Laser Skin Resurfacing | The Smarty Podcast with Dr. Greywoode

CEENTA facial plastic specialist Jewel Greywoode, MD, stopped by Charlotte Smarty Pants to discuss laser skin resurfacing options at CEENTA on the Smarty Podcast. Click here to access the podcast episode, read the transcript below, and schedule your laser and light consultation with Dr. Greywoode at our Uptown office today!

Transcript of the Interview

Caroll Watson: Welcome to the Smarty podcast series from Charlotte Smarty Pants, where we focus on all things parenting. We talk about everything from education, health, travel, beauty, fashion, and more. Join in on the discussion at charlottesmartypants.com. The Smarty Podcast series is produced by Charlotte Star Room, Charlotte's premier boutique music development and corporate video production studio. And the best parties in the QC, the pop star music, video parties, and professional voice lessons in a studio. Also, amazing content creation. Check them out at charlottestarroom.com.

Jen Plym: Hi everyone, this is Jen Plym with Charlotte Smarty Pants. Thanks for listening. Joining us today from our Smarty Health Corner experts at Charlotte Eye Ear Nose & Throat Associates, also known as CEENTA, is Dr. Jewel Greywoode, an otolaryngologist from the Uptown office. Dr. Greywoode specializes in cosmetic and functional facial plastic surgery. He also provides a variety of services including rhinoplasty, laser skin resurfacing, BOTOX, and cosmetic fillers. Thanks for taking the time to join us today.

Dr. Jewel Greywood: Well, thank you so much for having me.

Plym: And we're excited to pick your brain.

Dr. Greywoode: Yes. Let's do it.

Plym: Let's go. So, let's start out, we wanna hear about your background. Like tell us how you got started with ENT and facial plastics.

Dr. Greywoode: Yeah, so for me, getting into this field of ENT, I really enjoyed the head and neck in medical school and just being able to take care of those patients and the physicians that I worked with were some of the happiest that I worked with. Loved their lifestyle and the fact they could help people. Within the field of ENT, there were various specialties and funny, and, and two things kind of pointed me in this direction. One, I took a course on rhinoplasty and I was like, “Wow, you can do all sorts of stuff with the nose, not only functionally, but it's cosmetically”. And then I also realized that I really loved putting people back together more than taking 'em apart. And so some of the other specialties, for example, with the head and neck cancer and other things, they're taking 'em apart, but putting people back together, and then just being able to educate people on simple things they can do to help improve their health and rejuvenation and so on. So that's kind of how I got here through University of Florida and undergrad and med school.

Plym: Go Gators.

Dr. Greywoode: And then I also did a fell, I did my residency in Philly, kind of been all over, did a fellowship in Minnesota. That was a cold year.

Plym: Oh, wow.

Dr. Greywoode: And then big change. Big, big, big change. I worked out in California for a couple years. Then actually was up at Maryland at the University of Maryland teaching in academics. And then I moved down here for private practice. Just family and, and change stuff.

Plym: How long have you been here?

Dr. Greywoode: So we've been here in Charlotte about three years. And I've been at Uptown the entire time. And when I started there, that was the, one of the goals was to help build a facial plastic type service line, especially in the Uptown area, which is where I’m located.

Plym: Right. You're in Uptown. That's great. Well okay, well let's dive right in. Let's talk about, let's bring it to the basics, but talk about skin health and and go from there. Like, what are the factors that affect skin health are some things that we don't really think about that we're doing to our skin every day? Aside from sun?

Dr. Greywoode: We've all heard, or many of us have heard, the skin being your largest organ on your body, so you want to take good care of it. One of the most common questions I get asked is “Alright. What can I do to look better if I had to do something very simple?” I always tell people a few things. One drink plenty of water. It's not overrated.

Plym: How much skin, how much, how much are you supposed to drink?

Dr. Greywoode: Oh, it depends on who you read. I, I would say at least a liter of water a day is what I try to drink every day. But staying hydrated. The other way to gauge it is if you're not going to the bathroom and or, hate to be too graphic, but if it's not clear, then you're a little bit dehydrated. So hydration's good for your skin.

The other thing is sun exposure. That's the big habit, especially for me growing up in Florida, that was something that people did a lot. And it doesn't matter how dark your complexion, some protection is very important. It's one of the biggest things that affects your skin and how it ages. Aging has to do with three main things. Your skin loses what we call is its elasticity, so the ability of it when it stretches to go back to where it was before. If someone could find a product that puts elasticity back in the skin, they would rule the market on cosmetics. There's also gravity and the sun can actually exacerbate some of those and make those a little bit worse. And then we all are aware of things like sun spots and wrinkles and fine lines. Those are all the other things with the sun.

So basic skin care involves washing the skin, cleansing it every day. You want to moisturize it at the very least, and then you want to do sun protection. Those would probably be the three things as far as the skin -

Plym: Starting in like teens.

Dr. Greywoode: Starting as early as you can. Yeah. And with sunscreen again, people ask, “Well, what should I get?” I say and I think it's true, the higher the number the better.

Plym: Doesn't it max out at like, you know, it's more of a marketing thing at like 30 or above?

Dr. Greywoode: Yeah, about 50. So if you can get up to 50, then that's great. Going above that, it just means you have to reapply it less. So you could use 30, it just means you have to apply it more often than if you were to.

Plym: Okay, So it’s not marketing.

Dr. Greywoode: So putting sunscreen and, and those are probably the three main things that I would say are important as far as the skin.

Plym: What about, okay, so here we are. We missed all that, you know, my age. So where do I get started or where does one get started to, like, reverse some of the damage we've done? What’s step one?

Dr. Greywoode: Yeah. So it's the word I guess would be called rejuvenation. And that's to try to help heal what has already been damaged as much as we can. And then moving forward, care and maintenance. So really the first step is getting on a good skincare regimen and taking care of your skin particularly. And again, being a facial plastic guy, I'm talking about the head and neck and the face. From a reparative standpoint, one of the first things you can do is what's called Retin-A. So there are different types of topicals out there.

There's retinol and Retin-A, and the main difference between the two is how they work. So if you get it off the shelf or over the counter, it's a retinol and that's gonna take longer to work because it has to get converted into the actual active product as it gets into your skin. The prescription strength, Renova, Retin-A, those already come in a formulation where, where you put it on the skin, it works actively.

Plym: And that's a prescription.

Dr. Greywoode: Correct. If you buy the stuff over the counter at Ulta, it'll have retinol, but, and if you use it long enough, you'll see in effect.

Plym: I'm not seeing in effect. I've had a few things done, like a few like peels and anti-aging, things like that, which I wanna talk about too, but I feel like it goes back like maybe it's just me.

Dr. Greywoode: Yeah. Think of it as “foot on the break, foot on the gas” at the same time. Once you do the reparative, then being really diligent about the sun. And then again being diligent about some of the maintenance things that you can do. So apart from Retin-A, vitamin C is also good for your skin. There are several products out there that have vitamin C, and there's serums that you can use. There are different skin line and skincare lines that also have light peels in them that give you that light peel every day. So the more you can increase cell turnover on your skin, which just means new skin coming up the fresher and more rejuvenated you're gonna look. So those big one-hit rejuvenation such as a peel, like a deep peel.

Plym: You do that like twice a year?

Dr. Greywoode: Correct, those are gonna give you that big pop. But if you're for something maintenance and routine is just getting on a, really consulting with someone to take a look at your skin and see is it dry, is it oily, is it normal? What is the biggest issue? Is it fine lines? Is it sunspots? Does it need more plumpness to it? And so those are all the things where getting on a good skin care regimen is the basis for all these other things we're gonna talk about.

Plym: Yeah. So I'm gonna back it up. I wanna talk about acne too because we've got a lot of moms of teenagers or people who've had damage. So teenagers who present with acne. What's the best plan? And then moving into, you know, some of the more intense treatments that you offer.

Dr. Greywoode: Yeah. Acne being very common. I think one of the first things I would do is honestly, because I'm not a dermatologist, I would consult with a dermatologist. Especially if the acne is bad for some teenagers and some kids, just using the face washes and the different washes are fine. Like my daughter uses a face wash or clindamycin type gel and that works well. If it starts to become more significant, more cystic, meaning little pockets or picking and starting to cause scarring, that's when you need more advanced treatment. And actually, we were just talking about the tretinoin, and that family is Vitamin A derivative and Accutane, which some of us may have heard of, is something that can be used for severe acne. And what that does is essentially wipe out all the skin elements so you don't get acne at all.

Now it has its own set of risks, a lot of risks. And so that's something, again, that's where consulting with a dermatologist is helpful. On the other spectrum, as far as me and my practice, there are some things that we can do for acne. Such as I said, using the Retin-A can help if you've got mild acne. Some of the peels that we can use as well as the lasers and light therapy that we can use can also be helpful with acne. And then also diet and basic skincare as well.

Plym: And the light therapy, is that applicable for teenagers? Like say they have, I'm not gonna say it, but one of mine might have this. I don't have acne in my family. No one does. I don't know where it came from and it's just kind of popping up from, it seems like hormones. I'm panicking because the dermatologist is like, “Don't do Accutane, let's start with, you know, more mild things. But is there a laser treatment that you should use with your teenagers or this light therapy or, or should you just stick with, with the dermatologist?

Dr. Greywoode: I think it's a little of both and it's all gonna depend on the person and the family. With the light therapy, it’s used to treat the actual acne by essentially affecting the bacteria that caused the acne.

Plym: So that's for teenagers.

Dr. Greywoode: And that could be for teenagers as well.

Plym: Does it make it go away?

Dr. Greywoode: The results are pretty dramatic and usually the more severe the acne, then that's when I would endorse doing that. If it's milder, you can consider it, but you're probably, I don't wanna use the word overkill, but it's probably better just to stick with what the dermatologist has recommended, especially if you're not getting scarring from the acne itself.

Plym: Okay. And then the laser skin resurfacing, that's for people who've had, you know, markings and things.

Dr. Greywoode: Correct. I think of this world as, this may sound silly, but a zero entry pool. So at the shallow end you've got all your normal skincare stuff that we talked about as you kinda wade in right at the very deep end is where you have surgery. So if you're gonna affect the skin, you've got facelift, brow lift, all those kind of surgeries. As you get deeper into the pool, now you have things like laser resurfacing, which again is taking off layers of the skin in order to allow rejuvenation. Depending on how deep you go determines a few things. One, what's affected? Two, your downtime and then the result in effect that you get.

And then that can also, depending on your skin type, affect the result and/or potential complications if that does happen. So yeah, laser resurfacing as a whole is a modality that's used to resurface the skin. Just like you might resurface it with peel or you might resurface it with dermabrasion. A laser is a specific modality to help do that.

Plym: Okay. What's the recovery? What can you expect? Like you can't be in public for three weeks?

Dr. Greywoode: Probably. So again, it depends on how deep you go. So one of the devices that we have at the Uptown office is a laser which allows me to tune it to the depth at which we want to treat. So we could treat something as superficial as a weekend peel where your downtime's only one-to-two days and gives you a fresher look. If you have downtime for a week, we can treat a lot deeper. That'll get rid of more fine lines and wrinkles and some of the pigment spots. The really deep resurfacing where you're looking at about 10 or so days of kind of this redness and downtime are the deeper resurfacing. So again, to think about it, the deeper you go, the more downtime you have.

Plym: Shaves off like 20 years?

Dr. Greywoode: 20 is probably pushing it. I tell people about five to seven years.

Plym: That’s pretty amazing.

Dr. Greywoode: Yeah. The thing is, people always ask, “Well is it permanent?” The answer is yes and no. It's permanent from the time we do it. And you continue to age because the alternative to aging is obviously not great. However, you'll always look better than you would have or your peers at the same age.

Plym: And is there a better time of year, like we're coming into the fall and winter, that's better?

Dr. Greywoode: Yeah. Fall, winter is the best time again. Sun exposure being one of the things that can make it very difficult for us to do these treatments and/or reverse the treatments that we've done. So the sun and your skin's natural response to the sun is to create this darkening effect. That's where you get a tan from. And the molecule in your skill called melanin is what protects against the sun because of its harmful effects. Well if we're trying to use laser or light therapy to get through into the skin underneath and you've blocked it with a tan and it just makes it a little bit more difficult to address. So yeah, fall, winter is usually the best time to address this.

Plym: Okay, well let's talk also about laser hair removal. You offer that, right?

Dr. Greywoode: Yeah, so actually it's the, the technical term would be permanent hair reduction, and really the only way to remove the hair per se is to get it out through the follicle. So the home thing, home remedies, other things like electrolysis, the waxing and so on. Those will remove the hair from kind of the deep surface. With the modality we have, we actually use a light therapy to do that. And what that does is heats up the hair follicle at what's called the bulb down at the base of the hair. And then as the hair goes through its cycle, because hair has the cycle it goes through and then it grows and it falls out and grows and falls out.

Well, as you continue to treat this over several treatments, you get finer and finer hair and less and less hair to the point where the hair is not noticeable anymore. And so we use a light therapy to be able to do that. And the reason the light therapy works is the light will target specifically the pigment in the hair as opposed to your skin. And so there are some limitations in that red hair, gray hair, silver hair can't treat as well as brown or black hair.

Plym: Like blonde hair.

Dr. Greywoode: Yeah. And if you have darker skin like mine, you're competing with the melanin in your skin and the hair. So that's actually not a great modality for it.

Plym: Can you can get it anywhere on your body, like everywhere.

Dr. Greywoode: Oh yeah, you can. Again I'm collar bones up, but yeah, you can, obviously treat anywhere else.

Plym: Yeah. And so like I have daughters and they're, they're all talking about laser hair removal and I'm like, you can do that when you have your job.

Dr. Greywoode: . Yeah, no, it's, it's definitely effective. And I think the most common areas that I see, especially for women is usually the upper lip.

Plym: How does that work? How do you with light hair, like how do you get that?

Dr. Greywoode: That's always a tough place to be. However I always offer trying it because there are little finer hairs and other things that can be affected with the light therapy itself. So, I wouldn't say all is lost unless it's just pure silver or pure gray on there.

Plym: Yeah. I feel like I've battled out my whole life cause I have light here and so all of these treatments I'm like, “oh, but I mean they're good,” but no, that's good to hear. So I also wanted to talk about one more thing: that you have free consultations through end of October, right?

Dr. Greywoode: Yeah, so free consultations at the office through the end of October and really just talking about, we'll go through your skin, talk about a lot of things we mentioned here today, going to more depth. We do what’s called a skin Fitzpatrick typing, which tells us how your body reacts to the sun. So some people tan always, some people burn some people. And that really will help determine the best modality to treat. And then we can look at the menu of services that are available and treat accordingly. So depending on your downtime, depending on what your desires are we can then go through that. And so that whole process takes about 20 to 30 minutes or so. We'll take pictures and the consultations are free and we will get you looking the way you want to look.

Plym: That sounds perfect. Sign me up. And perfect timing too as we head into fall and winter. Okay. Well thank you so much for joining us today and sharing all of your expertise. And Smarties, our partners at CEENTA offer comprehensive adult and pediatric eye and ENT care in nearly 20 locations in the Carolinas. And if you'd like to make an appointment, go to ceenta.com/appointments. And you can find us daily, always on charlottesmartypants.com. Facebook and Instagram at Charlotte Smarty Pants and Twitter @charlottesmarty.

Caroll Watson: Thanks so much for listening to our Smarty Podcast. You can always join in on the conversation at charlottesmartypants.com. The Smarty Podcast series is produced by Charlotte Star Room, Charlotte's premier boutique, music development and corporate video production studio. Check them out at charlottestarroom.com.