In Treatment

or, how to win at laser tag

Gentle readers, new and old, welcome! In honor of election day, an obscure piece of American history. Our fifth president, James Monroe—to whom I am unrelated but who, like me, once made a large purchase in Louisiana—married the willful Elizabeth, who loved all things French. While in France during the Reign of Terror (bold move), she helped rescue Madame Lafayette, wife of the Marquis, from prison—and maybe even the guillotine (bold move # 2). Please make your bold move in the voting booth. If you vote and you tap the little ❤️ above, our voting rights (along with HNTFUYF) might live for another season.

The number of you who’ve read my dermatologist-approved simple skincare routine has reached the size of a small town; a few of the populace seem interested in treatments involving some kind of device. Which brings me to a query from one of the more vocal in the community.

“Ask Val” answers your urgent questions, Vol. 38

Yes, you in the front row sporting goggles?

Q: I want to invest in having laser facials one or two times a year. But there are so many lasers now! What’s the best treatment to start with?

A: I think what’s most important about what you're calling laser facials is that you have your treatments—whatever you choose—in a board-certified dermatologist's office. Why? The success of your treatments will depend largely on the quality and condition of your skin. So consulting with a dermatologist is mandatory. Which is why I emailed HNTFUYF DermDiva Heidi Waldorf, who, as usual, had lots to offer.

First, Waldorf notes that “laser facial” can mean many different things. Laser, in case you forgot, is an acronym for Light Amplification by Stimulated Emission of Radiation. So when you describe something as a laser, it’s like describing that furry creature nestled on your couch as a dog. Is it a teacup Pomeranian or a Tibetan Mastiff? There’s a range of devices with an equally wide range of effects. 

To complicate matters more, “laser” is often used loosely to describe other light sources, like intense pulsed light (IPL). (Unlike lasers that emit a focused beam of one wavelength of light, pulsed-light devices emit a range of wavelengths.) There are also non-light, energy-based devices that use radiofrequency, ultrasound, electric currents and/or radio waves; non-energy based devices like microneedling; and others that use these modalities in combination, says Waldorf. 

Whatever the device, the results depend on the wavelength, power, number of passes on the skin, and other important parameters. And this is why it’s critical that the person wielding the wand knows exactly how the magic happens. I’m reminded here of a favorite William Carlos Williams poem:

so much depends

upon

a red wheel

barrow [the dermatologist]

glazed with rain water [her expertise]

beside the white

chickens [uh, devices]

Waldorf adds that when devices are used correctly and parameters are adjusted for a patient’s skin color, treatment area, and specific needs, they’re generally safe. But because side effects can and do occur, it’s critical you’re treated by a person—or someone who has direct access to a person—who can handle complications quickly and effectively. 

At the very least, be sure whoever is doing the procedure asks specifics about your medical history; explains the benefits, risks, alternatives, and cost of the recommended treatment; and lets you know who you can contact if you have concerns afterward, says Waldorf. 

This post will, I hope, help preserve your skin and your health. I probably haven’t helped you figure out what kind of treatment you might like—but that’s hard, because I don’t know the condition of your skin or anything else that might contribute to understanding what might be most effective for you. In general, IPL treatments work well to brighten the complexion and diminish little spider veins and hyperpigmentation (dark spots). Personally, I like radio frequency microneedling to brighten my skin. But ask a doctor what might most benefit you and, as much as possible, the results you’ll see. Be clear about your goals: More even skin tone? A teensy (and pricey) tightening? Clarity about what you’re aiming for will likely be the most reliable bellwether of your satisfaction.

As always, before you do anything, take a long, loving look at your face.

HNTFUYF, a Payola-Free Zone

Readers, a few of you have asked if I get a cut from sales when I mention a beauty product. I do not. I only mention products I’d like to buy myself, and therefore think you might like, too. I share this so you know my recommendations are offered without obligation.

Book Club News: A compelling new read!

Though I’ve been a latecomer to audiobooks, once I discovered them I couldn’t get enough. I borrow them from the public library, but as I’ve mentioned before, sometimes the library snatches them back before I can finish. So I'm happy to share I'm partnering with Chirp to organize an audiobook club of biographies and memoirs called “Unfiltered Women.” Two things: It’s free to subscribe and Chirp offers great deals. Plus, you obviously get to keep the book to listen to at your leisure.

Every other month I’ll announce a new book club pick we’ll listen to together. You’ll have a chance to share your thoughts on the book a few weeks later and hear what other readers thought, too. My fourth pick is the devastating Hunger: A Memoir of (My) Body, by writer and commentator Roxane Gay. Her story is one of extremes: of extreme weight; of extreme sexual violence; of other people’s extreme repudiation and contempt. And yet, because her narration is consciously controlled, analytic, and wise, Gay comes across as a person who—in spite of (or because of) her traumas and her position far outside the grid of social norms—is supremely gifted at accomplishing what’s required for her to not only survive, but also to thrive. In that way, her story feels like a triumph.

To get started, go to chirpbooks.com/val and press FOLLOW to join my club. (Again, it’s free and there is NO commitment.) There, for a limited time, you can buy Hunger for only $4.99 (normally $18.99), including a 50% discount with code VAL50 if it's your first Chirp purchase.

Val Asks You

Don’t be shy! What’s your most vexing or intractable appearance issue? Send your beauty-related questions to valeriemonroe@substack.com. If I don’t have a good answer, I’ll find someone who does.