The Sensitivity Doctors

Glowing Skin for Sensitives: Navigating Aesthetic Lasers with Dr. Abigail Waldman

Episode Summary

Dr. Abigail Waldman (FAAD, FACMS), dermatologist at Brigham and Women's Hospital in Boston & Assistant Professor at Harvard Medical School, joins the podcast. Dr. Abby is known for her informative TikTok and social media posts and talks to Jeanne today about aesthetic treatment options for sensitive skin.

Episode Notes

Dr. Abby Waldman discusses various aesthetic treatments for sensitive skin, including V-beam Perfecta, fractional laser, and BBL (broadband light). These treatments target redness, wrinkles, and hyperpigmentation.  In this conversation, Dr. Abby  highlights the need for a comprehensive approach to skincare, comparing it to health and fitness. She explains that just as a good diet and exercise can be improved with weight training or cardio, skincare can benefit from additional procedures. 




00:00 Introduction

01:58 Importance of Sun Protection

02:17 V-beam Perfecta

06:01 Pain and Downtime of V-beam Perfecta

10:20 Fractional Laser

13:46 Pain and Downtime of Fractional Laser

19:01 Microneedling vs. Laser

22:03 BBL (Broadband Light)

23:30 How BBL Works

25:39 Choosing the Right Treatment Provider

31:08 Considerations for Medications and Health Conditions

32:46 Safety of IPL/BBL

37:46 Do You Need Aesthetic Treatments?

39:06 The Basics of Skincare

40:17 Skincare Requires a Comprehensive Approach

41:12 Where to Find Dr. Abby

Episode Links

Jeanne Retief: Blog | Podcast | Instagram | FIGGI Beauty Shop

Dr. Abigail Waldman: TikTok | Instagram | YouTube | Website

Episode Transcription

Jeanne (00:09)

Okay, there we go. So welcome Dr. Abby Waldman. We're so happy to have you on the My FIGGI Life podcast. Thank you so much for being here.


Abigail Waldman (00:18)

Thank you for having me.


Jeanne (00:20)

I am so excited to talk to you about this, especially for our dry and sensitive skincare community. And the thing that I always think about in terms of being a sensitive soul is just because my skin is sensitive doesn't mean that I don't also want access to all of these beautiful tools that can.


help your skin and rejuvenate, but it's really difficult to choose the options that work best for you because you obviously also don't want to be in agony for a long period after that. So we have three kind of aesthetic treatments we want to ask you about today. And first, before we kick that off, as we understand it, it's best to kind of do these aesthetic treatments during the winter or fall months because then you're not so exposed to the sun and


that's just so much worse for your skin. And if you're already sensitive, that can just make everything so much worse. Is that the correct assumption to make?


Abigail Waldman (01:14)

Yes, absolutely. In fact, we say before getting any sort of laser or any sort of procedure that you don't get sun two weeks before and two weeks after. And that's regardless of whether you have sensitive skin or not. The reason is, is the sun stresses your skin quite a bit. You can get hyperpigmentation if you injure it with UV light during the time that it's healing. So you can get increased, you know,


rosacea or increased redness if you get sun right during that period. So that's like the critical period. Now, of course you should be protecting your skin in general from the sun, but that two weeks after, especially is like that critical time.


Jeanne (01:58)

Okay, so we're definitely doing the right thing for waiting for fall and winter months. So there are so many aesthetic treatments right now. It's so confusing to understand what each one does and which one you should be choosing. So let's talk about the V-beam Perfecta first. What is that and what does it do?


Abigail Waldman (02:14)



Yeah, so Vbeam Perfecta is the brand name, essentially, the company that makes a type of laser called pulse dye laser. So when you see Vbeam Perfecta, it's referring to a type of laser that targets redness. It's one of the oldest lasers that's been around. Since lasers have been around over the last many decades, it is one of the oldest studied lasers. It targets redness.


especially for rosacea, kind of a diffuse redness, opposed to maybe some of these big vessels you might see on your legs or even bigger vessels inside your nose. It's really good at targeting that diffuse pinkness because it goes in the dermal layer and the wavelength, all lasers have different wavelengths and they're kind of think of them as like, they just find


that area where it like kind of hones it in to the one place that it should go. And in the case of the V-beam perfecta, it's the blood vessels. And so it's great for patients who have flushing types of rosacea. I myself have flushing types of rosacea. I actually did V-beam just yesterday. I do it twice a year and you can kind of see like my face is a little puffy and red.


Jeanne (03:39)



Abigail Waldman (03:43)

today, the day after, 12 hours after. It's generally a pretty well tolerated laser, whether you have rosacea or eczema or sensitive skin, you are gonna notice a little bit of redness afterwards, maybe like a slight amount of swelling. Everyone's skin is different. Mine definitely swells a little bit. Some people don't notice any swelling whatsoever. It usually only lasts a day or two.


and kind of peters out. And you just use sensitive skincare during that time, gentle skincare, nothing with fragrance, just a really gentle moisturizer and cleanser while it's healing. And again, just no sun. You can use SPF, mineral sunscreens, just really be good about getting, even here in the winter, I'm in Boston, it's the winter, we don't have a lot of sun, but even then, I'm wearing sunscreen.


Jeanne (04:29)

No sign yet.


Yeah, so it's definitely more focused toward people that have that issue with redness. And just to understand correctly, you know those little small kind of very thin vein, reddish veins that form just like to the side of your nose, is it for that as well? Okay.


Abigail Waldman (04:56)

Yep, it can work for that as well. For the bigger ones, sometimes you need a laser that's going a little bit deeper. So if you have like a really prominent, those are called telangiectasias, a really prominent one. And the pulse dye laser, the V-beam perfecta is not working. Sometimes you need what's called an ND-YAG laser that gets a little bit deeper, get some of those sort of bigger purpler telangiectasias, those vessels. But for the most part, the V-beam perfecta, I mean, this is like,


a workhorse for dermatologists and people who do these types of procedures. It's very effective. Now you may need more than one treatment and most people do. Usually we say anywhere from like two to four upfront, usually spaced about a month apart, but they can be longer than a month apart. And often you'll need one to two kind of maintenance treatments going forward.


two times a year, just sort of as a maintenance to keep that redness from coming back.


Jeanne (06:01)

Okay, so you will definitely need to do it like four times once a month just to get, you know, if you're starting and then you need to maintain it to keep the redness kind of at bay. So does it hurt? Is it painful?


Abigail Waldman (06:09)

Mm-hmm. Exactly. Yeah. That's a really good question. It's not exactly painful. It feels, the best I can describe it, it feels like somebody snapping a rubber band in your face. So it's more alarming than anything else. You always should be wearing eye protection. I mean, whoever's doing your procedure should know to put very good eye protection, because that's pretty much the only


Jeanne (06:25)

Ha ha!


Abigail Waldman (06:39)

side effect of the laser is that it potentially can hurt your eyes if shined directly in your eyes, but usually, you know, there's set safety protocols for that. So you should be wearing these little like tight glasses to protect your eyes. That being said, sometimes you can kind of it's so alarming to have this snapping in your face and you can kind of see like a bright color halo in the periphery, but that's not hurting your eyes. So, you know,


it you should like make sure you're kind of like in a good head space and you're like breathing and then it won't be so like alarming right it's more just like surprising than anything else. Most of the time the V-Beam Perfecta uses a coolant so it doesn't feel like heat or anything because you actually have like a little bit of a cold spray that helps kind of cool it so unless you're very sensitive it generally doesn't.


Jeanne (07:14)

Yeah, yeah, yeah.




Abigail Waldman (07:33)

hurt. Now some areas are more sensitive than others. I would say the upper lip is particularly sensitive. Sometimes actually above the eyebrow, the nerve is very shallow there and that can be a little sensitive. But you know, again, it's one of these things that if you're doing your whole face, it probably takes maybe five to 10 minutes. So it's, it's not, yeah, it's quick. And if you're just doing like a few, you know, let's say you're just, you know,


Jeanne (07:54)

Oh, quick.


Abigail Waldman (08:02)

bothered by your cheeks or just the area around your nose that gets red, then we're talking a few minutes, if that. So I tell people they can go to work that day. Again, like I said, you can kind of see, especially on this side, I did it. It's like a little swollen. This side I didn't do. Exactly.


Jeanne (08:09)

Oh, wow. Okay. And what's the downtime on that? Like the recovery period?




But it's really subtle. It's not like, yeah, yeah.


Abigail Waldman (08:29)

No, it's not like you're like, whoa, and I'm not wearing any makeup or anything. So it's, you notice it. Like you're gonna look at your face and be like, that doesn't quite look normal. Exactly, like unless, you know. So I actually tell, you know, I would hold off on putting any makeup on for 24 hours, just do gentle skincare. And then after that, you can actually apply makeup. You can go to work. You really have no limitations in terms of exercise. Some doctors will limit your alcohol.


Jeanne (08:38)

Mm, but other people probably won't. Yeah.


Abigail Waldman (08:58)

afterwards just again because it can increase bruising and things like that. You know the VB imperfecta in theory has a risk of bruising most of the time based on the settings your doctor or provider uses. It's very rare to get that. You know certainly you can set it so that you'll get pretty decent bruising. The more bruising you get the better it works.


Jeanne (09:02)





Abigail Waldman (09:26)

And so sometimes like especially off the face, we'll put on bruising settings. But that's I guess the only sort of, obviously if you get a bruise, then you're gonna have to cover that for the week. But that is, that's actually pretty unusual to get a bruise when you. So, I'm gonna go ahead and do that.


Jeanne (09:39)



Okay. And any like dryness or uncomfortableness in your skin or something that you can expect afterwards? Nothing like that.


Abigail Waldman (09:51)

Sometimes for like an hour afterwards, you have like a little bit of tingling, burning, but definitely not like not pain and not anything significant like ice packs do the trick, just regular, you know, Vaseline or gentle, gentle moisturizer will relieve it. It's not, it's not like significant pain or discomfort. It's very mild.


Jeanne (10:13)

Okay. So then I think that leads me into my next question because you were saying this is a pulse dye


laser. So if we're talking about the other one, I think it's a fractional laser. What does that do? Because from what I've read and what I understand, that's a little bit more intense. Is that okay for people with sensitive skin? And why would you choose that type of laser treatment instead of this?


Abigail Waldman (10:20)







Right. So fractional laser, so there are different types of fractional laser. The ones, basically it depends on what the laser in it is and how fast you're looking for results. So the most, the lowest downtime types of fractional laser are non-ablative lasers. They usually use a type of laser called like erbium or ND-YAG, something that's not completely


like getting rid of the top layer of the skin, it goes through the top layer of the skin and then kind of targets the dermis and even a little bit deeper and helps remodel it. So it kind of, it's really good for wrinkles. It's good for texture change. Like if you had like some mild acne scars or just sort of some irregular texture, that is what fractional laser is best for. It's actually putting, it's called fractional because it's like,


it's actually putting like little tiny holes that are skipping like the laser, similar to like if you had a laser printer that's like printing out words based on how it's setting. It's similar in that it's like saying, well, we're, we're going to skip every like nanometer and put these like tiny little nano or pico holes or injuries, I should say through the skin. And that kind of triggers your body to, to like,


Jeanne (11:49)



Abigail Waldman (12:07)

turn on the machinery that it used to have on all the time when you were young and like say, hey, let's like get that collagen going again. Let's turn on some of this machinery that's gonna help reduce wrinkles and textural change. So that's what fractional laser is. Now it depends, you can have something called the nebulative fractional layer, which is usually like CO2 that actually will like


Jeanne (12:11)





Abigail Waldman (12:36)

remove, again, kind of skipping different areas, but remove that top layer of skin. It is painful. Both of them are a little painful, not to be honest, but the ablative one is much more of a commitment. So whereas the fractional laser that is non-ablative, you know, you might hear, like the most common one here is fractal, but the same, you know, FRAX Pro is the same thing.


Jeanne (12:42)

Ah, that sounds painful.


Abigail Waldman (13:06)

These are non-ablative fractional lasers and there's very little downtime. It doesn't feel great. Sometimes your doctor will use a numbing medicine or even actually like inject some numbing medicine depending on sort of the area that's being treated. And you know, oftentimes the topical medicine is applied an hour before and it doesn't completely relieve the pain, but it's going to take the edge off. I usually describe it as a bee sting.


Jeanne (13:32)



Abigail Waldman (13:34)

So it's not so bad when you start, but then right at the end, you're like, hey, you know, and so some people.


Jeanne (13:40)

Okay, okay. Right at the end, so how long does that take? How long does the streaming take?


Abigail Waldman (13:46)

So it depends on how big of an area. Again, it's like, let's say you're just doing under your eyes or around your lip, like we're talking 30 seconds to a minute. If you're doing your whole face, it's gonna be like five minutes, 10 minutes. Sometimes they'll give you like a cooling air to put on your face during the procedure to again, kind of like distract and relieve some of the like burning and the pain. But this is a much more intense procedure to go through than...


Jeanne (13:56)





Abigail Waldman (14:16)

the V-beam that we had talked about.


Jeanne (14:18)

Yes, but this is also for something different, right? The V-beam is more for the redness and this one, it sounds more like anti-aging and texture changes, right? Okay. So is it... Ah, okay.


Abigail Waldman (14:21)

It's for something different. Exactly.


Exactly, exactly. We also use it a lot for scars. We actually use both of them for scars a lot. They do different things like the fractional laser will kind of help remodel the scar, but actually the V-beam because all scars have a blood supply and so the V-beam actually is very helpful to kind of reduce the blood supply to that scar and also help with the color of a scar, because oftentimes scars will get pink, especially if you have rosacea.


Jeanne (14:47)



Abigail Waldman (14:56)

So we actually use both of these lasers all the time with surgical scars or other scars. And again, they do different things and they kind of work together to help remodel scars.


Jeanne (15:07)

Yeah. How many treatments would you need of this kind of laser?


Abigail Waldman (15:13)

So again, it depends. So if you want results really fast and you want maybe like a one and done type of thing, then it's worth doing via bladed fractional laser. Again, a lot more pain, a lot more downtime, like you're gonna look super red for a week.


Jeanne (15:28)

Can people with really sensitive skin do that? Or would you recommend that they don't?


Abigail Waldman (15:32)

I would, that's a really good question. Yes, they can, but I would, it's probably not the right thing to just like jump into. If you haven't had other laser, I would definitely start with a fractional non-ablative laser like Fraxil or FraxPro. And certainly if you are gonna do an ablative CO2 or, you know, other type of ablative fractional laser to do it under the guidance of a like,


you know, somebody who's done it many, many times, right, and like has done it with sensitive skin, all different skin types, you can get in trouble with the ablative lasers if you have darker skin. And so again, you're going to want to work closely with your provider to make sure that you're not going to cause like hyperpigmentation and things like that with some of these deeper lasers. Whereas that's not really.


Jeanne (16:05)

Mm. Mm-hmm.


Oh wow, okay.


Abigail Waldman (16:31)

an issue. Again, as long as you stay out of the sun, it's not that's not an issue for like the VB imperfecta. It's rarely an issue for the fractional non ablative lasers. But again, you just want to make sure you've addressed that with your provider if you're like a darker skin tone and tend to hyperpigment.


Jeanne (16:49)

So what's the downtime for ablative versus non-ablative?


Abigail Waldman (16:53)

Non-applative usually is like a day or two. Yeah, it's redness. It almost looks like you have hives a little bit in the area that you've treated just for an hour or two. And then it's maybe a little red. You might notice a little dryness and peeling, but mild, almost more like a sandy feeling than a true exfoliation.


Jeanne (16:56)

And then what is it like redness and dryness or?


Ha ha ha.


Abigail Waldman (17:19)

And usually it resolves within a few days. You can put, again, like gentle skincare for a few days. Usually you can put on makeup by the time it's healed in a few days. Very little downtime. Again, more something you're gonna notice than other people are gonna notice. The ablative fractional laser is about a week. Like you are gonna look red and crusty.


Jeanne (17:30)





Abigail Waldman (17:47)

for easily a week, usually by then. And you might have some pinkness that remains for an additional week or two after that.


Jeanne (17:51)



This may be a silly question because it's obviously not really medicine or anything that you're putting on your face, but can you have some kind of allergic reaction to this type of procedures?


Abigail Waldman (18:08)

No, usually, again, because it's like a procedure, you can't have an allergic reaction. Of course, you know, if you put something on your face is going to be you've created like these tiny little holes, right for a fractional laser. So anything you put on your skin is going to get absorbed more easily. Right. So if you do have an allergy or you're sensitive to something, it's going to be even more so.


Jeanne (18:28)



Abigail Waldman (18:35)

getting one of these fractional lasers because you've like basically opened up your skin a little bit to absorb things from the outside.


Jeanne (18:42)

So if these lasers are more for kind of skin texture and anti-aging, in terms of anti-aging, would you then not rather recommend, you know, for wrinkles and so on, Botox and for the skin texture, micro-needling for sensitive skin? Or do you think it's better to still do the laser?


Abigail Waldman (19:01)

really like microneedling for sensitive skin. You know, microneedling is probably the safest based on the studies for like skin of color. And then again, like depending on the needle, like you can do whole microneedling as long as the needle is less than 0.5 millimeters. And then in office microneedling, usually the needle is longer. So again, it can it can cause more of like a similar reaction to the fractional laser.


Jeanne (19:12)



Abigail Waldman (19:29)

like the non ablative fractional laser, it just creates bigger holes. So micro needling is like, you know, micro holes and the fractional laser are like these little nano holes. So that's pretty much the difference. Otherwise they actually are similar in their concept, which is like creating these small injuries that cause your body to kind of like help with remodeling and turning over pigment and wrinkles and whatnot.


Jeanne (19:39)



Abigail Waldman (19:59)

So, you know, if you're totally new to it, then doing microneedling may be the way to go. Again, you know, in terms of, like, what you expect to get out of it, the slower you go, the less intense procedure, the less of a reaction you're gonna get or outcome you're gonna get, right? So you have to be patient, because if you're gonna do it, like, with microneedling or, again, like,


Jeanne (20:22)



Abigail Waldman (20:29)

even non ablative fractional laser, like you have your expectation has to be that you're going to get minimal results, but cumulative. So if you, you know, you'll have to probably go back, you know, two to four times depending on your, you know, your, it's a journey, right? And if you're just like, and it still might not be enough, like, let's say you really bad acne scars, like really, you know, intense surface area change.


Jeanne (20:38)



It's a journey. It's definitely a journey. Okay.


Abigail Waldman (20:58)

the microneedling and the non-ablative laser may not get deep enough or cause enough of, you know, that injury to really cure them, right? So it really has a lot to do with like, what are you looking to do? And that's why like a good provider who has like a lot of experience can kind of guide you. Because they can say like, look, we can do, you know,


Jeanne (21:04)







Abigail Waldman (21:27)

microneedling treatments and will get to you to where you want to be. Or they may say, like, look, you're going to do eight microneedling and you're still probably going to have, you know, issues that you are not satisfied with. Right. So, um, so certainly like with sensitive skin, you want to go slow, but just knowing that your results will be slower.


Jeanne (21:38)



for sure. And in terms...


And in terms of the anti-aging effect, would you say it's a good option for those people that are not quite ready for Botox yet or for whatever reason, scared to get Botox, they can choose the laser


option? Okay.


Abigail Waldman (22:03)

Yeah, absolutely. They work very differently. So the laser is more like fixing like the framework of the house. It kind of like helps with remodeling the skin, whereas Botox goes in and actually turns off the muscles from moving. And so it makes it actually makes those lines invisible because you can't actually really move them. Yeah, right. And so they work very


Jeanne (22:20)



Use them, move them, yeah, okay.


Abigail Waldman (22:34)

And Botox is probably like the fastest results you're gonna see like within a week, like, because it, yeah, that's like, that's like, you know, I wanna look good, you know, I wanna have no lines on my forehead in two weeks for my wedding. You're gonna see a lot more from Botox, but the results are temporary. They last two to five months depending on the person. And you know, it's,


Jeanne (22:42)

Not the journey, the race.




Abigail Waldman (23:03)

There's some data to show that maybe if you do it long term, it's going to reduce wrinkles, but that's not a sure thing either so it's like the Lasers are actually more of like an investment, you know, like you When you do the lasers like it's helping you in the short term and it's actually probably helping you in the long term, too It's like keeping up the maintenance of your house right so


Jeanne (23:10)





Okay, okay. And then the BBL here, what does that do?


Abigail Waldman (23:30)

Yeah, that's a good question. So BDL again is a brand name. And it's a brand name for a type of a light procedure, not a laser. It's a light procedure. So it's, it stands for broadband light. But the technique that it uses is made is known as intense pulse light. So essentially what it is, is a laser


Jeanne (23:39)

Ah, okay.


Abigail Waldman (23:57)

is light of only one wavelength. So it's like taking just that, let's say it's a color, like red or green light because you want to target red. So you're going to put just green of one exact wavelength and put it through a funnel. And it all comes out as one punch. Right?


Jeanne (24:11)



Abigail Waldman (24:25)

So it's a lot, lasers are like, you know, almost like taking like a pin and like really jamming it. Right, you get like a huge result. It's like a, you know, whereas intense pulse light actually takes all of the light in the air, all the light that we naturally kind of have, or from like a light source. And then it filters it to try to get that same,


Jeanne (24:33)



Abigail Waldman (24:52)

wavelength. I know this is kind of confusing. People like do like hold PHDs in this, right? So it's like, so it's basically like instead of having just one like really intense pulse, you take all the light and you filter it through to try to get that same, let's say you want to target redness, right? So you would try to pick that same wavelength as V beam. So you would pick like, you know, 595 nanometers and you would put it


Jeanne (24:54)



Abigail Waldman (25:19)

through and then it would have a similar effect as the V beam, but it's not coming through like a funnel. It's kind of more like just boom coming at you like this, right? Like it would be like having like 20 needles come out, but not as intensely. And so


Jeanne (25:27)

Okay, okay, okay.


But why would you use it? Sorry, why would you use the BBL?


Abigail Waldman (25:39)

Right. So why would you do that instead of like the laser? So the laser, you have to buy a separate laser for each of the things you want to target. Right. So that's why there are so many different lasers and why it's confusing. Right. Because they have one light source. The IPL or BBL, which is the brand, is you can change the filter to have the effect that you want. Right. So it's a multi-purpose.


Jeanne (25:42)



Abigail Waldman (26:08)

So you can use BBL for like pigment by picking the filter that kind of targets pigment more. You can use it for hair removal by picking the filter that targets the hair follicle a little bit more. You can use it for rosacea by doing, so it's more of a like a manable trades type of device.


Jeanne (26:36)

Okay, so it's not really targeted on hyperpigmentation.


Abigail Waldman (26:41)

Well, you can try to target it by again, putting the right filter in. So the machine comes with all the different filters and you can like, if you know, ideally the one who's using the machine should really know what they're doing, right? And be able to pick the right filter. But oftentimes these machines will also tell you which one they recommend. So if you're like, oh, okay, you know, we're treating redness for rosacea, you can say, okay, the patient has this skin type.


Jeanne (26:43)

Ah, okay.




Abigail Waldman (27:07)

the Evers Asia, you know, we're treating this area and it will say, use 595 nanometers. And then you go and you find your little filter and you put it in and that will filter the light to be just that wavelength. It's kind of more similar to like an LED light, right? Like if you've seen people using like these LED mass or LED, like for hair, for, for redness on the face, right? It's kind of like that. It's more,


Jeanne (27:25)

Mm, mm.


Abigail Waldman (27:35)

it's less targeted. It's kind of just like filters the light to just be sort of the wavelength that you want to use, but it's not as like targeted like a gun, right? Right, so you actually would think so. I actually yesterday in anticipation this did my other side of my face with IPL, because I actually almost never use IPL because I usually do the pulse dilation for my rosacea. And I was surprised it, so what it does is it uses the light and it turns it into heat.


Jeanne (27:44)

So it's also not as painful.




Abigail Waldman (28:04)

in your skin and that's the heat is what's doing the work. And so the it in some areas it was more painful it was interesting it doesn't have that same like surprise to it you know you don't have that pulse because you don't have a laser shooting at you but it's warm it's like really warm and they yeah like a burning but it's quick.


Jeanne (28:16)

Oh wow, okay.


Oh, almost like burning?


Abigail Waldman (28:31)

And so on my cheeks, I didn't notice anything, but actually up here on my forehead and my temple, it was more painful than the pulse dilator, which again, I've done a bazillion, you know, I've done a lot of pulse dilators, so I know what to expect. So I was surprised that in this area anyway, like it was very warm, but they have like a cooling mechanism with it. But I think in some areas it works great, because like on my cheeks, I literally couldn't feel anything being done.


Jeanne (28:40)



Abigail Waldman (29:00)

Um, so it's.


Jeanne (29:01)

Okay. And do you also have a topical ointment to apply to just kind of make the pain a little less?


Abigail Waldman (29:07)

So some doctors, yeah, so there's a downside to that. The topical lidocaine that you can use or different types of topical anesthesias constrict blood vessels a little bit and you want those blood vessels to be like open and active in order to target them. So if they go into hiding, it's actually your procedure is gonna be less effective. So I try to encourage people not to apply


Jeanne (29:26)



Abigail Waldman (29:34)

the topical numbing if you're doing it for redness. If for anything else, I think it's fine. But if you can tolerate it, you'll get a better effect by not using the topical numbing or the injectable numbing.


Jeanne (29:40)



and the downtime for the BBL.


Abigail Waldman (29:52)

I honestly, I could barely tell, you know, yeah, right. On that side, it's like my normal redness. So, you know, I think again, it depends on like what you're using it for. Cause again, you can use the BBL for various things, for hyperpigmentation, for redness. But in this case, you know, most cases where I tell people is again, the same two weeks, like don't get any sun for two weeks.


Jeanne (29:55)

Yeah, I can't even see anything on your skin actually. So yeah.


Abigail Waldman (30:20)

And like you may have like a little bit of burning maybe like an hour or two after gentle skincare for 24 hours and then you can cover it with makeup. But I feel like there's a lot less downtime with and even compared to the pulse dye laser, there's like a less noticeable swelling or redness. But of course, remember you're getting sort of a less targeted effect, right?


Jeanne (30:26)





Yeah, yeah, for sure. And for people in our community, especially, these types of treatments, are there anything that you should be cautious of in terms of medications that you may be on or some kind of health problems that you may have that would not make you a good candidate for these or that you should be careful


of? So for example, if you're on types of anxiety medications or heart medications, you know, in our...


Abigail Waldman (31:08)



Jeanne (31:16)

age group, you're starting to struggle with hormones and you may be having issues with that. Is that anything that we should be aware of?


Abigail Waldman (31:23)

So I think if you're on a blood thinner, you're probably a little more likely to bruise from any of these procedures. But again, bruising is unusual if it's used appropriately. I think the biggest one would be if you have an autoimmune disorder, you definitely, you know, that doesn't mean you can't get these procedures, but that you really have to be working with somebody who knows


Jeanne (31:43)



Abigail Waldman (31:53)

autoimmune disorders and knows what would be safe and what would not. Because some of them are very light sensitive. Most of them are usually UV light sensitive, but they can also be visible light. And most of these lasers and light procedures use some sort of spectrum within the visible light spectrum or maybe like the infrared spectrum. And so you just have to be working with somebody.


who really know. So like if you have lupus, if you have dermatomyositis, if you have Sjogren's, if you have certain types of autoimmune disorders, that's probably where I'd be the most cautious. Yeah, because...


Jeanne (32:25)

Mm. Mm-hmm.


cautious. Okay. And then, you know, how would you advise us to choose carefully? Like, what do we need to look out for? Because to me, it feels like, sorry, but every kind of hole in the wall


spa has this on their treatment list. And you really don't know, are you being helped by somebody that really understands how to use this equipment? Should you really be going to like,


Abigail Waldman (32:46)



Jeanne (32:57)

qualified board certified dermatologists going to a hospital or clinic or is it safe to have these kind of treatments in aesthetic centers?


Abigail Waldman (33:04)

Yeah. So I think most of these ones that we discussed are relatively safe. You know, it's especially, I would say the V beam and the fractal. And that it's, you can have complications from them, obviously, but that they're, you know, most, if you've been doing a lot of these procedures, whether you're a physician or, you know, another sort of provider.


as long as you've done enough and had the experience, usually they're relatively safe. That being said, I would say that if you know that you have very sensitive skin, you tend to react. Certainly if you have an autoimmune disorder or if you have darker skin, I would err on the side of caution and see a board certified dermatologist or a plastic surgeon, someone who really can kind of


more make like a medical decision to like take into account sort of your whole entire picture. But I think for the most part, like if you're sort of like even just have like summer's Asia, you probably it's safe depending on where you are to sort of go to most providers I would say.


Jeanne (34:14)



Abigail Waldman (34:33)

There are a lot of, I would say actually IPL, which is BVL, used by the wrong person can get you into trouble. And again, the reason is, is it requires you to kind of put in the right filter, right? So you can, if it's somebody who doesn't know what they're doing or doesn't know how the machine works or wasn't trained properly, you can burn,


Jeanne (34:47)





Abigail Waldman (35:03)

the skin, you can cause hyperpigmentation, you know, and you'll see, and oftentimes you'll see like even on social media or whatever, pictures of people who had IPL. IPL, you know, because it has like this long, it forms like a long rectangle. And you can like see where those little rectangles were put onto the skin. But again, if it's used correctly, it has low risk, but it is something.


Jeanne (35:04)

Oh gosh, okay. Wow.




Abigail Waldman (35:31)

that is a little more user dependent. So just be aware of that. And like really sort of do your homework if you're gonna get BBL, IPL, there are different brands for IPL, that you really like understand who's doing the procedure. And then the other thing, even more than sort of bad outcomes is that,


Jeanne (35:36)







Abigail Waldman (35:56)

you may just get no outcomes, right? So if it's somebody, again, who doesn't really know what they're doing and they're using maybe like just using too low settings, there's probably a bigger risk. If you're not going to a board certified dermatologist or a board certified, somebody who's focused on cosmetics, like a plastic surgeon or dermatologist, there is a big possibility that you get no results, right?


Jeanne (35:59)



Yeah, which is also bad because you're investing all this time and money.


Abigail Waldman (36:26)

All of these, right, you're paying. Yeah, exactly. Right, so, and I think that's almost like the bigger risk because the machines all have like settings, but the settings are pretty low, right? They're like meant to keep people out of trouble. And so oftentimes what you'll see if you're using like these kind of base settings from the machines is like, you're just not gonna really.


Jeanne (36:54)

Yeah, you want to.


Abigail Waldman (36:54)

see the results you want, especially if you have more severe. So I would say that's the biggest thing. Whereas someone who really has a ton of experience and really knows how the lasers work and how to use them, they can change, they can use settings that really will get you the most of that, I would say.


Jeanne (37:18)

Yeah. So before we let you go, last question to you is that I've been seeing a lot in the skincare community and also we've had opinions on the podcast that you don't really need these treatments. Like the only kind of the most proven things in skincare is like your retinoic acids and Botox if you really want to get rid of the wrinkles. What's your feeling about that? Is that true? Because I've done microneedling and


It may be a completely subjective opinion, but I've seen a good difference in my skin for me. So, you know, I'm just wondering because those opinions start to be getting stronger and stronger and stronger and there are many dermatological, you know, books from dermatologists coming out saying you don't need these procedures, don't do these procedures. What are your kind of thoughts on that?


Abigail Waldman (37:51)



I mean, certainly there's good data behind these lasers that they work. I mean, they were developed out of Harvard many years ago. There are tons of studies on V-beam. There's tons of studies on fraxel. And they certainly work to do what you're asking them to do. So, you know, like if you're, you know, V-beam has shown to improve redness in...


Jeanne (38:37)



Abigail Waldman (38:37)

a good proportion of people and then fraxel helps with reducing wrinkles. So I think there's no doubt that they work. You know, microneedling, tons of data on microneedling and its efficacy and safety. Whether you have to do them, I don't know. I think that's kind of like it kind of depends on what you want. Right. You know, the do they work and are you going to see some effect?


Jeanne (38:56)



Abigail Waldman (39:06)

Yes, most people are going to see some effect. That doesn't mean you have to do it or you can't get a lot of benefit just from retinoids alone. I mean, retinoids are great. I think they're kind of like the basics, right? Like sunscreen, washing your face, and retinoids are like the foundation of the house, but that doesn't mean you're not gonna be able to improve it by doing these other processes.


Jeanne (39:19)

Yeah, yeah, yeah.


almost like your health and fitness. Like just because you're eating a good diet and you're healthy doesn't mean you can not improve your body by adding a little bit of weight training or a little bit of cardio, like almost something like that.


Abigail Waldman (39:44)



Exactly. And I think similar to, to like health, you know, it's like almost, you know, there's this constant like debate, like, which one's the best? Like, is it weight training? Is it hit? Is it like cart, like long term cardio? Is it diet? And it's like time and time again, people like, well, it's kind of everything, right? It's like, the best results are actually doing a little bit of everything. And it's like, this constant debate about like, should you be? It's like, you shouldn't be doing all of one, right?


Jeanne (39:59)

Mm. Mm-hmm.






Abigail Waldman (40:17)

that it's really everything together. And I would say the same thing is skincare. And it requires kind of, again, a lot of the mentality now is like, oh, I want something and I want it to be done once and never have to do it again, right? And it's like instant results. I was like, the only thing, if you're looking for that, is a facelift, right? I mean, there's nothing, if you want that big of a result, you're gonna have to have


Jeanne (40:34)

Yeah. And I want instant results.




Abigail Waldman (40:47)

investment of time, money, downtime, risk, right? I mean, everything's a trade off. And so, you know, I think that, you know, it's a lot of skincare and even doing some of these procedures is kind of like a maintenance thing. And just like, knowing that you're like investing in your skin long term, same as like diet and exercise.


Jeanne (40:53)

Yeah, for sure.




That's wonderful. Thank you so much. I am so happy that you have given us some of your time to come onto the MyFiggyLife podcast. I think this may actually almost be a redundant question because we all love you so much, but if our audience wants to find you, it doesn't already know exactly where you are, where can we find you, where can we go to interact with you?


Abigail Waldman (41:34)

Sure, so I'm on TikTok, it's at DrAbby6. I'm on Instagram at abby.waldmanMD and YouTube at DrAbby. It's like Dr hyphen Abby. And you know, certainly you can follow me, reach out, like send me messages, whatever you like. And thank you so much for having me.


Jeanne (41:59)

Oh, it's such a pleasure. And as always, if you are driving Figgy Goddess, don't worry. All the links you need will be in the episode description. And we can't wait to see you again next time on the MyFiggyLife podcast. But until then, remember that everyone deserves to celebrate the goddess within. Thank you so much. I am so appreciative.


Abigail Waldman (42:17)

Thank you! Of course!