crystallize and die while leaving skin and other types of tissue in the areas unharmed.

Fat cells are much more sensitive to temperature changes, which is why they are much easier to damage with cold than other types of tissue. Once they die, the leftover matter from these cells is flushed out of the body through its natural processes.

With the right applicator, settings, and number of treatment sessions, CoolSculpting® is a quick, comfortable, and effective way to treat specific areas of fat. To learn more about the treatment, contact Ironwood Dermatology online or call 520.618.1630.

Skin Resurfacing Explained

There’s a saying that beauty is only skin deep. The Ironwood Dermatology team knows that beauty is a lot more than that, but still, there’s something to be said about rejuvenating the face by focusing on the outermost layers. By working with an experienced dermatologist, Tucson-area men and women can enjoy a refreshed, revitalized look—all by merely “scratching the surface.”

Such a cosmetic change is possible because many of the visual annoyances and problems associated with aging and looking aged—like wrinkles, spots, redness, and visible veins—can be found on the surface of the skin or just below. Skin resurfacing, via a Cynosure® Focus treatment laser, does exactly what it sounds like it does: It creates a new, younger-looking surface.

The Cynosure® Focus treatment laser work by sending pulses of specific wavelengths of light into the skin where they trigger natural healing processes. The heat energy generated by these pulses damages unwanted lesions and areas of pigmentation due to the presence of melanin, which absorbs the light more than the surrounding cells do. When laser light impacts a spider vein, for instance, the dark red in the hemoglobin “absorbs” the energy, which ultimately causes the unneeded blood vessel to seal off and wither away. Soon, what was once a visible thin, red line—or, more commonly, a web of these fine lines—is no longer seen on the face.

In addition to impacting lesions, the laser energy also encourages the rebuilding of vital skin components, like collagen and elastin. Production of these can diminish over time, so firing up cells in the skin to begin new production means that over time, after one or more treatments, the surface-level problems can fade and the nourishing benefits of replenished elements can become more noticeable.

To learn more about skin resurfacing with our Cynosure® Focus treatment laser, reach out to Ironwood Dermatology in Tucson online or phone 520.618.1630.

Not Just for Women: Men in Tucson Are Increasingly De-Wrinkling with BOTOX®

Gone is the age-old belief that men don’t care about their looks, as more and more of them smooth their scowls away and refresh their appearance. Data for the past few years have shown a significant increase in men opting to receive cosmetic procedures—and none more so than BOTOX®. The Tucson, AZ, dermatologists at Ironwood have noted this uptick in “brotox” and strive to educate men about how the injectable treatment works and what to expect from a session.

Aside from an overall confidence boost and a more youthful appearance, a fresh face from BOTOX® Cosmetic could help men bolster their chances professionally in a competitive job market, as well as romantically in the dating world.

BOTOX® Cosmetic works by treating what are known as “dynamic wrinkles” on the face—lines that are caused by the repeated contractions of facial muscles over time. If it is injected precisely and in controlled amounts to the muscles causing those contractions, the muscles weaken to soften the lines they would otherwise etch on the face.

While BOTOX® is FDA-approved to treat glabellar lines (also known as frown lines or 11s) between the eyebrows, horizontal lines across the forehead,  and crow’s feet at the outer corners of the eyes, the injectable can also be used to correct a wide variety of facial concerns, such as:

  • Vertical lip lines
  • Marionette lines
  • Drooping nasal tip during smiling

Note that if the wrinkles are “static” (meaning they are present even with the face resting), dermal fillers may be a more appropriate treatment option.

There is a myth that BOTOX® will make patients look unnatural or unexpressive. When administered by a licensed, skilled, and experienced injector, it can soften only the lines you don’t want, but leave the overall face entirely capable of a full range of expression.

Men in particular tend to prefer to leave small areas, such as crow’s feet, relatively unchanged, to preserve a look of experience and distinction. Since injecting BOTOX® is so precise—with the effects limited only to a small area—our dermatologists are able tailor treatment protocol to meet the unique concerns and goals of any patient.

To learn more about BOTOX® Cosmetic and determine if it’s right for you, contact Ironwood Dermatology online or call 520.618.1630.

ART OF HEALTHY LIVING – The Keys to Beautiful Skin

One of the most common problems my patients have is sun-damaged skin. Over the years ultraviolet radiation from the sun causes dyspigmentation (abnormal color), atrophy (thinning), and rhytids (wrinkles).

While there are many medications, products, and procedures that can help improve the appearance of sun-damaged skin, the best way to have beautiful skin is to prevent the damage from ever occurring. I know that here in Arizona it is extremely difficult to completely avoid the sun, but there are several things you can do to significantly reduce your exposure, and thereby limit the damage to your skin and the need for restorative treatment.

The first step is to minimize your outdoor activities during the peak daylight hours (11:00 a.m. to 2:00p.m. in the winter and 9:00 a.m. to 4:00p.m. in the summer). The second step is protective clothing, including long sleeves, pants, and a broad-brimmed hat, which are more effective than sunscreens since clothing can block the sun’s rays, provided the weave of the cloth is tight enough. The last layer of protection is sunscreen. Obviously, here in Arizona this is what most of us depend on for our protection against the sun since we are outside frequently during the day, and the normal attire is shorts and a short sleeved shirt.

There are a few keys to using sunscreen appropriately that I would like to emphasize. The main key is to use enough of the sunscreen. Studies have shown that most of us use approximately 25% of the recommended amount, which manufacturers use to determine SPF (sun protection factor). What this means is that even if you have a sunscreen that is SPF 65, it becomes an SPF of 2.8 when you use one quarter of the normal amount. The other key is to use sunscreen daily. If you apply sunscreen to the same area every day, the SPF factor increases significantly because the skin retains a portion of it for several days. It will also protect you during those times that you find yourself outside when you didn’t expect to be there.

If you follow these simple guidelines you can keep your skin beautiful longer, minimize the amount of restorative treatment, and reduce your risk of skin cancer.

By Dr. Colin Trout


Many people complain of dry, itchy skin that worsens in the winter. It can frequently progress to a diffuse, red, scaly rash that is so itchy that people can’t sleep at night and have difficulty focusing on their normal daily routine. The usual cause of this is xerotic dermatitis, which some people call “winter itch”. This is extremely common in southern Arizona because the climate is generally very dry and during the winter we are inside with heaters that lower the humidity even further. This causes the skin to lose moisture and results in a disruption of the normal barrier of the skin. Once this occurs, there is an inflammatory response (dermatitis) that is very itchy. Over time, with sun exposure and aging, the skin loses its ability to hold in moisture and this condition becomes even more prevalent.

The key to prevention and treatment of this condition is moisture. There are several ways to protect and replenish the barrier of the skin. The most important step is to use moisturizing creams daily. We recommend creams instead of lotions because they hold in more moisture and last longer than lotions. Some people do not like the greasy feeling of creams, but it is a small price to pay to prevent the development of xerotic dermatitis. Another helpful practice is to use soap-free cleansers in the bath or shower, because soap strips the skin of the components that create the barrier and contributes to dryness. Reducing the frequency of water exposure (baths, showers, pools, spa, etc.) and applying the moisturizing cream immediately after drying off will also help prevent flaring of this condition.

If you are disciplined about moisturizing and protecting your skin you can significantly reduce or prevent winter itch. If you have this problem and it is not controlled by the above guidelines, see your dermatologist for an evaluation. They may prescribe a topical steroid to get the condition under control in conjunction with daily moisturizers.

By Colin R. Trout, M.D.