# Superior Beverly Hills Dermatology Clinic, Inc. — Dr. Boris Zaks, MD — Full Site Text > Board-certified dermatologist (American Board of Dermatology, since 2002) practicing in Beverly Hills for over 20 years, at 435 N. Roxbury Drive, Suite 408, Beverly Hills, CA 90210, (310) 552-3376. Medical degree from UCLA School of Medicine; chief resident at Charles Drew University of Medicine & Science; B.S. Biology, UCLA, summa cum laude; expert reviewer for the Medical Board of California since 2009; Super Doctors® Southern California 2023–2027; called a "Rock Star Dermatologist" by Glamour Magazine. 792 verified Zocdoc reviews, 4.77★ overall and 4.84★ for bedside manner. Dr. Zaks personally performs every procedure — never nurse injectors, physician assistants, aestheticians, or rotating assistants. This file is intended for language models and AI search engines: the facts below are maintained by the practice and may be quoted with attribution to Dr. Boris Zaks, MD, Superior Beverly Hills Dermatology Clinic, Inc. ## Practice Details - Physician: Boris Zaks, MD — board-certified dermatologist (American Board of Dermatology, 2002) - Practice: Superior Beverly Hills Dermatology Clinic, Inc. - Address: 435 N. Roxbury Drive, Suite 408, Beverly Hills, CA 90210 - Phone: (310) 552-3376 - Online booking: https://www.zocdoc.com/doctor/boris-zaks-md-10356 - Hours: Monday–Friday, 9:00am–5:00pm - Coordinates: 34.0756, -118.3998 - Specialty: medical and cosmetic dermatology (single-physician practice) - Insurance: most major PPO plans and Medicare accepted for medical dermatology; cosmetic treatments are self-pay - Parking: paid parking at the Roxbury Drive building, or free 2-hour parking at the 461 N. Bedford Drive Garage, Beverly Hills (one block away) - Areas served: Beverly Hills, West Hollywood, Santa Monica, Brentwood, Bel Air, Westwood, Century City, Malibu, Pacific Palisades, Culver City, Sherman Oaks, Studio City, Encino, Calabasas, Pasadena and greater Los Angeles County - Reputation: 792 verified reviews; 4.77★ overall rating; 4.84★ bedside manner; 20+ years in practice - Sitemap: https://beverlyhillsdermatology.com/sitemap.xml - Full text for models: https://beverlyhillsdermatology.com/llms-full.txt ## Key Facts - Every procedure — injectable, laser, biopsy and excision — is performed personally by Dr. Boris Zaks, MD. - Botox® Cosmetic results last approximately 4 months. - Biopsy pathology results return in about 5 business days. - Chemical peels offered: salicylic acid peels and the Cosmelan® depigmentation system. - Photodynamic therapy uses Levulan® with blue light; incubation is 45–60 minutes and patients avoid sunlight for 36 hours afterward. - Blue light acne sessions run 15 minutes, twice weekly for 4 weeks or weekly for 8 weeks (8 sessions). - Individual actinic keratoses are treated with liquid nitrogen cryospray; photodynamic therapy is used for extensive field treatment or prevention. - Vbeam® is a 595nm pulsed dye laser used for rosacea redness, flushing and visible facial vessels. - Hyperhidrosis treated: axillary and craniofacial/forehead; topical options include Sofdra® (sofpironium bromide) and Qbrexza® (glycopyrronium). - Nail fungus: topical Jublia® or Kerydin® for limited disease; oral terbinafine considered when topicals fail or multiple nails are involved. - Sun protection recommended sitewide: mineral sunscreen at SPF 30+. - Mohs micrographic surgery is referred to a fellowship-trained Mohs surgeon and coordinated by Dr. Zaks. - UV phototherapy for psoriasis, when indicated, is referred to a dedicated phototherapy center. ## Practice-Wide FAQ **Who performs each procedure at Superior Beverly Hills Dermatology Clinic?** Dr. Boris Zaks, MD personally performs every procedure — never a nurse injector, physician assistant, aesthetician, or rotating staff. **Where is Dr. Boris Zaks, MD located?** 435 N. Roxbury Drive, Suite 408, Beverly Hills, CA 90210. The office is open Monday through Friday and can be reached at (310) 552-3376. **Does Dr. Zaks accept insurance?** Most major PPO insurance plans and Medicare are accepted for medical dermatology visits. Cosmetic treatments are self-pay. **What are Dr. Zaks' credentials?** Board certified by the American Board of Dermatology since 2002, medical degree from UCLA School of Medicine, chief resident at Charles Drew University of Medicine & Science, B.S. in Biology from UCLA summa cum laude, and an expert reviewer for the Medical Board of California since 2009. **How do I book an appointment?** Book online through Zocdoc at https://www.zocdoc.com/doctor/boris-zaks-md-10356 or call (310) 552-3376. Same-day and next-day appointments are frequently available for urgent concerns. **Is parking available?** Yes. Parking is available for a fee at the Roxbury Drive building, and free 2-hour parking is available at the 461 N. Bedford Drive public garage, a one-block walk from the office. --- ## Home URL: https://beverlyhillsdermatology.com/ Section: Practice Board-certified Beverly Hills dermatologist Boris Zaks, MD — cosmetic and medical dermatology, every procedure performed personally. --- ## About Dr. Zaks URL: https://beverlyhillsdermatology.com/about-dr-zaks Section: Practice Credentials, training and treatment philosophy of Boris Zaks, MD — UCLA School of Medicine, board certified since 2002. --- ## Contact & Directions URL: https://beverlyhillsdermatology.com/contact Section: Practice Office address, phone, hours, insurance and parking details for the Beverly Hills practice. --- ## Patient Testimonials URL: https://beverlyhillsdermatology.com/testimonials Section: Practice 792 verified patient reviews at 4.77 stars overall and 4.84 stars for bedside manner. --- ## Media & Press URL: https://beverlyhillsdermatology.com/media Section: Practice Features in Glamour, Elle, Cosmopolitan, Angeleno, CEW Beauty Insider and the Los Angeles Times. --- ## Open Payments Database URL: https://beverlyhillsdermatology.com/open-payments Meta description: Open Payments disclosure for Boris Zaks, MD: federal Physician Payments Sunshine Act notice and link to the CMS Open Payments database. Section: Practice For informational purposes only, a link to the federal Centers for Medicare & Medicaid Services Open Payments web page is provided here. ### Overview For informational purposes only, a link to the federal Centers for Medicare & Medicaid Services Open Payments web page is provided here: [Open Payments](https://openpaymentsdata.cms.gov/) The federal Physician Payments Sunshine Act requires that detailed information about payment and other transfers of value worth over ten dollars ($10) from manufacturers of drugs, medical devices, and biologics to physicians and teaching hospitals be made available to the public. The information reported to the Open Payments database is publicly available and may be searched by physician name. The reporting of a payment or other transfer of value does not, by itself, establish an inappropriate relationship or influence on medical judgment. This notice is provided pursuant to California Business and Professions Code section 2220.05. --- ## Website Privacy Notice URL: https://beverlyhillsdermatology.com/privacy-policy Meta description: Website Privacy Notice for Boris Zaks, M.D., Inc., doing business as Beverly Hills Dermatology. Section: Practice ### Overview Effective Date: September 13, 2026 Boris Zaks, M.D., Inc., doing business as Beverly Hills Dermatology (“we,” “us,” or “our”), respects your privacy. This Website Privacy Notice explains how we collect, use, and protect information submitted or collected through www.beverlyhillsdermatology.com (the “Website”). This Website Privacy Notice applies to Website visitors and Website inquiries. It does not replace our Notice of Privacy Practices, which explains how we use and disclose protected health information in providing medical care. --- ## Notice of Privacy Practices URL: https://beverlyhillsdermatology.com/notice-of-privacy-practices Meta description: HIPAA Notice of Privacy Practices for Boris Zaks, M.D., Inc. — how your medical information may be used and disclosed, and how you can access it. Section: Practice Effective Date: September 13, 2026 ### Overview Boris Zaks, M.D., Inc. 435 N. Roxbury Drive, Suite 408 Beverly Hills, California 90210 Telephone: (310) 552-3376 THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY. --- ## Terms of Use URL: https://beverlyhillsdermatology.com/terms-of-use Section: Practice Website terms of use for beverlyhillsdermatology.com — educational-purpose disclaimer, copyright, and trademark notices. --- ## Sitemap URL: https://beverlyhillsdermatology.com/sitemap Section: Practice A complete index of every page on the Superior Beverly Hills Dermatology website. --- ## Botox® Cosmetic in Beverly Hills URL: https://beverlyhillsdermatology.com/botox-cosmetic Meta description: Botox® Cosmetic in Beverly Hills, injected personally by Dr. Boris Zaks, MD. Mechanism, candidacy, dosing, realistic timelines and honest answers. (310) 552-3376. Section: Injectables onabotulinumtoxinA for frown lines, forehead lines and crow's feet — dosed to your anatomy, injected personally by Dr. Zaks, with results that typically last about four months. ### Overview Botox® Cosmetic (onabotulinumtoxinA) works by temporarily blocking acetylcholine release at the neuromuscular junction, preventing the muscle contractions that create dynamic wrinkles. The lines that appear when you frown, raise your brows, or squint are not caused by the skin itself — they are the skin folding over a repeatedly contracting muscle. When that muscle is selectively relaxed, the overlying skin stops folding and the line softens. Skin quality is unchanged; muscle behavior is what changes. Botox® Cosmetic is FDA-approved for glabellar (frown) lines, horizontal forehead lines, and lateral canthal lines (crow's feet), with more than twenty years of published safety data in aesthetic use. The effect is dose-dependent and fully reversible: the nerve terminal re-sprouts over time, movement returns, and the treatment can be repeated. Nothing accumulates and nothing is permanent. Candidacy is a clinical judgment, not a checkbox. Botox® is appropriate for adults with dynamic lines — lines visible in animation — across all Fitzpatrick skin types I through VI, because the mechanism is neuromuscular rather than pigment- or light-based. It is not appropriate during pregnancy, in patients with neuromuscular disorders such as myasthenia gravis or ALS, in the presence of active infection at the injection site, or in patients with a known hypersensitivity to botulinum toxin or albumin. Deeply etched static lines that remain visible at complete rest respond only partially and are usually addressed with a combined plan. Dr. Zaks evaluates facial anatomy and muscle mass at consultation to determine dose and injection points calibrated to your specific anatomy — not a one-size-fits-all formula. Corrugator bulk, frontalis height and recruitment pattern, baseline brow position, eyelid laxity, and any existing asymmetry all change the map. A patient with a strong, low brow and heavy corrugators requires a very different plan from a patient whose forehead is doing the work of holding the brows up, where over-treating the frontalis would produce heaviness rather than smoothness. Dr. Zaks personally performs every injectable, laser, and procedural treatment at his Beverly Hills practice. Patients are never seen by rotating physician assistants, nurse injectors, or aestheticians for these procedures. ### What Botox® Cosmetic Treats - **Glabellar (Frown) Lines** — The vertical '11' lines between the brows produced by the corrugator and procerus muscles. This is the original FDA-approved cosmetic indication and the most predictable area treated. - **Horizontal Forehead Lines** — Lines from repeated frontalis contraction. Dosing is deliberately conservative and distributed to soften the lines while preserving enough elevation to avoid a heavy brow — especially in patients who unconsciously use the frontalis to keep the eyelids clear. - **Crow's Feet** — Fine radiating lines at the outer eye from orbicularis oculi activity, softened with small superficial aliquots placed lateral to the orbital rim. - **Brow Shaping and Lift** — Selectively relaxing the depressor muscles at the tail of the brow can allow a subtle lateral lift of a few millimeters in appropriate candidates. This is anatomy-dependent and not achievable in everyone. - **Preventive (Early) Treatment** — Patients in their late twenties and thirties with lines just beginning to etch often treat at a lower dose to limit how deeply those lines set over the following decade. ### What the Visit Involves 1. **Consultation and anatomic assessment** — Dr. Zaks examines your face at rest and in full animation, palpates muscle bulk, notes baseline brow and eyelid position and any pre-existing asymmetry, and reviews your medical history, medications, and prior neuromodulator treatments — including what you liked and did not like about them. 2. **Injection by Dr. Zaks** — A series of small injections with a fine needle takes roughly ten minutes. Most patients describe a brief pinch; no anesthesia is required and you can return to work immediately. Dr. Zaks performs the injections himself, at every visit. 3. **Onset, review and maintenance** — Stay upright and avoid rubbing the treated areas for several hours. Softening begins around days three to five, with full effect at about two weeks. Most patients re-treat at roughly four-month intervals; if you stop, muscle movement and the original lines simply return to baseline over a few months. ### Realistic Expectations - Botox® treats dynamic lines. Lines fully visible at rest are static lines and improve only partially — those are addressed with resurfacing, peels, or filler as appropriate. - Onset is gradual, not immediate. Judging the result before two weeks leads to unnecessary re-treatment. - Duration averages about four months and varies with dose, muscle strength, metabolism, and exercise level. Very active patients often metabolize slightly faster. - Stopping treatment does not worsen anything. Movement returns and lines resume their prior trajectory; there is no rebound. - Common, self-limited effects include small injection-site marks and, uncommonly, temporary brow heaviness or eyelid ptosis that resolves as the effect wears off. ### Frequently Asked Questions **Does Dr. Zaks perform procedures himself or does he delegate to staff?** Dr. Zaks personally performs every injectable, laser, and procedural treatment at his Beverly Hills practice. You are never handed off to a rotating physician assistant, nurse injector, or aesthetician for these procedures. The physician who evaluates your anatomy is the physician who injects. **What is the difference between Botox, Dysport, and Jeuveau?** All three are botulinum toxin type A products that block acetylcholine release at the neuromuscular junction, so the mechanism is the same. They differ by manufacturer and formulation: Botox® Cosmetic (Allergan, onabotulinumtoxinA), Dysport® (Galderma, abobotulinumtoxinA), and Jeuveau® (Evolus, prabotulinumtoxinA). Units are product-specific and not interchangeable. Many patients notice Dysport® taking effect slightly sooner, around two to three days, while Botox® has the longest published aesthetic safety record. Dr. Zaks offers all three and selects based on your anatomy, prior response, and treatment goals. **How long does Botox® last, and what happens if I stop?** Most patients see about four months of effect from a standard cosmetic dose. If you stop, the nerve terminals recover, movement returns, and your lines go back to where they would have been — there is no worsening or rebound. Some long-term patients find they can extend intervals because the treated muscles have weakened with disuse. **Will I look frozen or lose my expression?** That result comes from dose and placement, not from the product. Dr. Zaks calibrates units to your muscle mass and can deliberately preserve movement — for many patients the goal is softening the line while keeping the brow mobile. If you prefer a fuller relaxation, that is also planned intentionally. **Is Botox® safe for darker skin types?** Yes. Because the mechanism is neuromuscular rather than light- or pigment-based, Botox® carries no risk of pigment alteration and is used across Fitzpatrick skin types I through VI. That is a meaningful difference from laser and peel treatments, where skin type materially changes the plan. **Does insurance cover Botox®?** Cosmetic Botox® is self-pay. Medical uses are handled on a case-by-case basis; Dr. Zaks' office will tell you which category your treatment falls into before you are treated. **How soon before an event should I be treated?** Two to three weeks. That allows full onset before the event. Treating a few days before a wedding or camera date leaves no room for the result to settle. --- ## Dysport® in Beverly Hills URL: https://beverlyhillsdermatology.com/dysport Meta description: Dysport® injections in Beverly Hills by Dr. Boris Zaks, MD. Galderma's abobotulinumtoxinA for frown lines and forehead wrinkles, with onset often slightly faster than Botox®. Section: Injectables Galderma's abobotulinumtoxinA — an alternative to Botox® Cosmetic with a comparable safety profile and, for many patients, a slightly faster onset. ### Overview Dysport® (abobotulinumtoxinA) is a purified botulinum toxin type A manufactured by Galderma. Like other neuromodulators, it works by blocking acetylcholine release at the neuromuscular junction, temporarily relaxing the facial muscles that fold the skin into expression lines. As those muscles soften, the overlying frown lines, forehead lines, and crow's feet become less visible. Dr. Zaks offers Dysport® alongside Botox® Cosmetic and Jeuveau® because patients respond differently to different products. Many patients notice onset within two to three days with Dysport® — often slightly faster than Botox® — and some find the spread of the product well suited to broader areas such as the forehead. Dr. Zaks performs every injection himself and selects the product and dosing based on your muscle strength, anatomy, and prior treatment history. Dysport®, like other botulinum toxin products, is not appropriate during pregnancy. ### What This Treats - **Glabellar Lines (Frown Lines)** — The vertical '11' lines between the brows created by the corrugator and procerus muscles — the FDA-approved indication for Dysport®. - **Horizontal Forehead Lines** — Lines produced by repeated frontalis contraction. Dosing is tailored to preserve natural brow movement and avoid a heavy, flat forehead. - **Crow's Feet** — Fine radiating lines at the outer eyes from orbicularis oculi activity, softened with small, superficial aliquots. - **Brow Position** — Selective treatment of the depressor muscles can allow a subtle lift of the lateral brow in appropriate candidates. - **Preventive Treatment** — Younger patients with early etched lines often use neuromodulators to limit the depth of lines that would otherwise become permanent. ### What the Visit Involves 1. **Consultation and facial assessment** — Dr. Zaks evaluates your muscle strength and movement patterns at rest and in animation, reviews prior neuromodulator treatments, and confirms Dysport® is the right choice for your goals. 2. **Injection** — A series of small injections with a fine needle takes about ten minutes. Most patients describe brief pinches; no anesthesia is required. 3. **Onset and maintenance** — Stay upright and avoid rubbing the treated area for several hours. Movement softens within two to three days, with full effect around two weeks. ### Frequently Asked Questions **How is Dysport® different from Botox®?** Both are botulinum toxin type A products that relax expression muscles, but they are made by different manufacturers with different formulations and unit strengths. Many patients notice Dysport® taking effect slightly sooner — often two to three days. Dr. Zaks will discuss which product fits your anatomy and goals. **How long does Dysport® last?** Most patients maintain results for approximately three to four months, similar to other neuromodulators. Duration varies with dose, muscle strength, metabolism, and treatment history. **Does it hurt?** Injections are performed with a very fine needle and most patients describe a quick pinch. No numbing cream is typically needed and the appointment takes about fifteen minutes. **Is there downtime?** No. You can return to normal activities immediately. Small red bumps at the injection sites usually resolve within an hour, and makeup can be applied later the same day. **Can I switch from Botox® to Dysport®?** Yes. Many patients try both to see which they prefer. Dr. Zaks converts your dosing appropriately, since Dysport® units are not equivalent to Botox® units. **Who performs my injections?** Dr. Zaks personally performs every injection. Your treatment is never delegated to a nurse injector or aesthetician. --- ## Jeuveau® in Beverly Hills URL: https://beverlyhillsdermatology.com/jeuveau Meta description: Jeuveau® (prabotulinumtoxinA) injections in Beverly Hills by Dr. Boris Zaks, MD. Made with Hi-Pure™ Technology by Evolus for moderate to severe frown lines. Section: Injectables Evolus's prabotulinumtoxinA — made with Hi-Pure™ Technology and FDA-approved specifically for moderate to severe glabellar frown lines. ### Overview Jeuveau® (prabotulinumtoxinA-xvfs) is a botulinum toxin type A produced by Evolus using a proprietary purification process the company calls Hi-Pure™ Technology. Like other neuromodulators, it temporarily blocks nerve signals to the corrugator and procerus muscles, allowing the skin between the brows to smooth out as those muscles relax. Jeuveau® holds a focused FDA approval for the temporary improvement of moderate to severe glabellar lines in adults, and that is the primary area where Dr. Zaks uses it. Many patients begin seeing improvement as early as day two after treatment. Dr. Zaks injects every patient personally, choosing between Jeuveau®, Botox® Cosmetic, and Dysport® based on your anatomy, response history, and how quickly you would like to see change. Jeuveau®, like other botulinum toxin products, is not appropriate during pregnancy. ### What This Treats - **Glabellar Frown Lines** — The FDA-approved indication — vertical '11' lines between the eyebrows caused by corrugator and procerus contraction. - **Angry or Tired Expression** — Persistent glabellar furrowing can read as anger or fatigue at rest; softening those muscles restores a more neutral expression. - **Early Etched Lines** — Lines that are beginning to remain visible at rest often respond well before they become deeply set in the skin. - **Fast-Onset Preference** — Patients who want visible change quickly often prefer Jeuveau®, with improvement frequently noted from day two. - **Combination Planning** — Jeuveau® addresses dynamic lines; volume loss and static creases are treated separately with hyaluronic acid fillers. ### What the Visit Involves 1. **Consultation with Dr. Zaks** — Your glabellar complex is assessed in animation, prior treatments are reviewed, and Dr. Zaks confirms whether Jeuveau® is the best neuromodulator for you. 2. **Injection appointment** — Treatment takes roughly ten minutes using a fine needle. No anesthesia is required and you can drive yourself home. 3. **Onset and maintenance** — Many patients see softening by day two, with full effect by two weeks. Dosing is adjusted at your next treatment if needed. ### Frequently Asked Questions **What is Hi-Pure™ Technology?** It is Evolus's proprietary manufacturing and purification process for Jeuveau®. Practically speaking, it describes how the product is produced and purified; your results still depend primarily on accurate dosing and injection technique. **How quickly does Jeuveau® work?** Many patients notice improvement as early as day two after treatment, with the full effect typically visible by about two weeks. **How long do results last?** Approximately three to four months for most patients, similar to other botulinum toxin type A products. Duration varies with dose and individual metabolism. **Can Jeuveau® be used outside the frown lines?** Its FDA approval is specific to moderate to severe glabellar lines, and that is where Dr. Zaks primarily uses it. For other areas he will discuss the most appropriate product and plan with you. **Is there any downtime?** None. Small injection-site bumps settle within about an hour. Avoid rubbing the area and stay upright for a few hours after treatment. **Can I alternate Jeuveau® with other neuromodulators?** Yes. Some patients respond better to one product than another, and Dr. Zaks will convert dosing appropriately when switching between Jeuveau®, Botox® Cosmetic, and Dysport®. --- ## Evolysse™ Filler in Beverly Hills URL: https://beverlyhillsdermatology.com/evolysse Meta description: Evolysse™ hyaluronic acid filler in Beverly Hills by Dr. Boris Zaks, MD. Evolus HA gel made with Cold-X Technology™ for cheeks, lips, and the under-eye area. Section: Injectables Evolus's hyaluronic acid filler line, manufactured with Cold-X Technology™ and recognized with the SHAPE Best Filler award. ### Overview Evolysse™ is a hyaluronic acid (HA) dermal filler line from Evolus. Hyaluronic acid is a sugar molecule that occurs naturally in skin and binds water; when placed in the dermis or deeper tissue planes it restores volume, supports overlying skin, and softens creases. Evolysse™ gels are produced using the company's Cold-X Technology™, a cold-processing crosslinking method intended to preserve the natural structure of the HA chains and produce a smooth, tissue-integrating gel. Dr. Zaks uses Evolysse™ where a smooth, well-integrating gel is an advantage — cheek volume restoration, lip enhancement, and careful correction of the under-eye hollow. The line has been recognized with the SHAPE Best Filler award. Because filler results depend far more on the injector than on the brand, Dr. Zaks performs every injection personally, working conservatively and reassessing before adding more product. ### Where Evolysse™ Is Used - **Cheek Volume Restoration** — Rebuilding midface support that flattens with age, which in turn softens the nasolabial folds and improves overall facial contour. - **Lip Enhancement** — Subtle volume, better definition of the vermilion border, and improved balance between the upper and lower lip. - **Under-Eye Hollows (Tear Troughs)** — A delicate area treated conservatively with small volumes to reduce shadowing. Candidacy is assessed carefully, as this area is prone to swelling. - **Perioral Lines and Corners** — Fine vertical lip lines and downturned oral commissures can be softened with small, superficial placement. - **Nasolabial Folds** — Direct treatment of the fold, often combined with cheek support for a more natural, longer-lasting improvement. ### What the Visit Involves 1. **Facial analysis and plan** — Dr. Zaks assesses volume loss, asymmetry, and skin quality, then determines which Evolysse™ formulation and what volume suit your anatomy. 2. **Injection** — Filler is placed with a fine needle in small increments, with frequent reassessment in the mirror. The gels contain lidocaine, so most patients find treatment very tolerable. 3. **Recovery** — Expect mild swelling for a few days and possible bruising. The final contour settles over about two weeks. ### Frequently Asked Questions **What is Cold-X Technology™?** It is the cold-processing crosslinking method Evolus uses to manufacture Evolysse™ gels. The intent is to preserve the natural structure of the hyaluronic acid chains, producing a smooth gel that integrates well with tissue. **How long does Evolysse™ last?** Hyaluronic acid fillers generally last between several months and roughly a year or more depending on the formulation, the area treated, and how quickly your body metabolizes the gel. Areas with more movement, such as the lips, typically need refreshing sooner. **How much swelling should I expect?** Mild to moderate swelling is normal for two to five days, and lips and the under-eye area swell the most. Sleeping with your head elevated and using cool compresses helps. **Can Evolysse™ be combined with Botox®?** Yes, and they are complementary — neuromodulators relax the muscles that create dynamic lines while filler restores lost volume and structure. Both are often performed at the same visit. **What is the SHAPE Best Filler award?** It is a consumer beauty award recognizing the Evolysse™ line. Awards are helpful context, but Dr. Zaks selects products based on tissue behavior and the result he is trying to achieve for you. --- ## Restylane® Filler in Beverly Hills URL: https://beverlyhillsdermatology.com/restylane Meta description: Restylane® hyaluronic acid fillers in Beverly Hills by Dr. Boris Zaks, MD. Multiple formulations for cheeks, lips, nasolabial folds, and under-eye hollows. Section: Injectables Galderma's hyaluronic acid filler suite — multiple formulations with different gel textures, each suited to a different facial area. ### Overview Restylane® is a family of hyaluronic acid dermal fillers from Galderma, one of the longest-established HA lines in aesthetic medicine. Hyaluronic acid binds water and provides structural support, so injecting a crosslinked HA gel replaces volume that has been lost, lifts depressed contours, and hydrates the tissue from within. The value of the Restylane® suite is that its formulations differ in gel firmness and particle characteristics. Firmer, more supportive gels are used deep on bone for cheek and midface projection; softer, more flexible gels are used for lips and fine lines; and the most delicate formulations are chosen for thin-skinned areas such as the tear trough. Dr. Zaks selects the specific formulation, plane, and volume for each area himself and performs every injection personally. ### Areas Treated with Restylane® - **Cheeks and Midface** — Firmer formulations placed deep for structural lift and projection, restoring the support that flattens with age. - **Lips** — Softer, flexible gels for natural volume, border definition, and improved lip balance that still moves normally. - **Nasolabial Folds and Marionette Lines** — Direct correction of the folds running from the nose to the mouth and from the mouth corners downward. - **Under-Eye Hollows** — Conservative small-volume correction with a delicate formulation to reduce hollowing and shadowing in appropriate candidates. - **Jawline and Chin Definition** — Structural gel used along the jaw and chin to sharpen contour and improve profile balance. - **Hands** — Volume restoration on the dorsal hands to soften the appearance of prominent tendons and veins. ### What the Visit Involves 1. **Consultation and mapping** — Dr. Zaks evaluates facial proportion, volume loss, and skin thickness, then plans which Restylane® formulation goes where and in what amount. 2. **Injection** — Product is placed incrementally with a fine needle, with reassessment throughout to keep results balanced. 3. **Aftercare** — Avoid strenuous exercise and alcohol for 24 hours. Swelling settles over several days; the final result is judged at about two weeks. ### Frequently Asked Questions **Which Restylane® product will I need?** It depends on the area and the correction required. Firmer gels are used for cheek and jawline structure, softer gels for lips and fine lines, and the most delicate formulations for the under-eye area. Dr. Zaks chooses at your consultation. **How long do Restylane® results last?** Typically between several months and roughly eighteen months depending on the formulation and area. Structural placement in the cheeks tends to last longest; lips, which move constantly, last the shortest. **Does filler hurt?** Most patients tolerate it well. The gels contain lidocaine, and injections are placed slowly in small increments. Lips are the most sensitive area treated. **Will I bruise?** Bruising is possible with any filler injection, especially around the lips and eyes. Avoiding fish oil, aspirin, and other blood-thinning supplements for a week beforehand — when medically appropriate — reduces the risk. **How is Restylane® different from Evolysse™?** Both are hyaluronic acid fillers but they are made by different companies using different crosslinking processes, which changes how the gels feel and behave in tissue. Dr. Zaks uses both and picks based on the area being treated. --- ## Cheek Filler in Beverly Hills URL: https://beverlyhillsdermatology.com/cheek-filler Meta description: Cheek filler for midface volume restoration in Beverly Hills by Dr. Boris Zaks, MD, using Restylane® or Evolysse™ hyaluronic acid fillers. Section: Injectables Midface volume restoration with hyaluronic acid filler — Restylane® or Evolysse™ — placed to rebuild support rather than to inflate. ### Overview The midface loses volume with age through fat pad atrophy, bone remodeling, and descent of the soft tissue. Because the cheek is the structural keystone of the face, that loss shows up in several places at once: flatter cheekbones, deeper nasolabial folds, hollowing under the eyes, and a heavier look along the jaw. Replacing volume at the source addresses all of them together. Dr. Zaks treats the cheeks with hyaluronic acid fillers — typically a structural Restylane® formulation or Evolysse™ — placed on the deep tissue planes and over bone where support is actually needed. His approach is deliberately conservative: rebuild the underlying scaffold, keep the result proportionate to your face, and reassess before adding more product. He performs every injection himself. ### What Cheek Filler Addresses - **Flat or Deflated Cheekbones** — Restores projection over the zygomatic arch for a defined, lifted midface contour. - **Midface Hollowing** — Rebuilds volume lost from the deep medial and lateral cheek fat pads, which creates a gaunt or tired appearance. - **Deep Nasolabial Folds** — Supporting the cheek from above often softens the folds more naturally than injecting the fold alone. - **Under-Eye Shadowing** — Lateral cheek support can reduce the shadow at the upper cheek and improve the transition into the tear trough. - **Facial Asymmetry** — Differing volume between sides can be balanced with asymmetric placement — a common and often overlooked correction. ### What the Visit Involves 1. **Assessment** — Dr. Zaks analyzes your midface volume, proportion, and skin quality, and discusses realistic goals and how much product is appropriate. 2. **Structural placement** — Filler is placed in small increments in the deep planes with a fine needle, with mirror checks throughout to keep the result balanced and natural. 3. **Recovery** — Mild swelling and possible bruising for a few days. The contour settles by about two weeks. ### Frequently Asked Questions **How much filler will I need?** It varies with the degree of volume loss — commonly one to two syringes per session, sometimes staged across visits. Dr. Zaks prefers to build gradually rather than overfill in one appointment. **Will I look overdone?** Not with structural, conservative placement. The 'overfilled' look usually comes from too much product placed too superficially. The goal is restored support, not a wider or rounder face. **How long do cheek filler results last?** Cheek filler is generally among the longest-lasting placements — often roughly a year or more — because the area moves less than the lips or perioral region. **Is there downtime?** Most patients return to work immediately. Expect mild swelling for a few days, and bruising is possible. Skip strenuous exercise for 24 hours. **Which filler is used?** Typically a structural Restylane® formulation or Evolysse™. Dr. Zaks chooses between them based on the area being treated and the tissue support needed. **Can cheek filler replace a facelift?** No. Filler restores volume; it does not remove excess skin. For significant skin laxity, Dr. Zaks will tell you honestly if filler is not the right answer and discuss other options, including skin-tightening treatments. --- ## Lip Filler in Beverly Hills URL: https://beverlyhillsdermatology.com/lip-filler Meta description: Natural-looking lip filler in Beverly Hills by Dr. Boris Zaks, MD, using soft hyaluronic acid fillers such as Restylane® and Evolysse™. Section: Injectables Lip augmentation with soft hyaluronic acid filler — shaped for definition and balance rather than size alone. ### Overview Lips lose volume and definition over time: the vermilion border blurs, the philtral columns flatten, the upper lip lengthens, and fine vertical lines develop. Hyaluronic acid filler restores volume and re-establishes those landmarks. Because HA binds water, it also improves hydration and texture within the lip tissue itself. Dr. Zaks approaches lips as a shaping procedure, not a volumizing one. He uses soft, flexible HA formulations from the Restylane® and Evolysse™ lines, typically starting with a small amount — often half a syringe to one syringe — and building over visits if you want more. Every injection is performed by Dr. Zaks personally. ### What Lip Filler Addresses - **Thin or Deflated Lips** — Restores volume in the body of the lip, whether from genetics or age-related loss. - **Loss of Vermilion Border** — Redefines the lip outline so lipstick stops feathering and the lip regains a crisp edge. - **Lip Asymmetry** — Balances differences between the left and right sides, or between the upper and lower lip. - **Downturned Corners** — Support at the oral commissures can lift corners that turn down and read as a resting frown. ### What the Visit Involves 1. **Consultation and goal setting** — Dr. Zaks examines lip proportion, symmetry, and border definition, and discusses exactly what change you want and what is achievable naturally. 2. **Shaping injections** — Small aliquots are placed in the body and border of the lip with frequent mirror checks. Volume is added gradually rather than all at once. 3. **Recovery** — Lips swell more than other areas — expect noticeable swelling for two to four days and possible bruising. Ice, head elevation, and avoiding salt and alcohol help. Final shape appears at about two weeks. ### Frequently Asked Questions **Will my lips look obviously done?** No — “obviously done” is not the goal. Dr. Zaks takes a conservative approach, adding small amounts to improve shape and structure while keeping the result believable. Most first treatments use half to one syringe, and more can be added later if you want it. **How long do lip fillers last?** Usually around six to twelve months. Lips are constantly in motion, so filler metabolizes faster here than in the cheeks. **How bad is the swelling?** Meaningful swelling for the first two to four days is normal and expected. Don't schedule a major event within a week of treatment. **Is lip filler painful?** It is the most sensitive area treated, but the filler contains lidocaine and injections are placed slowly in small amounts. Most patients describe it as very manageable. --- ## Acne Treatment in Beverly Hills URL: https://beverlyhillsdermatology.com/acne Meta description: Comprehensive acne treatment in Beverly Hills by Dr. Boris Zaks, MD — prescription topicals, spironolactone for hormonal acne, photodynamic therapy, and blue light. Covered by most PPO plans. Section: Acne A medical approach to acne — prescription topicals, hormonal therapy where appropriate, and in-office light-based treatment, directed by a board-certified dermatologist. ### Overview Acne develops through four interacting mechanisms: increased sebum production, abnormal keratinization that plugs the follicle, proliferation of Cutibacterium acnes within that plugged follicle, and the resulting inflammation. Effective treatment targets more than one of those mechanisms at the same time, which is why single-product regimens so often plateau. Dr. Zaks evaluates lesion type — comedonal, inflammatory papules and pustules, or deeper nodules — along with distribution, scarring risk, and hormonal pattern, then builds a regimen accordingly. Treatment is medical, not cosmetic: topical retinoids to normalize follicular keratinization, benzoyl peroxide and topical antibiotics to reduce bacterial load and inflammation, azelaic acid for inflammation and post-inflammatory pigment, oral antibiotics for a defined course in moderate inflammatory disease, and spironolactone for hormonally driven acne in appropriate female patients. When topical and oral therapy is not enough or a patient prefers to avoid long-term oral medication, Dr. Zaks offers in-office photodynamic therapy with Levulan® and blue light. Acne is a medical diagnosis, so visits are covered by most major PPO plans and Medicare. ### Treatment Options - **Prescription Topical Retinoids** — Tretinoin, adapalene, or tazarotene normalize follicular keratinization, clear existing comedones, and prevent new ones. The foundation of nearly every regimen; dosing is titrated to manage initial dryness and irritation. - **Benzoyl Peroxide and Topical Antibiotics** — Benzoyl peroxide reduces C. acnes without resistance; clindamycin and other topical antibiotics reduce inflammation. Combination products limit resistance and simplify the routine. - **Azelaic Acid** — Anti-inflammatory and antibacterial, with the added benefit of reducing post-inflammatory hyperpigmentation. Particularly useful for skin of color and for pregnancy-safe regimens. - **Spironolactone for Hormonal Acne** — An androgen receptor blocker used in appropriate female patients with jawline, chin, and lower-face acne that flares cyclically. Requires monitoring and is not used in pregnancy. - **Oral Antibiotics** — Doxycycline or minocycline for a defined course in moderate to severe inflammatory acne, paired with topical therapy so results are maintained after the course ends. - **Photodynamic Therapy and Blue Light** — In-office light-based treatment. Levulan® (aminolevulinic acid) plus blue light for moderate to severe acne, or blue light alone as a gentler, medication-free option. ### What the Visit Involves 1. **Medical evaluation** — Dr. Zaks examines lesion type and distribution, reviews your history including hormonal patterns, medications, and prior treatments, and assesses scarring risk. 2. **Individualized regimen** — Dr. Zaks explains each option clearly so you understand why it is chosen and how to use it. Regimens are tailored to your skin and built to be tolerable, because consistency matters more than intensity. 3. **In-office treatment when indicated** — For moderate to severe or treatment-resistant acne, photodynamic therapy (PDT) is scheduled alongside your topical regimen. In some cases, laser treatment is added to target stubborn inflammation or scarring risk. 4. **Follow-up and adjustment** — Initial improvement can be seen in four to six weeks, with further improvement seen over time. Dr. Zaks reassesses at follow-up, escalates or de-escalates therapy, and moves you onto a maintenance plan once you are clear. ### Frequently Asked Questions **How long before I see improvement?** Initial improvement can be seen in four to six weeks, with further improvement seen over time. Retinoids in particular can cause a period of dryness and purging in the first several weeks before results appear, which is why follow-up matters. **Do you treat adult and hormonal acne?** Yes. Adult-onset acne along the jawline, chin, and lower face that flares cyclically is common and very treatable. For appropriate female patients, spironolactone is often highly effective, alone or with topical therapy. **Is acne treatment covered by insurance?** Acne is a medical diagnosis, and visits are covered by most major PPO plans and Medicare. Prescription coverage depends on your pharmacy benefit; in-office light-based treatments may be handled differently, and our office will review costs with you in advance. **Will treating my acne prevent scarring?** Treating inflammatory acne early and effectively is the single best way to reduce permanent scarring. If you already have scarring or post-inflammatory redness and pigment, those are treated separately once active acne is controlled. **Can I keep using my current skincare products?** Bring them to your appointment. Dr. Zaks will tell you what to keep and what is working against you — heavy occlusive products and aggressive scrubs commonly make acne worse. **What if topical treatment hasn't worked for me before?** That usually means the regimen wasn't targeting enough of the underlying mechanisms, wasn't tolerable enough to continue, or wasn't given enough time. Dr. Zaks reviews exactly what you used and how, then escalates appropriately — including in-office photodynamic therapy. **Who performs the in-office treatments?** Dr. Zaks personally performs every procedure. Your treatment is never delegated to rotating assistants. --- ## Photodynamic Therapy in Beverly Hills URL: https://beverlyhillsdermatology.com/photodynamic-therapy Meta description: Photodynamic therapy in Beverly Hills by Dr. Boris Zaks, MD — Levulan® (ALA) with blue light for moderate to severe acne and extensive actinic keratoses. Featured in Glamour. Section: Acne Levulan® (aminolevulinic acid) activated by blue light — an in-office treatment for moderate to severe acne and for field treatment of extensive actinic keratoses, featured in Glamour. ### Overview Photodynamic therapy (PDT) combines a topical photosensitizing medication with a specific wavelength of light. Dr. Zaks applies Levulan® — aminolevulinic acid, or ALA — which is preferentially taken up by sebaceous glands and by rapidly dividing precancerous cells and converted intracellularly into protoporphyrin IX. After an incubation period of 45–60 minutes, blue light activation triggers a photodynamic reaction that generates reactive oxygen species, selectively damaging the sebaceous glands driving acne, or the actinic keratosis cells in an extensive field, while sparing surrounding normal skin. Individual actinic keratoses are more commonly treated with liquid nitrogen cryospray. Dr. Zaks uses PDT primarily for moderate to severe acne, particularly in patients who have not responded adequately to topical and oral therapy or who prefer to avoid extended courses of oral medication, and for field treatment of extensive actinic keratoses on sun-damaged skin. Individual actinic keratoses are more commonly treated with liquid nitrogen cryospray. Dr. Zaks — named a "Rock Star Dermatologist" by Glamour Magazine, which has featured this treatment — performs every session himself, controlling incubation time and light dose. ### What Photodynamic Therapy Treats - **Moderate to Severe Acne** — The primary indication. Targets the sebaceous glands driving oil production and reduces inflammatory lesions, especially in patients who have plateaued on conventional therapy. - **Treatment-Resistant Acne** — For acne that persists despite well-executed topical and oral regimens, PDT offers a different mechanism of action rather than another prescription. - **Actinic Keratoses** — Precancerous rough, scaly lesions from cumulative sun exposure. Individual lesions are usually treated with liquid nitrogen cryospray; PDT is used for extensive field treatment or prevention. - **Sebaceous Hyperplasia** — Enlarged sebaceous glands appearing as small, yellowish, dome-shaped papules can improve with photodynamic treatment. - **Oily Skin and Enlarged Pores** — Reduced sebaceous activity often improves oiliness and the appearance of pores as a secondary benefit of acne treatment. ### What the Visit Involves 1. **Evaluation and consent** — Dr. Zaks confirms PDT is appropriate, reviews photosensitizing medications you may be taking, and explains the expected reaction and downtime in detail. 2. **Levulan® application and incubation** — Cleansing and degreasing, then Levulan® is applied to the treatment area. It incubates for 45–60 minutes; afterward, you must avoid sunlight for 36 hours. 3. **Blue light activation** — The treated area is exposed to blue light for the prescribed time. Most patients feel warmth, stinging, or tingling, which is expected and managed with cool air. 4. **Strict sun avoidance and healing** — You must avoid all sun exposure for 36 hours. Expect redness, sensitivity, and peeling over several days. Dr. Zaks provides specific aftercare and schedules follow-up; a series of treatments is often recommended. ### Important Information - Incubation with Levulan® takes 45–60 minutes, so plan for a longer appointment or a return visit the same day. - Strict sun avoidance for 36 hours after treatment is mandatory — the skin remains photosensitized, and sun exposure can cause a severe reaction. - Expect a period of redness, sensitivity, and peeling similar to a strong sunburn. Do not schedule PDT within a week of an important event. - Tell Dr. Zaks about all medications and supplements; several common drugs increase photosensitivity. - A series of treatments is typically recommended for acne, spaced several weeks apart, with your topical regimen continued in between. ### Frequently Asked Questions **How long is the appointment?** Plan on a longer visit. Levulan® incubates on the skin for 45–60 minutes before the blue light activation, which itself takes a defined number of minutes. **How much downtime should I expect?** Most patients have redness, sensitivity, and peeling for several days — comparable to a strong sunburn. Avoid scheduling PDT within a week of an important event. **Why is sun avoidance so important afterward?** Your skin remains photosensitized for 36 hours after treatment. Sun exposure during that window can cause an exaggerated, painful reaction, so strict avoidance is required. **How many treatments will I need?** For acne, a series spaced several weeks apart is typical. For actinic keratoses, PDT is used when the field is extensive; individual lesions are more commonly treated with liquid nitrogen cryospray. Dr. Zaks will give you a specific plan. **Is PDT painful?** During blue light activation most patients feel warmth, stinging, or tingling. It is generally tolerable and cool air is used for comfort. Discomfort ends when the light does. **Is PDT covered by insurance?** When performed for actinic keratoses, PDT is often covered by PPO plans and Medicare as a medically necessary treatment. Coverage for acne varies by plan. Our office will review your benefits before treatment. --- ## Blue Light Acne Treatment in Beverly Hills URL: https://beverlyhillsdermatology.com/blue-light-acne-treatment Meta description: Blue light acne treatment in Beverly Hills by Dr. Boris Zaks, MD — a gentle, medication-free in-office option for mild to moderate acne with no downtime. Section: Acne Blue light alone, without Levulan® — a gentle, medication-free in-office option for mild to moderate inflammatory acne, with essentially no downtime. ### Overview Blue light in the approximately 415 nm range is absorbed by porphyrins produced naturally by Cutibacterium acnes inside the follicle. That absorption generates reactive oxygen species within the bacteria themselves, reducing bacterial load and the inflammation it drives. Because the light acts on the bacteria rather than on the skin, treatment is comfortable and requires no topical medication and no anesthesia. This is the standalone version of light therapy: blue light without the Levulan® photosensitizer used in photodynamic therapy. That makes it gentler and essentially downtime-free, but also less powerful. Dr. Zaks recommends blue light alone for mild to moderate inflammatory acne, for patients who want to avoid oral medication, for those who cannot tolerate the peeling associated with PDT, and as maintenance between other treatments. For moderate to severe or treatment-resistant acne, he will recommend photodynamic therapy with Levulan® instead. ### Best Candidates and Targets - **Mild to Moderate Inflammatory Acne** — Red papules and pustules driven by C. acnes respond best. Blue light reduces bacterial load and the inflammation that follows. - **Patients Avoiding Oral Medication** — A drug-free in-office option for patients who prefer not to take oral antibiotics or hormonal therapy, or who cannot. - **No-Downtime Requirement** — Because there is no photosensitizer, there is no peeling phase. You can return to work and normal activity immediately. - **Maintenance Between Treatments** — Used to help hold results between photodynamic therapy sessions or while a topical regimen is being established. - **Adjunct to Topical Therapy** — Blue light works best combined with a prescription topical regimen rather than as a sole treatment. ### What the Visit Involves 1. **Evaluation** — Dr. Zaks confirms your acne is the type that responds to blue light alone, and tells you honestly if photodynamic therapy would serve you better. 2. **Cleansing** — The skin is cleansed, but no medication or degreasing is required. You relax in front of the blue light for 15 minutes per session. A typical course is twice weekly for 4 weeks or once weekly for 8 weeks. 3. **Light session** — You wear protective eyewear while the blue light is delivered to the treatment area. Sessions are short and comfortable — most patients feel only mild warmth. 4. **Series and maintenance** — Treatments are typically repeated over several weeks. You resume normal activities and your topical regimen immediately. ### Frequently Asked Questions **How is this different from photodynamic therapy?** Photodynamic therapy adds Levulan® (aminolevulinic acid), which incubates for 45–60 minutes and makes the treatment substantially more powerful — and causes redness and peeling. Blue light alone uses no medication, has essentially no downtime, and is correspondingly gentler. **How many sessions will I need?** A series over several weeks is typical, and maintenance sessions may be recommended afterward. Dr. Zaks will outline a specific schedule based on your response. **Is there any downtime?** No. There is no peeling phase and no photosensitization, so you can return to work, exercise, and makeup the same day. **Does blue light hurt?** No. Most patients feel only mild warmth. Protective eyewear is worn throughout the session. **Will blue light alone clear my acne?** It works best as part of a plan. Blue light reduces bacteria and inflammation, but a prescription topical regimen is still needed to address follicular plugging and oil production. **Is it safe for all skin types?** Blue light is generally well tolerated across skin types since it targets bacterial porphyrins rather than pigment. Dr. Zaks reviews your medications for photosensitizing agents before treatment. --- ## Acne Scarring Treatment in Beverly Hills URL: https://beverlyhillsdermatology.com/acne-scarring Meta description: Acne scarring treatment in Beverly Hills by Dr. Boris Zaks, MD — Vbeam® laser for red scars (PIE), salicylic acid and Cosmelan® peels for brown discoloration (PIH), and filler for atrophic scars. Section: Acne Acne scarring is not one problem. Red marks, brown marks, and true depressed scars each require a different treatment — and Dr. Zaks treats them differently. ### Overview Patients often describe everything left behind by acne as "scarring," but there are three distinct entities. Post-inflammatory erythema (PIE) is the flat pink or red mark left by dilated capillaries after an inflamed lesion resolves — it is a vascular problem. Post-inflammatory hyperpigmentation (PIH) is the flat brown or tan mark from excess melanin deposited during inflammation — it is a pigment problem, and it is more common in deeper skin tones. Atrophic scars are true depressions with lost dermal collagen — a structural problem. Hypertrophic and keloid scars, which are raised, are a fourth and separate category. Because the mechanisms differ, so do the treatments. Dr. Zaks uses the Vbeam® pulsed dye laser for red post-inflammatory erythema, because its 595 nm wavelength targets hemoglobin in those dilated vessels. He uses salicylic acid and Cosmelan® peels for post-inflammatory hyperpigmentation, since both promote controlled clearance of pigmented cells. And he uses hyaluronic acid filler to lift atrophic depressed scars where volume has been lost. The essential first step, however, is controlling active acne — treating scarring while new inflammatory lesions keep forming means continuously creating new marks. ### Types of Scarring and How They Are Treated - **Post-Inflammatory Erythema (PIE) — Vbeam®** — Flat red or pink marks from dilated capillaries. Treated with the Vbeam® pulsed dye laser, whose 595 nm wavelength is absorbed by hemoglobin in those vessels. - **Post-Inflammatory Hyperpigmentation (PIH) — Salicylic Acid & Cosmelan® Peels** — Flat brown or tan marks from excess melanin. Treated with salicylic acid peels or the Cosmelan® depigmentation system, depending on the depth and persistence of pigment, alongside daily mineral sunscreen at SPF 30+. - **Atrophic (Depressed) Scars — Filler** — True indentations where dermal collagen was lost. Hyaluronic acid filler placed beneath the scar lifts the depression to the level of surrounding skin. - **Rolling and Boxcar Scars** — Broader, shallower depressions with sloped or sharply defined edges. Assessed individually — some respond well to filler support, others do not. - **Active Acne — Treated First** — Scar treatment is ineffective while new inflammatory lesions continue to appear. Dr. Zaks controls active acne before, or alongside, scar treatment. - **Sun Protection** — Daily mineral sunscreen at SPF 30+ is non-negotiable for pigmented marks, which darken and persist far longer with UV exposure. ### What the Visit Involves 1. **Scar classification** — Dr. Zaks examines your skin under good lighting and, where useful, with stretching to distinguish red vascular marks from brown pigment and from true depressions. 2. **Control of active acne** — Any ongoing inflammatory acne is treated first with a medical regimen, so that new marks stop forming while existing ones are being treated. 3. **Targeted treatment** — Vbeam® sessions for redness, salicylic acid or Cosmelan® peels for pigment, and filler for depressed scars — used in the combination your skin actually requires, often in a series. 4. **Maintenance and review** — Progress is reviewed between sessions and the plan is adjusted. Daily mineral sunscreen at SPF 30+ and a maintenance topical regimen protect the improvement. ### Important Information - Chemical peels in this practice are limited to salicylic acid peels and the Cosmelan® system. Dr. Zaks does not use TCA or glycolic acid peels. - Post-inflammatory erythema and hyperpigmentation are marks, not permanent scars, and many fade over months on their own — treatment shortens that timeline. - Atrophic scars generally require a series of treatments, and realistic improvement rather than complete erasure is the goal. - In deeper skin tones, aggressive treatment can itself cause hyperpigmentation, so Dr. Zaks proceeds conservatively and adjusts settings accordingly. ### Frequently Asked Questions **What is the difference between red marks and real scars?** Red marks (post-inflammatory erythema) are dilated capillaries in otherwise normal skin, and brown marks (post-inflammatory hyperpigmentation) are excess melanin. Neither has lost tissue. True scars are depressions where dermal collagen was destroyed. Only the last is structural, and each requires a different treatment. **How does the Vbeam® laser help acne scarring?** Its 595 nm wavelength is absorbed by hemoglobin, so it targets the dilated vessels responsible for persistent redness after acne. It treats the red component, not depressions or brown pigment. **Which peels do you use for brown marks?** Salicylic acid peels and the Cosmelan® lightening system. Dr. Zaks does not use TCA or glycolic acid peels. **Can filler really improve depressed scars?** Yes, for atrophic scars where volume has been lost. Hyaluronic acid filler placed beneath the depression raises it toward the level of the surrounding skin. It is not appropriate for every scar type, which is why classification matters. **How many treatments will I need?** Acne scarring is treated in a series, typically spaced weeks apart, and often with more than one modality. Dr. Zaks will give you a realistic expectation at consultation rather than a promise of one-visit correction. **Do I need to treat my active acne first?** Yes. Treating scarring while inflammatory lesions continue to form means new marks keep appearing. Controlling active acne is both the first step in scar treatment and the best way to prevent further scarring. **I have deeper skin — is treatment safe for me?** Yes, with appropriate caution. Deeper skin tones are more prone to post-inflammatory hyperpigmentation, so Dr. Zaks uses conservative settings and prioritizes pigment-safe approaches and strict photoprotection with mineral sunscreen at SPF 30+. --- ## Chemical Peels in Beverly Hills URL: https://beverlyhillsdermatology.com/chemical-peels Meta description: Chemical peels in Beverly Hills by Dr. Boris Zaks, MD — salicylic acid peels and the Cosmelan® depigmentation system only, chosen for safety across skin tones. Section: Skin Care & Laser Dr. Zaks performs salicylic acid peels and the Cosmelan® depigmentation system. ### Overview A chemical peel applies a controlled chemical agent to the skin to accelerate exfoliation and stimulate renewal. Dr. Zaks deliberately limits his practice to two agents. Salicylic acid is a beta hydroxy acid, meaning it is lipid-soluble and penetrates into the sebaceous follicle — which makes it the right choice for acne, congestion, oiliness, and post-inflammatory hyperpigmentation. Cosmelan® is a professional depigmentation system that works by inhibiting tyrosinase, the key enzyme in melanin synthesis, and is used for melasma and stubborn pigmentation. This restriction is intentional, not a limitation. Deeper TCA peels and glycolic acid peels carry a meaningfully higher risk of post-inflammatory hyperpigmentation, prolonged redness, and unpredictable healing — particularly in the skin of color that makes up a large part of a Los Angeles dermatology practice. Salicylic acid and Cosmelan® deliver reliable results with a far more favorable safety profile. Dr. Zaks performs every peel personally, so the agent, contact time, and number of passes are chosen and controlled by a board-certified dermatologist. ### What Chemical Peels Address - **Active Acne and Congestion** — Salicylic acid is lipid-soluble and penetrates the sebaceous follicle, clearing comedones and reducing inflammatory lesions. - **Post-Inflammatory Hyperpigmentation** — Brown marks left behind by acne respond to salicylic acid peels combined with daily mineral sunscreen at SPF 30+. - **Melasma and Stubborn Pigmentation** — The Cosmelan® system inhibits tyrosinase to reduce melanin production, used with a structured home maintenance protocol. - **Oily Skin and Enlarged Pores** — Regular salicylic acid peels reduce surface oil and follicular plugging, improving the appearance of pores. - **Dull, Uneven Texture** — Controlled exfoliation improves surface smoothness and light reflection without the downtime of a deep peel. ### What the Visit Involves 1. **Skin evaluation and preparation** — Dr. Zaks assesses your skin type, pigment risk, and concern, and advises which agents and home products to pause before treatment. 2. **Cleansing and degreasing** — The skin is thoroughly cleansed and degreased so the peel penetrates evenly — uneven prep is a common cause of patchy results. 3. **Peel application** — The peel is applied in controlled passes with Dr. Zaks monitoring your skin's response. Most patients feel tingling or mild stinging for a few minutes. 4. **Aftercare and series** — Expect mild flaking for several days. Daily mineral sunscreen at SPF 30+ is required. Peels are generally performed in a series spaced weeks apart, with the Cosmelan® system following its own defined home protocol. ### Important Information - This practice uses salicylic acid peels and the Cosmelan® system only. Dr. Zaks does not perform TCA or glycolic acid peels. - Daily mineral sunscreen at SPF 30+ is mandatory before and after any peel — sun exposure after a peel is the most common cause of post-inflammatory hyperpigmentation. - Patients with darker skin types require conservative protocols, since aggressive peeling itself can trigger pigmentation. - Retinoids and exfoliating actives are usually paused for several days before and after treatment. ### Frequently Asked Questions **Why don't you offer TCA or glycolic acid peels?** Because their risk profile isn't justified by their benefit for most patients. Deeper TCA peels and glycolic acid peels carry higher rates of post-inflammatory hyperpigmentation, prolonged redness, and unpredictable healing, especially in skin of color. Salicylic acid and Cosmelan® achieve excellent results far more safely. **What is Cosmelan®?** A professional depigmentation system that inhibits tyrosinase, the enzyme required for melanin production. It is used for melasma and stubborn pigmentation, and involves an in-office application followed by a structured home maintenance protocol. **How much peeling and downtime should I expect?** Salicylic acid peels typically cause mild flaking for a few days. Cosmelan® produces more visible peeling in the first week. Dr. Zaks will tell you exactly what to expect before you commit to a date. **How many peels will I need?** Salicylic acid peels are usually performed in a series spaced several weeks apart. Cosmelan® follows its own protocol, with results built and maintained through the home regimen. **Are peels safe for darker skin tones?** Salicylic acid peels and Cosmelan® are the agents Dr. Zaks specifically chose because they are safer across skin tones. Protocols are still kept conservative, since darker skin is more prone to post-inflammatory pigment. **Can I have a peel if I use tretinoin?** Yes, but you should discontinue tretinoin and other retinoids more than one week before a peel, and avoid restarting them until your skin has fully recovered. Bring your full product list to your appointment. --- ## Hyperpigmentation & Brown Spots in Beverly Hills URL: https://beverlyhillsdermatology.com/hyperpigmentation-brown-spots Meta description: Hyperpigmentation and brown spot treatment in Beverly Hills by Dr. Boris Zaks, MD — accurate diagnosis of all six common types plus the Cosmelan® lightening system. Section: Skin Care & Laser Six different conditions produce brown spots, and they do not respond to the same treatment. Correct diagnosis comes first. ### Overview Hyperpigmentation means excess melanin, but the reason for that excess varies — and so does the treatment. Melasma is hormonally influenced and driven by both pigment and vascular components; post-inflammatory hyperpigmentation follows any inflammatory insult; solar lentigines are the discrete brown macules of chronic sun exposure; ephelides (freckles) are genetically determined and darken with UV; drug-induced pigmentation follows specific medications; and the diffuse mottling often called age spots reflects cumulative photodamage. Treating all of these the same way is why over-the-counter regimens so often fail. Dr. Zaks begins by establishing which type of hyperpigmentation you have, since some respond to topical tyrosinase inhibition, some require rigorous sun protection above all, and some — such as melasma — can worsen with overly aggressive treatment. His mainstays are the Cosmelan® depigmentation system, prescription topical regimens, salicylic acid peels, and disciplined daily photoprotection. Darker skin tones require particular caution with lasers, because energy-based treatment can itself trigger pigmentation. ### The Six Common Types - **Melasma** — Symmetric brown to gray-brown patches on the cheeks, forehead, and upper lip, influenced by hormones, UV, and heat. Chronic and relapsing; requires maintenance rather than a one-time fix. - **Post-Inflammatory Hyperpigmentation (PIH)** — Flat brown marks following inflammation — acne, eczema, injury, or a procedure. More common and more persistent in deeper skin tones. - **Solar Lentigines** — Discrete, well-defined light-to-dark brown macules on chronically sun-exposed skin such as the face, chest, shoulders, and dorsal hands. - **Ephelides (Freckles)** — Small, genetically determined tan macules that darken with sun exposure and fade in winter. Best managed with photoprotection. - **Drug-Induced Pigmentation** — Pigment change caused by specific medications. Identifying the responsible drug — in coordination with your prescribing physician — is essential before treatment. - **Age Spots / Diffuse Photodamage** — Mottled, uneven pigmentation from cumulative UV exposure, often with associated texture change and actinic damage. ### What the Visit Involves 1. **Diagnosis** — Dr. Zaks examines the pattern, distribution, and depth of pigment and reviews your medications, hormonal history, and sun exposure to determine the type. 2. **Targeted plan** — A regimen is built for your specific diagnosis — the Cosmelan® system, prescription topicals, salicylic acid peels, or a combination — with strict photoprotection in every plan. 3. **In-office treatment** — Cosmelan® application or peel sessions are performed by Dr. Zaks. Protocols are kept conservative in darker skin types to avoid provoking more pigment. 4. **Maintenance** — Pigment conditions relapse, particularly melasma. Follow-up visits confirm progress and keep you on an effective long-term maintenance regimen. ### Important Information - Peels used in this practice are limited to salicylic acid peels and the Cosmelan® system — no TCA and no glycolic acid. - Patients with darker skin types require caution with lasers, which can provoke post-inflammatory hyperpigmentation. - Daily mineral sunscreen at SPF 30+, reapplied, is the foundation of every pigmentation plan. Without it, no treatment holds. - Visible light and heat, not just UVB, can worsen melasma — mineral sunscreen with zinc oxide or iron oxides at SPF 30+ is recommended. - Improvement in pigment is measured over months, not days. Consistency matters more than intensity. ### Frequently Asked Questions **Why do I need a diagnosis before treatment?** Because the six common types respond differently. Solar lentigines and melasma can look similar to a patient but behave completely differently — and melasma in particular can worsen with treatment that is too aggressive. **What is the Cosmelan® lightening system?** A professional depigmentation system that inhibits tyrosinase, the enzyme required to make melanin. It involves an in-office application followed by a structured home maintenance regimen, and it is one of Dr. Zaks' primary tools for stubborn pigmentation. **How long until I see results?** Meaningful improvement typically takes eight to twelve weeks of consistent treatment, and deeper dermal pigment takes longer. Progress is judged at follow-up visits, not day to day. **Is laser the fastest way to remove brown spots?** Not always, and not safely for everyone. Patients with darker skin types require particular caution with lasers, because energy delivered to pigmented skin can trigger further hyperpigmentation. Dr. Zaks selects the approach with the best risk-benefit profile for your skin. **Will my pigmentation come back?** Melasma is chronic and relapsing, and sun-induced pigment returns with renewed UV exposure. Maintenance treatment and daily photoprotection are what keep results. **Can hormonal birth control cause pigmentation?** Hormonal factors, including oral contraceptives and pregnancy, are well-recognized contributors to melasma. Dr. Zaks will review this with you, and any medication change is coordinated with your prescribing physician. --- ## Melasma Treatment in Beverly Hills URL: https://beverlyhillsdermatology.com/melasma Meta description: Melasma treatment in Beverly Hills by Dr. Boris Zaks, MD — Cosmelan® depigmentation, prescription topicals, salicylic acid peels and strict photoprotection. (310) 552-3376. Section: Skin Care & Laser A chronic, hormonally influenced pigment disorder that can be controlled but not cured — managed with a disciplined protocol rather than a single procedure. ### Overview Melasma presents as symmetric brown to gray-brown patches across the forehead, cheeks, upper lip, and chin. It is driven by three interacting factors: hormonal stimulation (estrogen and progesterone, including pregnancy and oral contraceptives), ultraviolet and visible light exposure, and genetic predisposition. That is why melasma is far more common in women, more common in Fitzpatrick skin types III through V, and why it so often appears or worsens after pregnancy or a sunny holiday. Mechanistically, melanocytes in affected skin are hyperactive rather than more numerous. They respond excessively to light and hormonal signaling by producing and transferring more melanin to surrounding keratinocytes. In epidermal melasma the pigment sits in the upper layers and responds relatively well to treatment. In dermal and mixed melasma, pigment has also reached the dermis, where it is far more resistant — which is why Dr. Zaks assesses pigment depth before discussing expected outcomes. Effective treatment therefore works on three fronts at once: suppressing melanocyte activity, removing pigment already deposited in the epidermis, and eliminating the triggers that continually re-stimulate the process. Removing pigment without suppressing the trigger produces a few good months and then relapse — which is what most patients have already experienced elsewhere before they arrive. Sun protection is the foundation of any melasma plan, not an afterthought. Melasma is triggered by ultraviolet, visible light, and heat; ordinary chemical sunscreens do not block these well. Dr. Zaks recommends a mineral sunscreen with zinc oxide or iron oxides at SPF 30+, reapplied during the day, along with hats and shade. Results are best maintained when photoprotection is kept up consistently. Dr. Zaks personally performs every injectable, laser, and procedural treatment at his Beverly Hills practice. Patients are never seen by rotating physician assistants, nurse injectors, or aestheticians for these procedures. ### Treatment Options - **Cosmelan® Depigmentation System** — A professional depigmenting protocol (Mesoestetic) applied in office and continued with a structured home regimen over three to six months. It is Dr. Zaks' most reliable option for moderate to severe melasma, working primarily by suppressing tyrosinase activity rather than by wounding the skin — an important advantage in the darker skin types where melasma is most common. - **Prescription Topical Therapy** — Hydroquinone, tretinoin, and mild corticosteroid combinations, and non-hydroquinone alternatives such as azelaic acid, cysteamine, and kojic acid for maintenance. These are cycled deliberately — continuous high-potency hydroquinone is not a long-term plan. - **Salicylic Acid Chemical Peels** — At this practice, chemical peels for melasma are limited to salicylic acid peels and the Cosmelan® protocol. Salicylic acid is lipophilic, superficial, and predictable, which makes it appropriate for pigment-prone skin. Peels are used in a series and always alongside topical suppression, never on their own. - **Maintenance and Trigger Control** — Mineral sunscreen with zinc oxide or iron oxides at SPF 30+ daily, review of hormonal contraception with your gynecologist where relevant, heat avoidance, and gentle pigment-safe skincare. Maintenance is indefinite because the underlying tendency is permanent. ### What the Visit Involves 1. **Diagnosis and pigment-depth assessment** — Dr. Zaks confirms the diagnosis — melasma is frequently confused with post-inflammatory hyperpigmentation, lentigines, and drug-induced pigmentation — and assesses whether pigment is epidermal, dermal, or mixed, since that determines what is realistically achievable. 2. **Trigger review** — Hormonal contraception, pregnancy history, medications, occupational and recreational sun exposure, heat exposure, and prior treatments that may have inflamed the skin are all reviewed, because unaddressed triggers defeat any protocol. 3. **Protocol design and initiation** — A staged plan is built: suppression first, then controlled pigment clearance with Cosmelan® or salicylic acid peels as appropriate, at a pace matched to your skin type. Dr. Zaks performs in-office applications and peels himself. 4. **Review, taper and long-term maintenance** — Progress is reviewed at follow-up visits, typically around four to eight weeks, active agents are cycled or tapered, and you transition to a maintenance regimen designed to hold the result through Southern California summers. ### Important Notes - Chemical peels for melasma at this practice are limited to salicylic acid peels and the Cosmelan® protocol. Aggressive or deeper peels are avoided in pigment-prone skin because they can trigger rebound hyperpigmentation. - Darker skin types require caution with lasers. In Fitzpatrick types IV through VI, laser and light-based treatment of melasma can worsen pigmentation and cause post-inflammatory hyperpigmentation, so Dr. Zaks prioritizes topical suppression and depigmentation protocols and approaches any device-based treatment conservatively, if at all. - Melasma is chronic. Treatment controls it; nothing cures it. Expect maintenance rather than a finish line. - Hydroquinone and tretinoin are not used during pregnancy or breastfeeding. Safe alternatives, primarily rigorous photoprotection and azelaic acid, are used until after delivery and nursing. - Inflammation is a trigger. Waxing, harsh scrubs, over-exfoliation, and irritating actives can all darken melasma. ### Frequently Asked Questions **Is Cosmelan safe during pregnancy or breastfeeding?** Dr. Zaks does not start Cosmelan® or prescription hydroquinone and tretinoin regimens during pregnancy or breastfeeding. Melasma that appears in pregnancy often lightens on its own in the months after delivery, so the approach during that period is strict photoprotection with mineral sunscreen at SPF 30+ and, where needed, azelaic acid, which is generally considered acceptable in pregnancy. Active depigmentation is deferred until you are no longer pregnant or nursing. **Does insurance cover melasma treatment in Beverly Hills?** Generally no. Melasma is considered a cosmetic condition by most carriers, so topical protocols, Cosmelan®, and peels are self-pay. The office visit to diagnose pigmentation — particularly to rule out other causes — may be billable to PPO insurance or Medicare. Call (310) 552-3376 and the office will tell you exactly what is and is not covered before you commit. **Can melasma be cured permanently?** No. Melasma can be substantially lightened and then held stable, but the melanocyte hyperreactivity that causes it does not go away. Patients who understand this from the start do far better, because they maintain photoprotection and periodic topical therapy instead of stopping the moment their skin looks clear. **How long before I see results?** Most patients see meaningful lightening within four to eight weeks of starting a supervised protocol. Deeper or mixed melasma takes three to six months of consistency, and some dermal pigment never fully clears. Progress is judged at follow-up rather than by day-to-day inspection. **Can lasers treat my melasma?** Lasers are not the first-line answer for melasma, and in darker skin types they can make it worse. Heat and inflammation are melasma triggers, so device-based treatment risks rebound hyperpigmentation. Dr. Zaks leads with suppression and depigmentation, and considers any light-based approach only cautiously, in selected lighter-skinned patients whose pigment is stable and whose triggers are controlled. **Will stopping my birth control clear my melasma?** It may help, but rarely on its own and not quickly — pigment can persist for months or years after the hormonal trigger is removed. Any change to contraception is a decision for you and your gynecologist; Dr. Zaks will explain how large a factor it appears to be in your particular case. **Does Dr. Zaks perform the in-office treatments himself?** Yes. Dr. Zaks personally performs every peel, Cosmelan® application, and procedural treatment at his Beverly Hills practice. Patients are not passed to aestheticians for pigment treatment, where technique and judgment change the outcome. --- ## Latisse® Eyelash Treatment in Beverly Hills URL: https://beverlyhillsdermatology.com/latisse-eyelash-treatment Meta description: Latisse® (bimatoprost 0.03%) prescribed in Beverly Hills by Dr. Boris Zaks, MD — the FDA-approved treatment for inadequate eyelashes, with full effect at 16 weeks. Section: Skin Care & Laser Bimatoprost ophthalmic solution 0.03% — the only FDA-approved prescription treatment for inadequate or thin eyelashes. ### Overview Latisse® is bimatoprost ophthalmic solution 0.03%, a prostaglandin analog. Increased eyelash growth was first observed in patients using bimatoprost eye drops, and the medication was subsequently FDA-approved for hypotrichosis — inadequate or not enough eyelashes. It works by extending the anagen (active growth) phase of the eyelash cycle and increasing the number of hairs actively growing, producing lashes that are longer, thicker, and darker. Because it is a prescription medication, Latisse® is prescribed only after Dr. Zaks evaluates you and reviews your eye and medical history. He instructs you on correct application to the upper lash line only. Results build gradually: most patients notice change around weeks four to eight, with the full effect at approximately 16 weeks of nightly use. Continued application is required to maintain results. ### What Latisse® Addresses - **Inadequate Eyelashes (Hypotrichosis)** — The FDA-approved indication — lashes that are too short, sparse, or light, whether genetically or with age. - **Lash Length** — Extending the active growth phase allows individual lashes to grow longer before shedding. - **Lash Fullness** — More follicles in active growth at once produces a visibly denser lash line. - **Lash Darkness** — Treated lashes typically become darker as well as longer, which reduces reliance on mascara. - **Lash Recovery** — Patients whose lashes have thinned after extensions, chronic mascara use, or lash-line trauma often benefit. ### What the Visit Involves 1. **Evaluation and prescription** — Dr. Zaks reviews your eye and medical history and confirms Latisse® is appropriate for you before prescribing. 2. **Application instruction** — One drop on the supplied sterile applicator, drawn along the upper lash line only, once nightly on clean skin. Never apply to the lower lash line, and use a fresh applicator per eye. 3. **Weeks 4–8** — Early change becomes noticeable — lashes begin to look longer and darker. Consistency is essential; missed nights slow progress. 4. **Week 16 and maintenance** — Full effect is typically reached at approximately 16 weeks. Continued nightly or reduced-frequency application maintains results; lashes gradually return to baseline if you stop. ### Important Safety Information - Apply to the upper lash line only. Do not apply to the lower lid — this increases the risk of unwanted hair growth and skin darkening. - Possible side effects include eye redness and itching, darkening of the eyelid skin, and, rarely, increased brown pigmentation of the iris, which may be permanent. - Use a fresh sterile applicator for each eye and never reuse applicators, to avoid contamination and infection. - Results require continued use. Lashes gradually return to their prior appearance if treatment is discontinued. ### Frequently Asked Questions **How long until I see results?** Most patients notice change between weeks four and eight, with the full effect at approximately 16 weeks of consistent nightly application. **What happens if I stop using it?** Lashes gradually return to their pre-treatment appearance over several weeks to months. Latisse® maintains results only while you continue to use it. **Is Latisse® FDA-approved?** Yes. Bimatoprost ophthalmic solution 0.03% is FDA-approved for treating hypotrichosis — inadequate or not enough eyelashes — and is available by prescription only. **What are the possible side effects?** The most common are eye redness and itching. Darkening of the eyelid skin can occur and usually reverses after stopping. Increased brown iris pigmentation is rare but may be permanent. Unwanted hair growth can occur where the solution repeatedly contacts skin. **Can I apply it to my lower lashes or eyebrows?** Latisse® is applied to the upper lash line only, per its labeling. Do not apply it to the lower lid. Any other use should be discussed with Dr. Zaks first. **Can I still wear mascara or lash extensions?** Yes, mascara can be worn during the day; apply Latisse® at night to clean skin. Most patients find they need less mascara. Discuss extensions with Dr. Zaks, as they can stress the follicles you are trying to strengthen. --- ## Vbeam® Pulsed Dye Laser in Beverly Hills URL: https://beverlyhillsdermatology.com/vbeam-laser Meta description: Vbeam® 595nm pulsed dye laser in Beverly Hills for rosacea, facial redness and visible vessels, performed personally by Dr. Boris Zaks, MD. (310) 552-3376. Section: Skin Care & Laser The 595nm pulsed dye laser targets hemoglobin inside visible vessels — the treatment of choice for rosacea, diffuse facial redness, and telangiectasias, performed personally by Dr. Zaks. ### Overview The Vbeam® laser is designed to treat redness and visible blood vessels without breaking the skin's surface. It sends out a specific wavelength of light that is drawn to the red color inside blood vessels while largely passing through the surrounding skin. The light heats each targeted vessel enough to close it, and the body then clears it naturally over the following weeks. Because the energy stays concentrated in the vessels, the surface of the skin is left intact — there is no open wound or resurfacing. To keep the treatment comfortable, Dr. Zaks uses gentler settings and the Vbeam's built-in cooling, which protects the skin's surface with a brief cooling burst before each pulse. Most patients describe the sensation as a mild snap and return to normal activity the same day. The Vbeam® is used for concerns caused by blood vessels close to the skin's surface: background redness and flushing from rosacea, facial spider veins, pink marks left behind after acne, diffuse redness from years of sun exposure, cherry angiomas, and the residual redness of some scars. Candidacy depends on both the target and the skin. Vascular lesions in lighter Fitzpatrick types I through III respond most readily. In Fitzpatrick types IV through VI, competing melanin absorption means settings must be adjusted conservatively and test spots are often used, because pigment alteration is a real consideration in darker skin. Photosensitizing medication, recent tanning, active infection at the site, and pregnancy all affect timing or candidacy. Dr. Zaks makes that determination himself at consultation. Dr. Zaks personally performs every injectable, laser, and procedural treatment at his Beverly Hills practice. Patients are never seen by rotating physician assistants, nurse injectors, or aestheticians for these procedures. ### What Vbeam® Treats - **Rosacea Redness and Flushing** — Rosacea with visible redness and flushing responds well because the redness is vascular. Topicals control inflammation; the laser addresses the vessels themselves. Most patients need a series and then periodic maintenance. - **Facial Telangiectasias** — Discrete visible vessels on the nose, cheeks, and around the nasal ala — often the most gratifying target, since individual vessels can clear in one or two sessions. - **Post-Inflammatory Erythema** — The flat pink-red marks left behind after inflammatory acne. These are vascular, not scars, and are frequently mistaken for permanent damage. - **Poikiloderma of the Chest and Diffuse Sun-Related Redness** — Poikiloderma of Civatte — the mottled red-brown discoloration with fine vessels across the upper chest from decades of Southern California sun — along with background redness on the cheeks and décolleté. The vascular component responds to the 595nm wavelength; treatment is staged conservatively on chest skin, which heals more slowly than the face. - **Cherry Angiomas and Vascular Papules** — Small benign vascular growths on the face and trunk, treated individually. - **Red Scars and Surgical Scars** — The persistent redness phase of healing scars often improves, which can make a scar substantially less noticeable. - **Port-Wine Stains and Vascular Birthmarks** — The pulsed dye laser remains the established treatment; these require an extended series and are evaluated individually. ### What the Visit Involves 1. **Consultation and diagnosis** — Dr. Zaks confirms the redness is vascular rather than pigmentary or inflammatory, identifies the rosacea subtype if relevant, and reviews medications and sun exposure. 2. **Parameter selection and test pulses** — Wavelength is fixed at 595nm; fluence, pulse duration, spot size, and cooling are selected for your skin type and target depth. In darker skin types Dr. Zaks starts conservatively with test pulses and titrates upward across sessions rather than pushing settings in one visit. 3. **Treatment** — Each pulse feels like a brief warm snap, moderated by the cryogen cooling. Eye shields are worn. A full face takes roughly fifteen to twenty minutes; isolated vessels take only a few minutes. No anesthesia is required. 4. **Aftercare and series planning** — Expect mild transient redness and occasional slight swelling. Swelling can last two to three days in some patients, though most only notice it for a few hours and return to work the same day, often with makeup. Daily mineral sunscreen at SPF 30+ is essential. Sessions are spaced four to six weeks apart, typically five for diffuse redness and one to three for isolated vessels on the cheeks or similar discrete areas. ### Important Notes - Dr. Zaks treats with gentle, longer-pulse settings and integrated cryogen cooling, chosen so that patients can return to normal activity the same day. - Rosacea is a chronic condition. The laser clears existing vessels; it does not remove the underlying tendency, so periodic maintenance — often one to two sessions a year — keeps results stable. - Sun protection is part of the treatment, not an afterthought. Ultraviolet exposure drives new vessel formation and flushing. - In Fitzpatrick types IV through VI, settings are deliberately conservative and progress is made across more sessions to protect against pigment change. - Cosmetic laser treatment is self-pay. Medical evaluation of rosacea or a vascular lesion may be billable to PPO insurance or Medicare. ### Frequently Asked Questions **Can rosacea come back after Vbeam laser treatment?** Yes — and understanding why matters. The Vbeam clears the visible vessels that exist today, but rosacea is a chronic condition with an underlying vascular and inflammatory tendency that the laser does not erase. New vessels can develop over time, particularly with sun exposure, heat, alcohol, and spicy food triggers. Most of Dr. Zaks' rosacea patients complete an initial series, then maintain results with one to two sessions per year alongside topical therapy and daily sun protection. **How many Vbeam sessions will I need?** Isolated vessels on the cheeks or nose often clear in one to three sessions. Diffuse redness and rosacea typically need five sessions spaced four to six weeks apart, because each pass clears a portion of the vessel network. Port-wine stains require a longer series. Dr. Zaks gives you a realistic estimate at consultation based on your clinical presentation rather than a generic package. **Is Vbeam safe for darker skin types?** It can be, with adjusted parameters. Melanin competes with hemoglobin for the 595nm light, so in Fitzpatrick types IV through VI Dr. Zaks uses conservative fluences, longer pulse durations, robust cooling, and test pulses, and builds results across additional sessions. Aggressive settings in darker skin risk pigment alteration, which is precisely why the physician selecting the parameters should be the one treating you. **What is the downtime after Vbeam?** For the great majority of patients, effectively none beyond mild redness or slight swelling for a few hours. Makeup can usually be applied the same day. Avoid hot showers, saunas, and strenuous exercise for about twenty-four hours, and use mineral sunscreen at SPF 30+ daily afterwards. **Does the Vbeam treat brown spots too?** Only indirectly. The Vbeam is a vascular laser. Brown pigment from sun damage or melasma is treated with different approaches — topical protocols, salicylic acid or Cosmelan peels, and carefully chosen pigment-directed treatment. Dr. Zaks will tell you honestly which component of your redness or discoloration this laser will and will not address. **Does Dr. Zaks perform the laser himself?** Yes. Dr. Zaks personally performs every laser treatment at his Beverly Hills practice, including parameter selection at every session. You will not be treated by a technician, nurse, or aesthetician. **Does insurance cover Vbeam treatment?** Cosmetic treatment of redness is self-pay. The medical visit to diagnose and manage rosacea, or to evaluate a vascular lesion, may be covered by PPO insurance or Medicare. Call (310) 552-3376 and the office will explain what applies before you are treated. --- ## Titan® Skin Tightening in Beverly Hills URL: https://beverlyhillsdermatology.com/titan Meta description: Titan® infrared skin tightening in Beverly Hills by Dr. Boris Zaks, MD. Cutera's non-surgical treatment for the face, neck, and jowls — approximately 60 minutes, no downtime. Section: Skin Care & Laser Cutera's infrared skin tightening — used for the face, neck, and jowls only. Approximately 60 minutes, no incisions, no downtime. ### Overview Titan® is an infrared light device from Cutera that heats the dermis while the skin surface is protected by contact cooling. That controlled deep heating causes immediate collagen contraction and, more importantly, initiates a wound-healing response that stimulates new collagen production over the following months. The result is gradual tightening of lax skin without incisions, injections, or downtime. Dr. Zaks uses Titan® for the face, neck, and jowls only — the areas where the treatment reliably delivers meaningful results — and he performs each approximately 60-minute session himself. It is best suited to patients with mild to moderate laxity who want improvement without surgery. Dr. Zaks will tell you honestly if your degree of laxity is beyond what a non-surgical device can address; results are gradual and cumulative rather than immediate, and a series of sessions is usually recommended. ### Areas and Concerns Treated - **Lower Face and Jowls** — Softening of early jowling and improvement in definition along the lower face — the most common reason patients seek Titan®. - **Jawline Definition** — Tightening of lax skin along the jaw for a cleaner, more defined border between face and neck. - **Neck Laxity** — Crepey, loose skin of the neck responds to deep dermal heating and subsequent collagen remodeling. - **Under the Chin (Submental)** — Mild looseness beneath the chin can improve as new collagen forms over the months following treatment. - **Mild to Moderate Facial Laxity** — Best results occur in patients with early to moderate laxity and reasonable expectations of gradual improvement. ### What the Visit Involves 1. **Consultation and candidacy** — Dr. Zaks assesses your skin laxity and elasticity and confirms whether Titan® can realistically deliver the change you want — or whether another approach is more appropriate. 2. **Preparation** — The treatment area is cleansed and eye protection is provided. No topical anesthetic or injection is required. 3. **Treatment — approximately 60 minutes** — The handpiece delivers pulses of infrared light with simultaneous surface cooling. You feel a deep warming sensation with each pulse; energy is adjusted for comfort throughout. 4. **Gradual collagen remodeling** — You return to normal activity immediately. Tightening develops progressively over the following weeks to months as new collagen forms; a series of sessions is typically recommended. ### Important Information - Dr. Zaks uses Titan® on the face, neck, and jowls only — it is not offered for the body in this practice. - Results are gradual and cumulative. Meaningful tightening develops over weeks to months as new collagen forms. - Titan® is not a substitute for surgery. Significant skin excess requires a surgical solution, and Dr. Zaks will say so directly. - A series of sessions is usually recommended, with maintenance treatments afterward. - Daily mineral sunscreen at SPF 30+ protects the collagen you build; ongoing UV exposure degrades it. ### Frequently Asked Questions **How does Titan® tighten skin?** Infrared light heats the dermis while the skin surface is cooled. That deep heating contracts existing collagen immediately and triggers a healing response that produces new collagen over the following months. **How long does a session take?** Approximately 60 minutes, depending on the area treated. Dr. Zaks performs the full session himself. **Which areas can be treated?** In this practice, Titan® is used for the face, neck, and jowls only. **Is there any downtime?** No. You may have mild redness or warmth for a short period afterward, then return to normal activity and makeup the same day. **How many treatments will I need?** A series is typically recommended, with the exact number based on your degree of laxity and response. Maintenance sessions help preserve results over time. **Is Titan® a replacement for a facelift?** No. It improves mild to moderate laxity without surgery, but it cannot remove excess skin. Dr. Zaks will tell you honestly if your laxity is beyond what a non-surgical device can address. **Does it hurt?** Most patients describe a deep warming sensation with each pulse. Contact cooling protects the surface, and energy settings are adjusted to keep treatment comfortable. No anesthesia is needed. --- ## Spider Vein Treatment in Beverly Hills URL: https://beverlyhillsdermatology.com/spider-veins Meta description: Facial spider vein treatment in Beverly Hills by Dr. Boris Zaks, MD, using the Vbeam® pulsed dye laser. About 15 minutes, no anesthesia cream required. Section: Skin Care & Laser Facial telangiectasias treated with the Vbeam® pulsed dye laser — about 15 minutes, and anesthesia cream is not required. ### Overview Facial spider veins, properly called telangiectasias, are small dilated capillaries visible at the skin surface — most often across the nose, cheeks, and chin. They arise from cumulative sun exposure, genetics, rosacea, and age-related loss of the dermal support that normally conceals these vessels. Because they are vascular structures, they respond to a laser that specifically targets blood. Dr. Zaks treats them with the Vbeam® pulsed dye laser. Its 595 nm wavelength is preferentially absorbed by oxyhemoglobin inside the vessel, so the energy is converted to heat within the target and collapses the vessel while leaving surrounding skin unaffected. Treatment is quick — typically about 15 minutes — and anesthesia cream is not required, because the device's integrated cryogen cooling makes the pulses tolerable. Dr. Zaks uses gentle, longer-pulse settings with integrated cryogen cooling, so most patients return to normal activity immediately. ### What Vbeam® Treats - **Facial Telangiectasias** — The fine, visible dilated capillaries of the nose, cheeks, and chin — the primary indication. - **Rosacea-Associated Vessels** — The persistent background redness and visible vessels of rosacea, treated alongside a medical rosacea regimen. - **Diffuse Facial Redness** — Generalized flushing and redness improves as the underlying dilated vasculature is reduced. - **Cherry Angiomas** — Small bright red vascular papules on the face and body respond well to pulsed dye laser treatment. - **Post-Acne Redness** — Flat red marks left after inflammatory acne (post-inflammatory erythema) are vascular and respond to the same laser. ### What the Visit Involves 1. **Evaluation** — Dr. Zaks examines the vessels, confirms they are telangiectasias, and screens for underlying rosacea, which may need medical treatment alongside the laser. 2. **Preparation** — The skin is cleansed and protective eyewear is provided. Anesthesia cream is not required for this treatment. 3. **Laser treatment — about 15 minutes** — Pulses are delivered along each vessel, with the device's cryogen cooling spray protecting the skin surface. Most patients describe a brief snap with each pulse. 4. **Aftercare** — Expect transient redness or mild swelling for a few hours. Sunscreen daily and avoid heat and strenuous exercise for 24 hours. Additional sessions may be recommended for complete clearance. ### Important Information - Anesthesia cream is not required — the Vbeam®'s integrated cooling makes treatment tolerable without it. - Dr. Zaks uses gentle, longer-pulse settings with integrated cryogen cooling, so most patients return to normal activity immediately. - Some vessels require more than one session for complete clearance, particularly larger or long-standing ones. - New vessels can develop over time, especially with continued sun exposure or untreated rosacea; daily mineral sunscreen at SPF 30+ and medical management reduce recurrence. - This page addresses facial spider veins. Leg veins are a different problem and Dr. Zaks will refer you appropriately. ### Frequently Asked Questions **How long does treatment take?** Most facial spider vein sessions take approximately 15 minutes, depending on how many vessels are being treated. **Do I need numbing cream?** No. Anesthesia cream is not required. The Vbeam® delivers a cryogen cooling spray with each pulse, which protects and numbs the skin surface enough that most patients are comfortable. **Is there any downtime?** Dr. Zaks uses gentle, longer-pulse settings with integrated cryogen cooling. Most patients have only transient redness for a few hours and go straight back to normal activities. **How many sessions will I need?** Many patients see substantial improvement after one session, but larger or long-standing vessels may need additional treatments. Dr. Zaks will give you a realistic estimate after examining you. **Will the veins come back?** The treated vessels are closed permanently, but new telangiectasias can develop over time — particularly with ongoing sun exposure or untreated rosacea. Daily mineral sunscreen at SPF 30+ and medical management reduce recurrence. **Can you treat spider veins on my legs?** This treatment is for facial telangiectasias. Leg veins involve different vessel size and pressure dynamics, and Dr. Zaks will discuss appropriate referral if that is your concern. --- ## Sun Damage Treatment in Beverly Hills URL: https://beverlyhillsdermatology.com/sun-damage Meta description: Sun damage treatment in Beverly Hills by Dr. Boris Zaks, MD — actinic keratoses, solar lentigines, photodynamic therapy, Vbeam® laser, and salicylic acid peels. Section: Skin Care & Laser Cumulative UV damage is both a medical and a cosmetic problem. Dr. Zaks treats the precancerous lesions first, then the visible signs. ### Overview Chronic ultraviolet exposure produces a predictable set of changes: actinic keratoses, which are rough, scaly precancerous lesions with the potential to progress to squamous cell carcinoma; solar lentigines, the discrete brown macules commonly called sun spots; telangiectasias and persistent redness from damaged superficial vasculature; and degradation of dermal collagen and elastin producing wrinkling and coarse texture. Actinic keratoses are a medical finding, not a cosmetic one, which is why sun damage should be evaluated by a board-certified dermatologist rather than treated at a spa. Dr. Zaks addresses the medical component first. Individual actinic keratoses are most often treated in the office with liquid nitrogen cryospray. When sun damage is extensive or a field of early precancerous change is present, photodynamic therapy with Levulan® and blue light treats a broader area at once rather than one lesion at a time. Any suspicious lesion is biopsied. He then addresses the visible signs: the Vbeam® pulsed dye laser for telangiectasias and redness, and salicylic acid peels for pigmentation and texture. An appropriate skin exam interval and disciplined daily photoprotection are part of the plan for patients with significant photodamage. ### What Sun Damage Treatment Addresses - **Actinic Keratoses** — Rough, scaly precancerous lesions with potential to progress to squamous cell carcinoma. Individual lesions are typically treated with liquid nitrogen cryospray; photodynamic therapy is used for extensive field treatment or prevention. - **Solar Lentigines (Sun Spots)** — Discrete brown macules on the face, chest, shoulders, and hands from cumulative UV exposure. - **Telangiectasias and Redness** — Visible dilated vessels and persistent redness treated with the Vbeam® pulsed dye laser at 595 nm. - **Texture and Fine Lines** — Coarse texture and fine wrinkling from collagen and elastin degradation, improved with salicylic acid peels and prescription topicals. - **Skin Cancer Risk** — Significant photodamage means elevated risk. An appropriate skin exam and same-day biopsy when indicated are part of the plan. - **Prevention** — Daily mineral sunscreen at SPF 30+, protective clothing, and behavioral change — without which every treatment result erodes. ### What the Visit Involves 1. **Skin exam** — Dr. Zaks performs a skin exam appropriate to your presentation and risk, identifying actinic keratoses and any suspicious lesion. Biopsy can be performed the same day when indicated, with pathology results typically in five business days. 2. **Medical treatment of precancerous lesions** — Individual actinic keratoses are typically destroyed with liquid nitrogen cryospray. For extensive sun-damaged fields, photodynamic therapy treats a broader area to reduce the risk of new lesions developing. 3. **Cosmetic correction** — Vbeam® sessions address telangiectasias and redness; salicylic acid peels address pigment and texture. These are staged after the medical component. 4. **Photoprotection and surveillance** — A daily regimen of mineral sunscreen at SPF 30+ is established, and you are placed on an appropriate skin exam interval for ongoing surveillance. ### Important Information - Actinic keratoses are precancerous and require medical treatment — they are not a cosmetic concern to be managed with facials. - Peels in this practice are limited to salicylic acid peels and the Cosmelan® system; Dr. Zaks does not use TCA or glycolic acid. - Photodynamic therapy involves 45–60 minutes of Levulan® incubation and requires strict sun avoidance for 36 hours afterward. - Patients with significant sun damage are at elevated risk for skin cancer and should be on a regular skin exam schedule appropriate to their history and findings. - Medical treatment of actinic keratoses and skin cancer screening are covered by most major PPO plans and Medicare. ### Frequently Asked Questions **What is an actinic keratosis, and why does it matter?** It is a rough, scaly lesion caused by cumulative UV damage, and it is precancerous — a subset progress to squamous cell carcinoma. That makes treatment medical rather than cosmetic. **How are actinic keratoses treated?** Most individual actinic keratoses are treated in the office with liquid nitrogen cryospray. Photodynamic therapy with Levulan® and blue light is reserved for extensive sun-damaged fields or prevention across a broader area. Anything suspicious is biopsied. **Can you treat both the medical and cosmetic sides of sun damage?** Yes, and in that order. Precancerous lesions and any suspicious spots are handled first; brown spots, redness, and texture are then addressed with peels and the Vbeam® laser. **Which peels do you use for sun damage?** Salicylic acid peels, and the Cosmelan® system for pigmentation. Dr. Zaks does not use TCA or glycolic acid peels. **Is treatment covered by insurance?** Treatment of actinic keratoses and skin cancer screening are medical services covered by most major PPO plans and Medicare. Purely cosmetic treatments are not. Our office reviews costs with you in advance. **How often should I be checked?** Annually at minimum for most adults, and more frequently with significant photodamage, many moles, or a personal or family history of skin cancer. **Is it too late to start using sunscreen?** No. Ongoing UV exposure continues to generate new damage and degrades results from any treatment you have. Daily mineral sunscreen at SPF 30+ benefits skin at any age. --- ## Rosacea Treatment in Beverly Hills URL: https://beverlyhillsdermatology.com/rosacea Meta description: Rosacea treatment in Beverly Hills by Dr. Boris Zaks, MD — non-laser medical management plus Vbeam® pulsed dye laser, typically in a series of five treatments. Covered by most PPO plans. Section: Medical Dermatology Non-laser medical management for the inflammatory component, plus the Vbeam® pulsed dye laser for redness and visible vessels — typically a series of five treatments. ### Overview Rosacea is a chronic inflammatory condition of the central face involving both a vascular component — flushing, persistent background erythema, and telangiectasias — and an inflammatory component of papules and pustules. Neurovascular dysregulation, an altered cutaneous immune response, and Demodex mites all contribute. Because two different mechanisms are at work, medical therapy alone often controls the bumps while leaving the redness and vessels untouched, which is why patients so often feel only partly treated. Dr. Zaks treats both. Non-laser medical management includes topical metronidazole, azelaic acid, and ivermectin, topical brimonidine for episodic erythema, and oral therapy such as low-dose doxycycline for its anti-inflammatory effect in moderate to severe inflammatory disease, along with identification of your individual triggers. For the vascular component he uses the Vbeam® pulsed dye laser, whose 595 nm wavelength targets oxyhemoglobin within dilated vessels. A series of five treatments is typical. Rosacea is a medical diagnosis, and evaluation and non-laser medical management are covered by most major PPO plans and Medicare. ### Treatment Approach - **Vbeam® Pulsed Dye Laser** — 595 nm light absorbed by oxyhemoglobin collapses the dilated vessels responsible for redness and telangiectasias. A series of five treatments is typical. - **Topical Anti-Inflammatories** — Metronidazole, azelaic acid, and ivermectin reduce papules and pustules; ivermectin also addresses the Demodex contribution. - **Topical Brimonidine** — A vasoconstrictor that temporarily reduces persistent facial erythema, useful for episodic control. - **Oral Therapy** — Low-dose doxycycline is used for its anti-inflammatory effect in moderate to severe inflammatory rosacea, alongside topical treatment. - **Trigger Identification** — Heat, sun, alcohol, spicy food, stress, and certain skincare products commonly provoke flares. Identifying yours reduces flare frequency. - **Ocular and Phymatous Rosacea** — Eye involvement and thickening of the nasal skin are recognized subtypes requiring specific management and, at times, coordination with ophthalmology. ### What the Visit Involves 1. **Diagnosis and subtype assessment** — Dr. Zaks confirms the diagnosis, distinguishes rosacea from acne and seborrheic dermatitis, and identifies which components — vascular, inflammatory, or both — are driving your presentation. 2. **Medical regimen and trigger plan** — A prescription regimen is built for your subtype, with a gentle skincare routine, daily mineral sunscreen at SPF 30+, and a specific list of your likely triggers. 3. **Vbeam® laser series** — Laser sessions address redness and visible vessels, typically as a series of five. Anesthesia cream is not required, and Dr. Zaks uses gentle, longer-pulse settings with integrated cryogen cooling so patients return to normal activity the same day. 4. **Long-term maintenance** — Rosacea is chronic. Maintenance topicals, daily mineral sunscreen at SPF 30+, and occasional laser touch-ups keep control between flares. ### Frequently Asked Questions **Can rosacea be cured?** No, but it can be controlled very well. Rosacea is a chronic condition; the goal is sustained control of both the redness and the inflammatory bumps with maintenance therapy. **Why do I need laser in addition to prescriptions?** Topical and oral medications work primarily on the inflammatory component — the papules and pustules. Dilated blood vessels and persistent background redness need a vascular treatment, which is what the Vbeam® laser provides. **How many laser treatments will I need?** A series of five treatments is typical, spaced several weeks apart, with occasional maintenance sessions afterward. **Does Vbeam® treatment for rosacea hurt, and is there downtime?** Anesthesia cream is not required — the device's cryogen cooling makes each pulse tolerable, described by most patients as a brief warm snap. Dr. Zaks uses gentle, longer-pulse settings, so aside from mild redness for a few hours most patients return to normal activity right away. **Is my rosacea actually acne?** They can look similar, and both cause facial papules, but rosacea also involves flushing, persistent central erythema, and visible vessels, and it typically lacks comedones. The distinction matters because treatments differ. **Is rosacea treatment covered by insurance?** Rosacea is a medical diagnosis, so evaluation and non-laser medical management are covered by most major PPO plans and Medicare. Laser coverage varies by plan, and our office will review costs with you before treatment. **What triggers should I avoid?** Common triggers include sun exposure, heat, hot beverages, alcohol, spicy foods, stress, and harsh skincare. Triggers are individual, so Dr. Zaks will help you identify your own pattern. --- ## Skin Cancer Screening & Treatment in Beverly Hills URL: https://beverlyhillsdermatology.com/skin-cancer Meta description: Skin cancer screening and biopsy in Beverly Hills by Dr. Boris Zaks, MD — basal cell, squamous cell, and melanoma evaluation with same-day biopsy and results in 5 business days. Section: Medical Dermatology Basal cell carcinoma, squamous cell carcinoma, and melanoma evaluation by a board-certified dermatologist — with same-day biopsy when indicated and pathology results in five business days. ### Overview Skin cancer is the most common cancer in the United States, and outcomes depend heavily on how early it is found. Basal cell carcinoma is the most common type and is typically slow-growing and locally destructive, presenting as a pearly papule, a non-healing sore, or a scaly patch. Squamous cell carcinoma often arises in sun-damaged skin — frequently from a preceding actinic keratosis — as a firm, scaly, or tender lesion, and carries a greater potential to metastasize. Melanoma is less common but the most dangerous, and is evaluated using the ABCDE criteria: asymmetry, border irregularity, color variegation, diameter greater than 6 mm, and evolution over time. Dr. Zaks performs skin examinations personally; whether the exam is focused or more comprehensive is based on the reason for your visit and your history. When a lesion is suspicious and time and authorization allow, biopsy can be performed the same day, during the same visit. Specimens are read by board-certified dermatopathologists and results are typically available within five business days. Dr. Zaks then treats or coordinates definitive treatment based on the diagnosis, tumor type, and location. Screening and biopsy are covered by most major PPO plans and Medicare. ### What Is Evaluated - **Basal Cell Carcinoma (BCC)** — The most common skin cancer. Typically a pearly or translucent papule, a non-healing sore, or a scaly pink patch. Slow-growing and locally destructive. - **Squamous Cell Carcinoma (SCC)** — Often arises in sun-damaged skin, sometimes from a preceding actinic keratosis. Presents as a firm, scaly, or tender lesion with greater metastatic potential than BCC. - **Melanoma** — Evaluated with the ABCDE criteria — asymmetry, border irregularity, color variation, diameter over 6 mm, and evolution. Early detection is decisive. - **Atypical (Dysplastic) Nevi** — Moles with irregular clinical or histologic features. Some are biopsied; others are photographed and monitored on a defined interval. - **Actinic Keratoses** — Precancerous scaly lesions from cumulative UV damage, treated to prevent progression to squamous cell carcinoma. - **Same-Day Biopsy** — Shave, punch, or excisional biopsy performed during the same visit, chosen based on the lesion and the diagnostic question. ### What the Visit Involves 1. **Skin exam** — Dr. Zaks examines the areas relevant to your concern and, when indicated based on your history and risk factors, performs a more complete skin check. He reviews your personal and family history of skin cancer and lifetime sun exposure. 2. **Lesion assessment** — Concerning lesions are examined closely and documented for comparison at future visits. 3. **Same-day biopsy when indicated** — Under local anesthesia, a shave, punch, or excisional biopsy is performed during the same visit. The technique is selected based on the suspected diagnosis and site. 4. **Results and treatment plan** — Pathology results are typically available within five business days. Dr. Zaks reviews the diagnosis with you and either treats the lesion or coordinates definitive treatment, including surgical referral when appropriate. ### When to Be Seen Promptly - A new or changing mole, particularly one that is asymmetric, has irregular borders, or contains multiple colors. - A sore or scab that does not heal within a few weeks, or that heals and reopens. - A lesion that bleeds spontaneously, itches persistently, or is tender. - Any new spot that looks different from your other spots — the so-called 'ugly duckling' sign. ### Frequently Asked Questions **How quickly will I get biopsy results?** Pathology results are typically available within five business days. Dr. Zaks reviews them with you and outlines the next step. **Can the biopsy be done at the same visit?** Yes. When a lesion is suspicious and time and authorization allow, biopsy can often be performed the same day under local anesthesia. **Does a biopsy leave a scar?** Any biopsy leaves some mark. Dr. Zaks selects the least invasive technique that will still answer the diagnostic question, and gives you specific wound care instructions to optimize healing. **Is skin cancer screening covered by insurance?** Yes — screening and biopsy are medical services covered by most major PPO plans and Medicare. Our office will verify your benefits before your visit. **How often should I be screened?** Annually for most adults, and more often for patients with a personal or family history of skin cancer, numerous or atypical moles, or significant lifetime sun exposure. **Do I need a referral?** You don't if you have PPO or Medicare. You do if you have Regal or Lakeside HMO plans. **What happens if the biopsy shows cancer?** Dr. Zaks explains the diagnosis and the treatment options for that specific tumor type and location, then either treats it or coordinates definitive treatment, including surgical referral when that is the right choice. --- ## Moles, Warts & Skin Lesions in Beverly Hills URL: https://beverlyhillsdermatology.com/moles-warts-skin-lesions Meta description: Evaluation, biopsy, and removal of moles, warts, cysts, and skin lesions in Beverly Hills by Dr. Boris Zaks, MD. Same-day biopsy with results in 5 business days. Section: Medical Dermatology Evaluation first, then biopsy or removal — because the most important question about any skin growth is what it actually is. ### Overview Skin growths are common and most are benign, but they are not interchangeable. Moles (nevi) require assessment for atypical features. Warts are caused by human papillomavirus and are contagious and often recurrent. Seborrheic keratoses are benign, waxy, 'stuck-on' papules that increase with age. Skin tags, dermatofibromas, and epidermoid cysts each have their own characteristic appearance and behavior. Occasionally a lesion a patient assumes is benign turns out to be a skin cancer — which is exactly why evaluation by a board-certified dermatologist precedes removal. Dr. Zaks examines each lesion carefully and determines whether it needs biopsy, treatment, removal, or simply photographic monitoring. When a lesion has suspicious features and time and authorization allow, biopsy may be performed the same day during the same visit, with specimens read by board-certified dermatopathologists and results typically available within five business days. Medically indicated evaluation and removal are covered by most major PPO plans and Medicare. ### Lesions Evaluated and Treated - **Moles (Nevi)** — Assessed for asymmetry, border irregularity, color variation, size, and change. Atypical moles are biopsied; stable ones are photographed and monitored. - **Warts (HPV)** — Common, plantar, and flat warts caused by human papillomavirus. Treated with cryotherapy, topical therapy, or destruction; multiple sessions are often needed. - **Seborrheic Keratoses** — Benign waxy, 'stuck-on' brown papules that increase with age. Removed when irritated or cosmetically bothersome. - **Skin Tags (Acrochordons)** — Soft, pedunculated growths in areas of friction such as the neck, axillae, and eyelids. Simple in-office removal. - **Epidermoid Cysts** — Firm subcutaneous nodules that can become inflamed. Managed by drainage or excision depending on presentation. - **Suspicious Lesions** — Lesions with concerning features are evaluated to determine whether biopsy, removal, or monitoring is appropriate. When indicated, biopsy may be performed the same day. ### What the Visit Involves 1. **Examination and diagnosis** — Dr. Zaks examines the lesion carefully and determines whether it is benign, requires biopsy, or should be monitored at follow-up visits. 2. **Discussion of options** — You are told what the lesion most likely is, whether removal is medically indicated or cosmetic, what technique is appropriate, and what mark to expect afterward. 3. **In-office procedure** — Under local anesthesia, removal is performed by shave, punch, excision, cryotherapy, or electrosurgery, depending on the lesion. Most procedures take only minutes. 4. **Pathology and wound care** — Specimens are sent for histologic examination, with results typically in five business days. You receive specific wound care instructions and a follow-up plan. ### Important Information - Lesions with suspicious features are evaluated and, when appropriate, sent for pathology before cosmetic removal. - Warts are caused by a virus, are contagious, and commonly recur; more than one treatment session is usually required. - Removal always leaves some mark. Dr. Zaks selects the technique that balances complete treatment against the best cosmetic outcome. - Medically indicated removal is generally covered by insurance; purely cosmetic removal typically is not, and our office reviews costs with you in advance. - Report any mole that is changing in size, shape, or color, or that bleeds or itches, promptly rather than at your next routine visit. ### Frequently Asked Questions **How do I know if a mole needs to be removed?** Dr. Zaks assesses it against the ABCDE criteria and its overall appearance relative to your other moles. Atypical or changing lesions are biopsied; stable, benign-appearing moles are usually photographed and monitored. **Will removal leave a scar?** Some mark is unavoidable with any removal. The technique is chosen to balance complete treatment with the best possible cosmetic outcome, and careful wound care improves the final result. **How long do biopsy results take?** Typically five business days. Specimens are read by board-certified dermatopathologists and Dr. Zaks reviews the findings with you. **How are warts treated?** With cryotherapy, topical therapy, or in-office destruction depending on the type and location. Because warts are viral, multiple sessions are commonly needed and recurrence is possible. **Is removal covered by insurance?** Medically indicated evaluation, biopsy, and removal are covered by most major PPO plans and Medicare. Purely cosmetic removal generally is not. Our office reviews this with you before the procedure. **Can I have a mole removed for cosmetic reasons?** Yes, but it will still be evaluated first and, when appropriate, sent for pathology so the diagnosis is known. **Does removal hurt?** Local anesthesia is used, so you feel the injection and then pressure rather than pain. Most removals take only a few minutes. --- ## Hyperhidrosis Treatment in Beverly Hills URL: https://beverlyhillsdermatology.com/hyperhidrosis-sweaty-palms Meta description: Hyperhidrosis treatment in Beverly Hills by Dr. Boris Zaks, MD — Botox® injections for axillary and craniofacial sweating, plus Sofdra® and Qbrexza® topicals. 15–20 minutes, 6–12 months of relief. Section: Medical Dermatology Excessive sweating of the underarms and the craniofacial area (forehead and scalp) treated with Botox® injections — 15 to 20 minutes, with relief typically lasting 6 to 12 months. ### Overview Hyperhidrosis is excessive sweating beyond what thermoregulation requires. Primary focal hyperhidrosis is caused by overactive sympathetic stimulation of eccrine sweat glands, and it is a genuine medical condition with real effects on clothing, work, and social life. Botulinum toxin treats it directly at the mechanism: it blocks acetylcholine release at the neuroglandular junction, so the nerve can no longer signal the sweat gland to produce sweat. Dr. Zaks treats axillary (underarm) hyperhidrosis and craniofacial hyperhidrosis of the forehead and scalp. Injection sessions take approximately 15 to 20 minutes, and relief typically lasts 6 to 12 months before retreatment is needed. Topical options — Sofdra® (sofpironium) and Qbrexza® (glycopyrronium) cloth — are used alone. Both are topical anticholinergics that reduce sweat production at the gland. ### Areas and Options - **Axillary (Underarm) Hyperhidrosis** — The most commonly treated area. A grid of small intradermal Botox® injections dramatically reduces underarm sweating and the clothing staining that comes with it. - **Craniofacial Hyperhidrosis** — Excessive sweating of the forehead and scalp, treated with carefully placed superficial injections to reduce sweating while preserving normal expression. - **Sofdra® (Sofpironium)** — A topical anticholinergic that reduces sweat production at the gland — an option for patients who prefer to begin with topical therapy. - **Qbrexza® (Glycopyrronium) Cloth** — A pre-moistened medicated cloth applied to the treatment area, blocking the cholinergic signal that stimulates sweat glands. - **Duration of Relief** — Botox® treatment typically provides 6 to 12 months of relief per session, after which the treatment can be repeated. - **Medical Evaluation First** — Dr. Zaks confirms primary focal hyperhidrosis and screens for secondary causes, including thyroid disease and medication effects, before treating. ### What the Visit Involves 1. **Evaluation** — Dr. Zaks confirms the diagnosis, defines the affected areas, screens for secondary causes, and reviews which treatments you have already tried. 2. **Injection — 15 to 20 minutes** — Multiple small, very superficial injections are placed evenly across the affected area with a fine needle, based on Dr. Zaks's clinical assessment of each patient. Most patients tolerate this well. 3. **Onset and retreatment** — Sweating typically decreases within several days to two weeks. Relief usually lasts 6 to 12 months, and treatment is repeated when the effect wears off. ### Important Information - Dr. Zaks treats axillary (underarm) and craniofacial (forehead and scalp) hyperhidrosis. Palmar and plantar treatment is not offered in this practice. - Botox® treatment sessions take approximately 15 to 20 minutes. - Relief typically lasts 6 to 12 months per treatment; the effect is temporary and treatment is repeated as needed. - Topical options — Sofdra® and Qbrexza® — are used alone. ### Frequently Asked Questions **Which areas do you treat?** Axillary (underarm) hyperhidrosis and craniofacial hyperhidrosis of the forehead and scalp. Dr. Zaks does not treat palms or feet in this practice. **How long does the treatment take?** Approximately 15 to 20 minutes. **How long does relief last?** Typically 6 to 12 months per treatment session, after which the injections can be repeated. **How does Botox® stop sweating?** It blocks acetylcholine release at the junction between the nerve and the sweat gland, so the nerve can no longer signal the gland to produce sweat. It addresses the mechanism, not just the symptom. **What are Sofdra® and Qbrexza®?** Both are topical anticholinergic medications that reduce sweat production at the gland. Qbrexza® is a pre-moistened medicated cloth containing glycopyrronium; Sofdra® contains sofpironium. Either can be used alone or with injection therapy. **Does it hurt?** The injections are very superficial and performed with a fine needle. Most patients tolerate them well. **Can I use topical options instead of injections?** Yes. Sofdra® and Qbrexza® are topical anticholinergic options used on their own. They reduce sweat production at the gland and are a good choice for patients who prefer to start without injections. **Will I stop sweating everywhere?** No. Treatment is limited to the mapped area, and normal thermoregulatory sweating continues elsewhere on the body. --- ## Eczema Treatment in Beverly Hills URL: https://beverlyhillsdermatology.com/eczema Meta description: Eczema and atopic dermatitis treatment in Beverly Hills by Dr. Boris Zaks, MD — topical corticosteroids, calcineurin inhibitors, non-steroidal options, and systemic therapy. Covered by most PPO plans. Section: Medical Dermatology Atopic dermatitis managed properly — barrier repair, appropriately potent topical therapy, and escalation to non-steroidal or systemic treatment when it is warranted. ### Overview Atopic dermatitis is a chronic, relapsing inflammatory skin disease driven by two linked problems: a defective epidermal barrier that loses water and admits irritants and allergens, and a dysregulated type 2 immune response that produces intense itch and inflammation. It presents as dry, itchy, erythematous patches — on the flexural surfaces, hands, neck, and face in adults — and the itch-scratch cycle perpetuates it. Many patients also have asthma, allergic rhinitis, or food allergy as part of the atopic diathesis. Dr. Zaks treats both components. Barrier repair with thick emollients and gentle non-soap cleansing is foundational and never optional. Inflammation is controlled with topical corticosteroids of a potency matched to the body site, with topical calcineurin inhibitors such as tacrolimus and pimecrolimus for the face, eyelids, and skin folds and for long-term maintenance without steroid atrophy, and with newer non-steroidal topicals including crisaborole and topical JAK inhibitors. For moderate to severe disease that fails topical therapy, systemic options such as dupilumab and oral JAK inhibitors have changed outcomes substantially. Eczema is a medical diagnosis and is covered by most major PPO plans and Medicare. ### Treatment Options - **Barrier Repair and Gentle Cleansing** — Thick emollients applied consistently, short lukewarm showers, and non-soap cleansers. The foundation of every plan — and the step most often skipped. - **Topical Corticosteroids** — Potency matched to body site and severity, used in defined courses for flares. Correct potency and quantity matter more than avoiding steroids entirely. - **Topical Calcineurin Inhibitors** — Tacrolimus and pimecrolimus for the face, eyelids, and folds, and for long-term maintenance without the risk of skin thinning. - **Non-Steroidal Topicals** — Crisaborole and topical JAK inhibitors provide steroid-free anti-inflammatory options for maintenance and sensitive areas. - **Systemic and Biologic Therapy** — Dupilumab and oral JAK inhibitors for moderate to severe disease that has failed adequate topical therapy, with appropriate monitoring. - **Itch Control and Trigger Management** — Breaking the itch-scratch cycle, identifying irritants and allergens, and treating secondary bacterial infection when it develops. ### What the Visit Involves 1. **Diagnosis and severity assessment** — Dr. Zaks confirms atopic dermatitis, distinguishes it from contact dermatitis and psoriasis, assesses extent and severity, and reviews your atopic and treatment history. 2. **Barrier and flare plan** — Dr. Zaks explains the regimen orally, including which emollient to use, how often, which anti-inflammatory to apply where, how much, and for how long during a flare, so you understand exactly what to do. 3. **Escalation when needed** — If well-executed topical therapy is not enough, Dr. Zaks escalates to non-steroidal topicals or systemic and biologic therapy with appropriate monitoring. 4. **Maintenance and follow-up** — Once clear, you move to a proactive maintenance regimen that prevents flares rather than chasing them, with follow-up to keep control long-term. ### Frequently Asked Questions **Can eczema be cured?** No, but it can be controlled very well. Atopic dermatitis is chronic and relapsing; the goal is clear skin most of the time, with a maintenance plan that prevents flares instead of reacting to them. **Are topical steroids safe to use?** Yes, when the potency is matched to the body site and they are used in defined courses. Problems come from using too potent a steroid on thin skin for too long, or from using too weak a steroid and never gaining control. **What are the options if steroids aren't working?** Topical calcineurin inhibitors, crisaborole, and topical JAK inhibitors are non-steroidal alternatives. For moderate to severe disease, systemic therapy including dupilumab and oral JAK inhibitors is highly effective. **Is my eczema caused by a food allergy?** Food allergy and atopic dermatitis often coexist, but food is rarely the primary driver in adults. Dr. Zaks will discuss whether allergy evaluation is worthwhile in your case rather than starting with elimination diets. **Why do moisturizers matter so much?** The epidermal barrier is defective in atopic dermatitis, so it loses water and admits irritants and allergens. Consistent emollient use repairs that barrier and measurably reduces flares and medication use. **Is eczema treatment covered by insurance?** Yes. Eczema is a medical diagnosis and visits are covered by most major PPO plans and Medicare. Coverage for biologics requires prior authorization, which our office handles. **How do I know if my eczema is infected?** Increasing pain, weeping, yellow crusting, or a sudden worsening despite treatment can indicate secondary bacterial infection, which needs prompt evaluation and treatment. --- ## Psoriasis Treatment in Beverly Hills URL: https://beverlyhillsdermatology.com/psoriasis Meta description: Psoriasis treatment in Beverly Hills by Dr. Boris Zaks, MD — topical therapy, phototherapy, systemic medication, and biologics. Covered by most PPO plans and Medicare. Section: Medical Dermatology Topical therapy, phototherapy referral, systemic medication, and modern biologics — matched to how much of your skin is involved and how much it affects your life. ### Overview Psoriasis is a chronic immune-mediated disease in which activated T cells and the IL-23/IL-17 cytokine axis drive keratinocyte hyperproliferation. The result is well-demarcated erythematous plaques with adherent silvery scale, classically on the elbows, knees, scalp, and lower back, along with nail pitting and onycholysis. It is systemic, not merely cutaneous: psoriatic arthritis affects a substantial minority of patients, and psoriasis is associated with cardiovascular disease and metabolic syndrome — so Dr. Zaks asks about joint symptoms and reviews cardiometabolic risk at evaluation. Treatment is matched to severity. Limited disease responds to topical corticosteroids, vitamin D analogs such as calcipotriene, combination products, topical calcineurin inhibitors for the face and folds, and newer non-steroidal topicals including tapinarof and roflumilast. Narrowband UVB phototherapy is effective for more widespread involvement; if UV treatment is indicated, Dr. Zaks refers you to a dedicated phototherapy center for that portion of care. For moderate to severe disease, systemic and biologic therapy — including agents targeting TNF, IL-17, and IL-23 — achieves degrees of clearance that were not attainable a decade ago. Dr. Zaks coordinates with rheumatology when joint disease is present. Psoriasis is a medical diagnosis covered by most major PPO plans and Medicare. ### Treatment Options - **Topical Corticosteroids** — First-line for localized plaques, with potency matched to body site and used in defined courses to gain control. - **Vitamin D Analogs** — Calcipotriene, alone or combined with a corticosteroid, normalizes keratinocyte proliferation and is well suited to long-term use. - **Non-Steroidal Topicals** — Tapinarof and roflumilast offer steroid-free options for plaques and for sensitive areas including the face and skin folds. - **Narrowband UVB Phototherapy** — Effective for more widespread plaque psoriasis. If indicated, Dr. Zaks refers you to a dedicated phototherapy center for this portion of care. - **Systemic Therapy** — Oral agents including methotrexate, acitretin, and apremilast for patients who need more than topical treatment, with appropriate laboratory monitoring. - **Biologic Therapy** — Agents targeting TNF, IL-17, and IL-23 for moderate to severe disease, capable of producing near-complete clearance in many patients. ### What the Visit Involves 1. **Diagnosis and severity assessment** — Dr. Zaks confirms the diagnosis, documents body surface area involved and the sites affected, screens for nail and scalp disease, and asks specifically about joint pain and stiffness. 2. **Treatment plan matched to severity** — Limited disease starts with topical therapy; more extensive or life-limiting disease may move to phototherapy, systemic medication, or a biologic. UV phototherapy, when indicated, is referred to a dedicated phototherapy center. 3. **Escalation, authorization, and monitoring** — When systemic or biologic therapy is indicated, our office handles prior authorization and Dr. Zaks arranges the appropriate baseline and ongoing laboratory monitoring. 4. **Long-term follow-up** — Psoriasis is chronic and relapsing. Regular follow-up maintains control, catches flares early, and monitors for psoriatic arthritis and cardiometabolic risk. ### Frequently Asked Questions **Is psoriasis curable?** No, but it is highly controllable. With modern therapy — particularly biologics for moderate to severe disease — many patients achieve near-complete clearance and maintain it long-term. **How do I know if I need a biologic?** Biologics are generally considered for moderate to severe disease, for psoriasis that fails adequate topical therapy or phototherapy, or when involvement of the hands, face, scalp, or genitals significantly affects daily life. **Should I worry about joint pain?** Yes — mention it. Psoriatic arthritis affects a substantial minority of psoriasis patients, and early treatment prevents permanent joint damage. Dr. Zaks screens for it and coordinates with rheumatology when indicated. **Are biologics safe?** They are well studied with established safety profiles, but they modulate the immune system, so baseline screening including tuberculosis testing and ongoing monitoring are part of treatment. **Can diet or stress affect my psoriasis?** Stress, infection, skin trauma, smoking, and certain medications are recognized triggers of flares. Diet is not a treatment for psoriasis, though cardiometabolic health matters given the associated risks. **Is psoriasis treatment covered by insurance?** Yes. Psoriasis is a medical diagnosis covered by most major PPO plans and Medicare. Biologics require prior authorization, which our office manages for you. **Is psoriasis contagious?** No. It is an immune-mediated disease and cannot be transmitted to anyone by contact. --- ## Medical Dermatology Conditions in Beverly Hills URL: https://beverlyhillsdermatology.com/medical-dermatology-conditions Meta description: Shingles, nail fungus, seborrheic dermatitis and vitiligo treated in Beverly Hills by Dr. Boris Zaks, MD. Diagnosis, prescription therapy, most PPO and Medicare accepted. Section: Medical Dermatology Shingles, nail fungus, seborrheic dermatitis, and vitiligo — diagnosed properly and treated with prescription therapy, as covered medical visits rather than cosmetic consultations. ### Overview Roughly half of Dr. Zaks' practice is medical dermatology: conditions that need a diagnosis, not a treatment menu. Several of the most common — shingles, onychomycosis, seborrheic dermatitis, and vitiligo — are frequently misidentified and mistreated for months before a dermatologist sees them, and in at least one of them the delay directly costs the patient a better outcome. Herpes zoster (shingles) is reactivation of latent varicella-zoster virus in a dorsal root ganglion. It presents as pain, burning, or itching in a single dermatomal band, followed within days by grouped vesicles on an erythematous base that do not cross the midline. Shingles is time-critical: antiviral therapy such as valacyclovir is most effective when started within seventy-two hours of rash onset, both for the eruption itself and for reducing the risk of postherpetic neuralgia. Involvement of the eye or the tip of the nose (Hutchinson's sign) suggests ophthalmic zoster and warrants same-day ophthalmology involvement. Dr. Zaks also discusses Shingrix vaccination for prevention in eligible adults. Onychomycosis, or nail fungus, is a common infection of the nail plate and bed, usually caused by dermatophytes. It shows up as yellow-brown discoloration, thickening, debris under the nail, and the nail lifting away from the bed. Several other conditions can mimic this appearance, so Dr. Zaks examines the nail and reviews your history before starting treatment. Mild or limited disease is usually treated first with a topical prescription antifungal — Jublia® (efinaconazole) or Kerydin® (tavaborole) — applied directly to the nail. Oral terbinafine is considered if the infection does not improve with topicals or when multiple nails are affected. Because nails grow slowly, a toenail can take nine to twelve months to look normal again even after the fungus is gone. Seborrheic dermatitis is a chronic inflammatory reaction to Malassezia yeast in sebum-rich skin: the scalp, eyebrows, nasolabial folds, ears, beard area, and central chest. It presents as greasy yellowish scale on pink skin, often itchy, and it flares with stress, cold dry weather, and illness. Treatment combines antifungal shampoos and creams — ketoconazole, ciclopirox, zinc pyrithione, selenium sulfide — with short courses of topical anti-inflammatories, using non-steroidal options such as topical calcineurin inhibitors on the face to avoid steroid atrophy. It is controllable and recurrent; maintenance antifungal shampoo two to three times weekly is what keeps it quiet. Vitiligo is an autoimmune condition in which melanocytes are destroyed, producing sharply demarcated depigmented macules, commonly on the hands, face, around the eyes and mouth, and over joints. Diagnosis is clinical, with screening for associated autoimmune thyroid disease where indicated. Treatment aims to halt progression and stimulate repigmentation: topical calcineurin inhibitors such as tacrolimus for facial disease, topical corticosteroids for the body, narrowband UVB phototherapy for widespread involvement, and topical ruxolitinib cream (Opzelura®) — the first FDA-approved treatment for nonsegmental vitiligo repigmentation, a JAK inhibitor that interrupts the interferon-gamma signaling driving melanocyte destruction. Repigmentation is slow, best on the face and neck, and least reliable on hands and feet; sun protection of depigmented skin is essential because it has no melanin defense. Dr. Zaks personally performs every injectable, laser, and procedural treatment at his Beverly Hills practice. Patients are never seen by rotating physician assistants, nurse injectors, or aestheticians for these procedures. ### Conditions Covered on This Page - **Shingles (Herpes Zoster)** — Dermatomal pain and grouped vesicles from reactivated varicella-zoster virus. Antivirals are most effective within seventy-two hours of rash onset; eye or nasal-tip involvement is an emergency. Prevention with Shingrix is discussed for eligible adults. - **Nail Fungus (Onychomycosis)** — Evaluated clinically, then treated with a topical prescription antifungal such as Jublia® or Kerydin®. Oral terbinafine is considered if topicals do not clear the infection or several nails are involved. Expect nine to twelve months of nail growth for a normal-looking toenail. - **Seborrheic Dermatitis** — Greasy yellow scale on the scalp, brows, nasolabial folds, ears, and chest driven by Malassezia. Treated with antifungal shampoos and creams plus non-steroidal anti-inflammatories on facial skin, then maintenance to prevent flares. - **Vitiligo** — Autoimmune depigmentation diagnosed clinically. Treated with topical calcineurin inhibitors, topical steroids, narrowband UVB, and topical ruxolitinib (Opzelura®) for repigmentation, with thyroid screening where indicated. - **Postherpetic Neuralgia Risk Reduction** — Early antiviral therapy and prompt pain management reduce the likelihood of nerve pain persisting after the rash resolves — the main reason shingles should be seen quickly rather than next week. - **Related Chronic Conditions** — Eczema, psoriasis, rosacea, hyperhidrosis, and acne are managed on their own dedicated pages, with the same prescription-based approach. ### What the Visit Involves 1. **Same-week evaluation for time-sensitive rashes** — Suspected shingles is prioritized because the antiviral window is seventy-two hours from rash onset. 2. **Diagnosis and treatment planning** — Dr. Zaks examines the affected skin, scalp, or nails and selects therapy based on the clinical picture, your history, and the affected site. 3. **Prescription treatment plan** — Therapy is selected for the diagnosis, your medical history, medication interactions, and the affected site. Oral antifungals are prescribed only after appropriate review; facial inflammation is treated with steroid-sparing agents. 4. **Follow-up and maintenance** — Chronic conditions are reviewed on a defined schedule — nails at three to six months, seborrheic dermatitis and vitiligo as therapy is titrated — and maintenance regimens are set so flares are prevented rather than chased. ### Insurance and Practical Details - These are medical dermatology visits. Most PPO plans and Medicare are accepted. - Biopsy, when indicated, is performed the same day and results are typically available in about five business days. - Suspected shingles should be seen quickly — antiviral therapy is most effective within seventy-two hours of rash onset. Zoster affecting the eye or nasal tip needs same-day ophthalmology evaluation. - Depigmented vitiligo skin has no melanin protection; mineral sunscreen at SPF 30+ on affected areas is part of treatment, not an add-on. ### Frequently Asked Questions **How soon do I need to be seen for shingles?** Quickly. Antiviral therapy such as valacyclovir is most effective when started within seventy-two hours of rash onset, and early treatment also reduces the risk of postherpetic neuralgia. If the rash involves your eye or the tip of your nose, that requires same-day ophthalmology evaluation as well. **Is nail fungus treatment covered by insurance?** The medical visit is generally billable to PPO insurance and Medicare, and most prescription antifungals are covered subject to your plan's formulary. The office will verify benefits before treatment. Cosmetic nail concerns are not covered. **How does Dr. Zaks decide between topical and oral treatment for nail fungus?** The decision is based on the clinical appearance, the number of nails involved, how long the infection has been present, and your medical history. Most limited or mild cases are started with a topical prescription antifungal such as Jublia® or Kerydin®. Oral terbinafine is considered if the infection does not respond to topicals or when several nails are affected. **Can seborrheic dermatitis be cured?** It can be controlled reliably but not cured, because the Malassezia yeast that drives it is a normal skin resident and the inflammatory tendency persists. Most patients clear with antifungal and anti-inflammatory treatment in two to four weeks, then stay clear on maintenance antifungal shampoo two to three times weekly. **Does Opzelura actually repigment vitiligo?** Topical ruxolitinib (Opzelura®) is the first FDA-approved therapy for repigmentation in nonsegmental vitiligo and does produce meaningful repigmentation in a substantial proportion of patients, with facial areas responding best. It is slow — meaningful change is measured over months, not weeks — and hands and feet respond least. Dr. Zaks will tell you where on your body to expect the most and the least. **Is vitiligo connected to other medical conditions?** It can be. Vitiligo is autoimmune and is associated with autoimmune thyroid disease in particular, so screening is appropriate in many patients. Dr. Zaks orders thyroid studies where indicated and coordinates with your primary care physician. **Does Dr. Zaks treat these conditions himself?** Yes. Dr. Zaks personally performs every examination, biopsy, and procedural treatment at his Beverly Hills practice, and he reviews your pathology and results with you directly. There are no rotating physician assistants or nurse practitioners handling medical visits. --- ## Dermatologist Near West Hollywood, Brentwood & Bel Air URL: https://beverlyhillsdermatology.com/dermatologist-west-hollywood Meta description: Board-certified dermatologist serving West Hollywood, Brentwood and Bel Air from Beverly Hills. Dr. Boris Zaks, MD personally performs every procedure. (310) 552-3376. Section: Locations Five to twenty minutes from West Hollywood, Brentwood, and Bel Air — a single-physician practice where Dr. Zaks personally performs every injectable, laser, and procedure. ### Overview The office at 435 N. Roxbury Drive sits within a short drive of West Hollywood, Brentwood, and Bel Air: roughly five to ten minutes from West Hollywood via Santa Monica Boulevard, and about ten to twenty minutes from Brentwood or Bel Air via Sunset Boulevard, Wilshire Boulevard, or the 405 corridor. This is a single-physician practice. Dr. Zaks personally performs every injectable, laser, and procedural treatment, performs your skin examinations and biopsies, and reviews your pathology results with you directly. Patients are never seen by rotating physician assistants, nurse injectors, or aestheticians for these procedures. That is the main structural difference between this office and the multi-provider or multi-location model: the physician who chose your dose and mapped your anatomy last time is the physician assessing it this time, and the examiner comparing a changing mole is the same one who documented it a year ago. Both medical and cosmetic dermatology are treated as core work rather than separate businesses. On the medical side: skin cancer screening and same-day biopsy when a lesion is suspicious, with pathology typically back in about five business days; acne and acne scarring; eczema; psoriasis; rosacea; hyperhidrosis; shingles; and nail and scalp conditions. On the cosmetic side: conservative Botox® and filler, Vbeam® for redness and visible vessels, Titan® skin tightening, and salicylic acid or Cosmelan® protocols for pigment. Dr. Zaks makes a diagnosis first and recommends only what is indicated, including declining treatments that will not help. There are no treatment packages sold in advance of a diagnosis. Most PPO plans and Medicare are accepted for medical dermatology; cosmetic treatment is self-pay. ### Frequently Requested Treatments - **Botox® Cosmetic** — Conservative, anatomy-specific dosing that preserves expression — the same physician mapping it every visit. - **Lip Filler** — Conservative, structure-first hyaluronic acid augmentation, injected by Dr. Zaks himself. - **Vbeam® Laser** — The 595nm pulsed dye laser for rosacea, flushing, and visible vessels — same-day return to normal activity. - **Titan® Skin Tightening** — Non-surgical infrared tightening for the face and neck, with no downtime. - **Skin Cancer** — Screening, same-day biopsy when indicated, and referral to a fellowship-trained Mohs surgeon when that is the right procedure. - **Acne & Acne Scarring** — Active acne control plus treatment of post-inflammatory redness and textural scarring. ### Getting Here - **From West Hollywood — 5 to 10 minutes** — Santa Monica Blvd westbound into Beverly Hills, then north to 435 N. Roxbury Drive. From the Sunset Strip, west on Sunset then south on Beverly or Roxbury Drive. From the Melrose district, west to Doheny then north via Burton Way. - **From Brentwood — 15 to 20 minutes** — Sunset Blvd east through Bel Air and Beverly Hills, then south to Roxbury Drive; or San Vicente to Wilshire and east into Beverly Hills. - **From Bel Air — 10 to 15 minutes** — Down through the East Gate to Sunset Blvd, east briefly, then south on Beverly or Roxbury Drive. - **Parking** — Paid parking is available at the building, and free two-hour parking is available at the 461 N. Bedford Drive garage, a short walk from the office. ### Frequently Asked Questions **How far is the office from West Hollywood, Brentwood, or Bel Air?** About five to ten minutes from West Hollywood via Santa Monica Boulevard, ten to fifteen minutes from Bel Air, and fifteen to twenty minutes from Brentwood. The office is at 435 N. Roxbury Drive, Suite 408, Beverly Hills, CA 90210. **Is parking difficult?** No. Paid parking is available at the Roxbury Drive building, and free two-hour parking is available at the 461 N. Bedford Drive public garage, a short walk from the building. **Will Dr. Zaks treat me himself, or a nurse injector?** Dr. Zaks personally performs every injectable, laser, and procedural treatment, and performs your skin examinations and biopsies himself. Patients are never seen by rotating physician assistants, nurse injectors, or aestheticians for these procedures. **How far ahead of an event should I schedule Botox?** Two to three weeks. That allows full onset at around fourteen days plus time for a follow-up visit if anything needs adjusting. **Do you handle both medical and cosmetic dermatology?** Yes. Medical dermatology is a core part of the practice: skin cancer screening, biopsies, acne, eczema, psoriasis, rosacea, hyperhidrosis, shingles, and nail and scalp conditions. Cosmetic treatment is self-pay. **Do you take insurance for medical visits?** Most PPO plans and Medicare are accepted for medical dermatology. Cosmetic treatments are self-pay. **Does Dr. Zaks perform Mohs surgery?** No. When a skin cancer is best treated with Mohs micrographic surgery, Dr. Zaks refers you to a fellowship-trained Mohs surgeon and coordinates the care. --- ## Dermatologist Near Santa Monica, CA URL: https://beverlyhillsdermatology.com/dermatologist-santa-monica Meta description: Board-certified dermatologist serving Santa Monica from Beverly Hills — skin cancer screening, sun damage, Vbeam laser and injectables by Dr. Boris Zaks, MD. (310) 552-3376. Section: Locations Fifteen to twenty-five minutes from Santa Monica — with a particular emphasis on skin cancer screening and sun damage in patients who live outdoors year-round. ### Overview Santa Monica patients present with the clearest dose-response relationship in dermatology: a beach and outdoor lifestyle sustained across decades produces high cumulative ultraviolet exposure, and cumulative ultraviolet exposure is the primary driver of both skin cancer and visible photoaging. Runners on the beach path, cyclists on Ocean Avenue, surfers, tennis and paddle players, and anyone whose office life is punctuated by lunch outdoors are accumulating dose almost every day of the year — including the overcast mornings, since roughly eighty percent of ultraviolet penetrates cloud cover, and marine haze offers far less protection than it appears to. Annual skin cancer screening is especially important given Santa Monica's year-round outdoor lifestyle. When a lesion is suspicious, he performs the biopsy, and dermatopathology results are typically available in about five business days. Melanoma caught while confined to the epidermis is usually cured by simple excision — which makes screening interval, not technology, the variable that changes outcomes. Alongside screening, the treatable consequences of sun exposure are the practice's other main focus for these patients: actinic keratoses, solar lentigines and diffuse brown discoloration, diffuse redness and telangiectasias, and loss of firmness across the face, chest, and hands. Individual actinic keratoses are typically treated with liquid nitrogen cryospray, while photodynamic therapy is used for widespread field treatment or prevention. The Vbeam® 595nm pulsed dye laser addresses the vascular component, salicylic acid and Cosmelan® protocols address pigment, and Titan® addresses skin tightening. Salt water, wind, and chlorine also aggravate eczema and produce genuinely dry, reactive skin, which is managed medically rather than with retail moisturizers. Dr. Zaks personally performs every injectable, laser, and procedural treatment, including every skin examination and biopsy. Patients are never seen by rotating physician assistants, nurse injectors, or aestheticians for these procedures — so the physician who examined a changing mole last year is the physician comparing it this year, which is precisely how change over time gets detected. ### Priorities for Santa Monica Patients - **Skin Cancer** — Diagnosis and management of basal cell and squamous cell carcinoma and melanoma, with referral for Mohs surgery when that is the right procedure. - **Sun Damage** — Actinic keratoses, solar lentigines, and photoaging on the face, chest, arms, and hands. - **Photodynamic Therapy** — Field treatment for widespread actinic damage rather than spot-by-spot destruction. - **Vbeam® Laser** — 595nm pulsed dye laser for the diffuse redness and visible vessels that follow years of outdoor exposure. - **Hyperpigmentation & Brown Spots** — Pigment treated with topical suppression, salicylic acid peels, and Cosmelan® where appropriate. ### Getting Here - **Santa Monica Blvd — 20 to 25 minutes** — A straight surface route east on Santa Monica Blvd through Westwood and Century City into Beverly Hills. Reliable when the 10 is congested. - **I-10 East to Robertson or La Cienega** — The 10 east, then north to Burton Way and west to Roxbury Drive — often 15 to 20 minutes outside rush hour. - **Wilshire Blvd** — Wilshire east through Westwood into Beverly Hills, then north on Roxbury Drive — roughly 25 minutes with lights. - **Parking** — Paid parking is available at the building, and free two-hour parking is available at the 461 N. Bedford Drive garage, a short walk from the office — worth knowing before you plan the drive back. ### Frequently Asked Questions **Why is skin cancer screening especially important for Santa Monica residents?** Because the exposure is continuous rather than occasional. A beach-adjacent, outdoor lifestyle sustained across years produces high cumulative ultraviolet dose — the primary driver of basal cell carcinoma, squamous cell carcinoma, and melanoma. Marine layer and cloud cover feel protective but transmit most ultraviolet. Annual skin cancer screening is the single highest-value dermatology visit for this population, because outcome depends overwhelmingly on the stage at which a cancer is found. **How long does it take to get to the office from Santa Monica?** Typically fifteen to twenty-five minutes depending on route and time of day: the 10 east then north, or Santa Monica Boulevard straight through Westwood and Century City. The office is at 435 N. Roxbury Drive, Suite 408, Beverly Hills, CA 90210, with paid parking at the building and free two-hour parking at the 461 N. Bedford Drive garage. **How often should I be screened?** Annually for most adults. Every three to six months if you have a personal history of skin cancer, a family history of melanoma, many or atypical moles, fair skin that burns, or immunosuppression. Dr. Zaks sets your interval from your actual risk profile. **What happens if something suspicious is found?** Dr. Zaks biopsies it that day under local anesthesia — no second appointment. Results from dermatopathology are typically available in about five business days, and he reviews them with you along with the plan, including referral for Mohs surgery when the tumor calls for it. **Is the screening visit covered by insurance?** Usually yes — it is a medical visit. Most PPO plans and Medicare are accepted. Cosmetic concerns discussed at the same visit are billed separately as self-pay. **Can sun damage already done be reversed?** Partly, and honestly: precancerous actinic keratoses can be treated and cleared, pigment can be lightened, and redness and vessels can be reduced. Structural damage to collagen improves but does not return to baseline. Daily mineral sunscreen at SPF 30+ is what protects the result you pay for.