Radiofrequency Microneedling: the Latest in Skin Tightening

There is a relatively new technique that dermatologists are using to tighten your skin. Its called RF microneedling, and Legacy Dermatology Group is proud to offer this groundbreaking treatment!

RF stands for radio-frequency. RF microneedling affects the skin in two ways. You get the physical injury from the microneedling device, along with the simultaneous radiofrequency which adds a heat effect in the dermis (the deep layer of your skin where collagen is formed and rests). This forces your skin to create an abundance of collagen for many months after your treatment. That’s one reason why you see such amazing results.

On top of tightening your skin, this treatment helps with acne, scars, stretch marks, axillary hyperhidrosis (excessive sweating in your underarms), and even the vertical lines some women develop on their chest.

The best part? There is very minimal downtime! The treated areas may experience redness that may last for about 48 hours, but that’s it! Stacked treatments about a month apart will lead to a gradual tightening and rejuvenation effect. You can get this treatment and get back to you routines without missing a beat. Now that’s lifestyle dermatology!

This is Dr. Legacy’s actual patient who can given written consent to have her treatment photos used for our media. Please do not use or reproduce these without permission. Photos are property of Michelle S Legacy, DO.

This is Dr. Legacy’s actual patient who can given written consent to have her treatment photos used for our media. Please do not use or reproduce these without permission. Photos are property of Michelle S Legacy, DO.

Hilton, Lisette. “RF Microneedling Applications.” 19 Jan. 2017.

Can you treat your acne with the right diet?

Acne is a very common skin issue in people of all ages. If you have ever struggled with acne, you may have heard of a few foods to stay away from. You might now avoid grabbing a greasy burger because you believe it will cause a new pimple to pop up, and you might not be wrong. Recent studies do show a correlation between diet and acne, but I bet it’s not for the reasons you think. Let’s take a look at what components of your diet truly cause your breakouts.


High-glycemic foods

High-glycemic foods are foods that are easy for your body to turn into sugar. American culture has conditioned us to crave lots of high-glycemic foods and beverages, unfortunately. These foods include white bread, doughnuts, potato chips, fries, white rice, and sugary drinks just to name a few. Researchers have found that when people made the switch to a low glycemic diet they had less acne. A study was done placing 2,258 patients on a low-glycemic diet originally to just lose weight, little did they know they would learn something more. Along with losing weight, 87% of them said they had less acne, while 91% of them said they needed less acne medication than before. 

Why do high-glycemic foods increase your acne?

  • High-glycemic foods cause your blood sugar to spike, which causes inflammation throughout your entire body. These spikes also cause your body to create more sebum, an oily substance in your skin. If you can lessen your bodies inflammation and excess sebum, it will lead to less acne!

What’s the best way to change your diet to avoid this?

  • Adding low-glycemic foods to your daily routine is the best way to make the change. These foods include fresh vegetables, some fresh fruits, steel-cut oats and most beans. If you can find a way to incorporate these types of foods into your diet, while eliminating the french fries and milkshakes, your skin will thank you. 



Some studies are suggesting a milk to an increase in acne breakouts. Although it is a low-glycemic beverage, a few studies found that all types of milk (whole, low-fat, and skim) have been leading to acne. One study looked at patients aged 10 to 24, who were all seeing a dermatologist for moderate to severe acne, along side patients in the same age group seeing a dermatologist for a different skin condition. They were all asked what they ate and drank on a daily basis. The only difference in diet they found, was the patients being seen for acne drank significantly more milk than the patients with little to no acne at all. 

Why does drinking milk increase your acne?

  • As with many medical conditions, more research is needed to uncover the exact reasoning behind this. One theory is that the hormones in milk cause inflammation in your body which can clog your pores and lead to breakouts. 

What’s the best way to change your diet to avoid this?

  • With all the milk alternatives out there, it makes it easy to swap out the 2% milk in your fridge for perhaps almond milk instead. Maybe try getting coconut milk in your next Starbucks coffee. This change will not have the same effects on each and every person, but as someone who has struggled with acne for longer than they want to admit, anything that could possibly get rid of acne breakouts is worth a try!

What does all this mean for you?

As talked about above, each person will see different results when changing their diet. One thing that dermatologists recommend is that you pay attention to your breakouts and take note if certain foods or beverages seem to trigger them. If you do find a trigger item, what happens if you don’t have that food or beverage for a day, a week, or a month?

If you have questions, or are wondering if you are a good candidate for professional acne treatment, call to schedule a consultation with our Board Certified Dermatologists Dr Michelle Legacy and Dr Lynn Sikorski.

“Can the Right Diet Get Rid of Acne?” American Academy of Dermatology, 14 Dec. 2018,

Everything you need to know about microneedling

What is microneedling? 

  • Microneedling, or collagen induction therapy, uses a powered pen like device with 36 fine-gauge needles at the end. These needles vibrate in and out of the skin, up to three millimeters deep, causing the skin to produce more collagen.

    • The depth the needles penetrate and the speed at which they move is adjustable. Your dermatologist will determine those factors based on the treatment surface area and skin type.

What can I expect during the procedure?

  • First you will put a numbing cream over the entire area to make the procedure more comfortable. 

  • A sufficient amount of hyaluronic acid gel or Platelet Rich Plasma is applied on the treatment area surface to facilitate the gliding of the device.

  • Your dermatologist will then begin the microneedling process by rolling the device over the treatment area making a few passes in all directions over each section.

    • The total time this takes will vary on the size of the surface area and the type of skin being treated. Thicker skin may take a few more passes to achieve the best results.

  • Pinpoint bleeding will occur (nothing crazy, don’t let that freak you out), so after the procedure, cold/wet gaze will be used to clean the surface area.

  • You can expect the skin to stay slightly pink anywhere from three days to one week after microneedling. Nothing to worry about as it is very easy to cover up with make up, which can be used as early as two days following the procedure. 

  • Expect a rough and vibrating sensation during the procedure but very little pain.

What are the benefits of microneedling?

  • The goal of microneedling is to produce more collagen in the skin to rejuvenate it and in some cases get rid of scars. 

    • Skin rejuvenation

      • This is becoming the most popular way to get rid of wrinkles and create a smooth complexion. 

      • Microneedling can also be used to get rid of stretch marks on the stomach, hips or thighs. 

    • Clearing acne and surgical scars 

      • The needles of the device can reach deep scar tissue without the heat production of a laser treatment. 

      • Microneedling can be used on a small surface area when treating a small scar because unlike laser treatments, there is no fear of discoloration.

When will I see results?

  • The ideal results are best seen after the third treatment at intervals of two to four weeks apart. However, some patients will opt to only have microneedling done once or twice a year to maintain their cosmetic outcomes.

  • It takes a little time for the collagen to be produced and remodeled, but this lag time varies for each patient. 

I’ve seen at home microneedling kits on Instagram, do those do the same thing?

  • There have been many at home microneedling kits circulating social media. The bottom line is, they are not safe! And moreover, you are not going to get the results that you will achieve with an in-office microneedling treatment by using one of those at home.

  • There are a few problems with them. 1) There is not a good way to clean these devices at home, so spreading infections you didn’t even know you had is very common. 2) There is no way to sharpen/interchange the needles. Needles dull after just 1 treatment. In-office treatments require the needles to be changed with each treatment to achieve the desired results.

  • Bottom Line: skip the at-home microneedling and contact Legacy Dermatology Group to make an in-office appointment. 

If you are craving a smooth complexion with little to no down time, Consult Dr. Legacy about how microneedling can work for you!

Margosian, Emily. “The Many Uses of Microneedling”. Dermatology World, September 2018: 44-49. Print.

PRP: The New Way to Treat Hair Loss


80 Million Americans

suffer from hair loss according to the American Academy of Dermatology.

Using platelet-rich plasma (PRP) is not a new phenomenon. It has been used for years as a way to repair joint damage. The most recent use for it however, is to reverse hair loss. PRP has been found to stimulate the hair follicle promoting thick, healthy hair to grow fairly quickly. Injected deep into the scalp, the solution then tends to diffuse into the dermis where it works its magic! The 15 minute procedure, where the PRP is injected in a grid like pattern in and around the affected area, may require an anesthetic numbing cream to make the procedure more comfortable. In some types of hair loss, PRP spawns new hair growth in six to 12 months, with many doctors seeing initial results in as little as three months!

Because there are so many types of hair loss, it is imperative that you see a board certified dermatologist to rule out causes that may indicate other health issues. You may require a biopsy or further evaluation before initiating PRP treatments.

If you are interest in getting a PRP treatment on your scalp, schedule your consultation with our Dr. Legacy to see what PRP can do for you!

“Hair Loss Solutions”. New Beauty summer-fall 2018: 114. Print.

How to treat and prevent uneven pigmentation

Not all dark spots are the same. There are different types of hyperpigmentation (dark spots) and each one is treated differently. Many people will have multiple types of hyperpigmentation in one area requiring multiple types of treatment. If dark spots are treated incorrectly they could worsen, making it even more important that you see your dermatologist to get the correct treatments, before grabbing the newest dark spot corrector at your favorite department store.

The 4 types of hyperpigmentation

  1. Melasma

    • One of the most difficult types of hyperpigmentation to treat. It presents itself as large and patchy spots and is mostly cause by hormonal changes. This is why melanoma is seen on women during pregnancy in the second and third trimesters and while taking birth control pills for one to four months. There are two types of melasma: epidermal and dermal. Epidermal is on the surface of the skin and seen as light discoloration, whereas dermal is deeper in the skin and seen to the naked eye as dark brown or grey patches. 

    • In-office treatments 

      • Lasers and chemical peels for epidermal melasma only

  2. Post-inflammatory hyperpigmentation (PIH)

    • PIH is most seen as a result of cystic acne or extreme inflammation. It is seen on the skin as red, pink or brown spots and can surface anywhere from a couple of days to a fe weeks post-trauma. Ways to avoid PIH are to not pick your breakouts, keep your skin out of the sun, and to use anti-inflammatory products on your skin that contain green tea extract or bisabolol. The most important way to avoid post-inflammatory hyperpigmentation is to find out the underlying cause of it and treat that as well. If your cystic acne is causing the PIH, it is smart to start treating your breakouts as well. 

    • In-office treatments

      • Chemical peels 

  3. Age and sunspots

    • These spots, usually found on the face, chest, and hands, are spots of different shades of brown cause by the sun. They can turn up as you age due to a sunburn you had as a kid or a sunburn you got a year ago. It might take hours to days for sunspots to appear, although it is likely some pigment has been building up for years. 

    • In-office treatments

      • Intense pulsed light (IPL), chemical peels, and for heavy sun damage lasers can be used

  4. Freckles

    • Most freckles pop up during childhood before puberty and fade as you age. However, exposure to the sun will darken them if not protected. Freckles are most visible on light skin, but all skin tones can develop them. 

    • In-office treatments

      • Lasers 

Pigment Preventers

Blocking tyrosinase (an enzyme responsible for melanin production) is crucial to impeding discoloration of the skin. There are a few inhibitors out there that you can use to do the blocking.

  1. Hydroquinone 

    • The heavy hitter of tyrosinase inhibitors. This is the best option for blocking pigment, but can only be used for a few months at a time. If used too long it will create a dark blue-black pigment that is almost impossible to erase. It is the fastest working ingredient known to lighten dark patches. 

  2. Azelaic acid

    • This is a great alternative to hydroquinone and can be used when you need to take a break from it. Azelaic acid is a natural anti-inflammatory agent and has the ability to lighten skin. 

  3. Licorice extract

    • Licorice contains a natural tyrosinase inhibitor: glabridin. This is a gentle substitute for harsh chemical-based products. 

  4. Vitamin C

    • Vitamin C is rich in antioxidants, therefore naturally increases the skins antioxidants and vitamin E. Both of these aid in producing pheomelanin (a type of melanin), which slows down the production of tyrosinase. 

  5. Kojic acid

    • Kojic acid comes from mushrooms and rice, making it a naturally derived lightning agent. It is a good option for those with sensitive skin!



Fading discolorations on the skin does not happen overnight. On average it takes three months for you to see a change. Exfoliating will speed up the process and help to even out the skin’s complexion. However you should use each exfoliator with caution, over exfoliating can lead to inflammation eventually causing PIH. Here are some useful ingredients to look for in your exfoliators:

  1. Glycolic Acid

    • This is the smallest of the alphahydroxy acids (ADAs), meaning it penetrates the skin deep and fast. 

  2. Salicylic acid

    • A product mostly used for acne-acne-prone skin, salicylic acid breaks up discolorations and dead skin without causing irritation.

  3. Fruit enzymes

    • Papaya, pineapple, pomegranate and grapefruit are all acid-rich fruits that gently dissolve dead skin cells. 

  4. Retinol

    • Retinol and retinoids (the prescription version) lift away discolored skin cells by stimulating cell turnover. They are often paired with a low-dose steroid and short-term use of hydroquinone when treating discoloration. 


It is important to know what you are putting on your skin and the best ways to treat your dark spots. Coming in to see Dr. Legacy is your best bet at a bright and clear complexion! 

Tabin, Elise M. “The Guide: Hyperpigmentation”. New Beauty, Summer-Fall 2018: 100-106. Print.

Skin Cancer 101: Get the Facts

You hear about it all the time, but what exactly is skin cancer? 

  • Skin cancer is the growth of abnormal cells in the epidermis (the outermost layer of skin). The growths are caused by unrepaired DNA damage that triggers mutations, leading the skin cells to rapidly multiply and from tumors. The leading causes of skin cancer are UV rays produced by the sun or tanning machines. There is some good news when it comes to skin cancers though! Most of them are treatable by your dermatologist if caught early on. 

Let’s get the facts on the 3 most common forms of skin cancer. 


Basal Cell Carcinoma (BCC)

The most common skin cancer

Basal cell carcinoma is the most common form of skin cancer, with more than 4 million cases seen a year. 

  • It is an abnormal growth that starts in the skin’s basal cells located in the epidermis. 

  • BCCs typically arise in spots most exposed to the sun, such as the face, neck, ears, scalp, shoulders and back. 

  • The most common cause of BCCs is the exposure to UV radiation from the sun. It is a combination of the intensity of the rays and the length of time they are in contact with your skin. 

  • Around 3,000 people die from advanced BCC in the US each year.

  • What to look for:

    • Red crusty patches that don’t heal or keep bleeding

    • Open sores that don’t heal

    • Shiny bumps that grow over time

    • Pink growths that continue to change and bleed or itch 


Squamous Cell Carcinoma (SCC)

Squamous cell carcinoma is the second most common form of skin cancer, with more than 1 million cases diagnosed each year in the US.

  • It is an uncontrolled growth of abnormal cells that forms in the squamous cells located in the epidermis. 

  • SCCs are typically found on sun exposed areas where the skin most often reveals sun damage, including wrinkles and sun spots. 

  • The most common cause for SCCs is long term exposure to UV rays from both the sun and tanning machines. 

  • Nearly 15,000 deaths occur from invasive SCC of the skin each year.

  • What to look for:

    • A wart like growth, scaly red patches with irregular borders, an elevated growth, an open sore that bleeds



Melanoma is the most dangerous of the 3 most common types of skin cancer. It is very curable if found early, but if not melanoma can spread to vital organs proving to be deadly.

  • Melanoma is a cancer that develops from the cells in the skin that produce melanin pigment, called melanocytes. These are the cells that give skin its color. 

  • It is caused by intense UV ray exposure from the sun and/or tanning machines when resulting in sunburn.

  • Each year in the US more than 178,00 cases of melanoma are diagnosed, causing around 9,000 deaths.

  • What to look for:

    • The ABCDEs of melanoma

      • Asymmetry - A line through the middle would not create matching halves

      • Border Irregularity - Uneven boarders or notched edges

      • Color variability - Different shades of brown, tan or black. As melanoma

        progresses, the colors red, white, and blue may even


      • Diameter - Melanomas are generally at least the size of a pencil eraser, about

        1/4 inch in diameter, but some may be smaller.

      • Evolving - Any change in appearance or symptom overtime such as bleeding,

        itching, or crusting, may be a sing of melanoma. 


Remember, if you have any concerns about possible skin cancer, Contact Us Now.

It could save your life!


“Skin Cancer 101”. The Skin Cancer Foundation Journal 2018: 26-27. Print.

Surprising factors that may increase your risk for skin cancer

Yes, UV radiation from the sun causes most skin cancers. There are however a few other factors that might increases your risk for skin cancer. A few of these have been exaggerated in the media as of late, so lets make one thing clear that will make you feel better while reading this article. An absolute risk is the chance of you developing a condition over your lifetime. A relative risk is the chance that a group of people with a certain characteristic (lets say that use a tanning bed every day) develop a condition versus a group of people who have never used one in their life. There is a big difference. Now keeping that in mind, lets find out if these factors raise any concern to you!

Surprising factors that may increase your risk for skin cancer.png

White wine

No one likes when a study comes out resulting in a negative health benefit coming from something they love. However, a 2016 study came out saying drinking alcohol (particularly white wine) is correlated to the increased risk of invasive melanoma in white men and women. It is suggested that white wine has the largest correlation because of its higher levels of acetaldehyde, and its lower levels of antioxidants compared to red wine. Drinking a glass of white wine a day showed an increased risk of 13 percent, while that goes all the way up to a 50 percent increase for the people who drank the most white wine throughout the study. If you do not have any preexisting risks for skin cancer, such as family history of skin cancer, exposure to toxic chemicals, previous skin cancers yourself, or use indoor tanning beds, a 13 percent increase is not something to worry about. Determine how prevalent your preexisting factors are, and have a chat with Dr. Legacy if you have any concerns!

Surprising factors that may increase your risk for skin cancer.png

Blood pressure medication

Millions of people take hydrochlorothiazide to lower their high blood pressure. Are you one of them? It has been found that there is a connection between this medication and squamous cell carcinoma (SCC), which is the second most popular type of skin cancer. Hydrochlorothiazide is the generic name for diuretics, which help your body get rid of water and extra salt lowering your blood pressure. The most important factor here is how long you take the diuretics. Researchers at the University of Southern Denmark looked at 80,000 cases of skin cancer and found that there is a direct correlation between the length of time patents took the medication, and their increased risk for developing SCC. This risk is up to seven times grater than if never taking the drug at all. Again, you have to think about your preexisting factors and weigh the differences. By no means should you stop your medication, but if you are concerned talk to your physician. There may be an alternative treatment for you!


Endometriosis is a condition in which tissue that usually lines the uterus becomes trapped, and grows elsewhere in the body instead of being shed during the menstrual cycle. There is a definite correlation between this condition and many cancers, including ovarian cancer, non-Hodgkin’s lymphoma, and a new study suggest skin cancer as well. Scientists conducted a study on 100,000 French women and recognized that there are many genetic factors that are associated with both endometriosis and melanoma. Some of these factors are red hair, freckles, and sensitivity to sun exposure. If you have endometriosis along with a family history of skin cancer you may want to consult Dr. Legacy.

Surprising factors that may increase your risk for skin cancer.png

Being a firefighter

Recent studies have found that firefighters are not only at risk to get cancers such as mesothelioma and lung cancer on the job, but are also at risk of melanoma. This may be linked to chemicals from the combustion of materials they face daily or from flame retardants they use to put out fires. An Australian study found that firefighters had a 45 percent higher rate of developing melanoma over the general population with different careers. Many states have put forth legislation to help out firefighters who do get melanoma and other cancers. Laws are being created so firefighters now don’t have to prove their cancer is job-related to obtain disability benefits.

Surprising factors that may increase your risk for skin cancer.png

Erectile dysfunction drugs

Researchers have found a potential association between sildenafil (generic name for Viagra) and melanoma. Now remember “association” does not mean “cause”. The found relative risk of a male developing melanoma from taking these drugs is 84 percent, while the absolute risk is only .43 percent. That sounds like a big difference. That’s why it is important to be informed on the differences between a relative risk and an absolute risk as talked about above. More research is needed on this one to find a stronger correlation, but we know one thing’s for sure: if you are ever concerned about melanoma it’s always a good idea to talk to Dr. Legacy about it!

Human Papillomavirus

Human Papillomavirus (HPV) is a widely common virus affecting nearly 80 million people worldwide. There are clear relationships between HPV and some cancers such as cervical, anal, oral and now squamous cell carcinomas as well. Researchers found that 16 of the 150 different HPV strands (when mixed with exposure to UV radiation) may promote skin cancer. Very few studies have been conducted looking into whether or not the HPV vaccine will help decrease this risk. However, one study found remarkable results in the decrease of new SCCs and BCCs in patients a year after receiving the vaccination.

Surprising factors that may increase your risk for skin cancer.png

Autoimmune diseases

The main job of the immune system is to distinguish healthy tissue from cancerous ones. When you have an autoimmune diseases, the immune system may attack healthy tissue instead of fighting the dangerous disease present. People with an autoimmune disease are at higher risk of developing basal cell and squamous cell carcinomas for this reason. Another factor may be the medications prescribed to people with these diseases. Many of these medications suppress the immune system as a whole making it that much harder to fight off dangerous diseases, including skin cancer. If you are taking medication for an autoimmune disease it might be a good idea to talk to Dr. Legacy about extra ways to protect your skin. 


Singer, Jen. “Beyond the Sun”. The Skin Cancer Foundation Journal 2018: 79-83. Print.

8 Things you didn't know about redheads

7 things you didn't know about redheads.png

And does their skin really need extra protection?

  1. Redheads make up only 1 to 2 percent of the total population

    • Northern Europe houses the highest percentage of them, with some of their countries having up to 13 percent of their population redheaded! 

  2. Redheads are more efficient at producing vitamin D

    • Vitamin D is produced when UV light reacts with a compound found in the skin called 7-dehydrocholesterol (lets call it 7-D). Redheads lack a protective dark pigment that absorbs and scatters the sun’s UV rays called eumelanin. Because of this deficit, the UV rays can more easily react with the 7-D in their skin producing vitamin D very efficiently. 

  3. Redheads need more anesthetic

    • Based on a 2004 study, women with red hair needed 20 to 30 percent more anesthetic to reach the same sedation level as women with blonde and brown hair. This goes for local anesthetics as well, such as those used by your dermatologist to perform a biopsy or skin cancer surgery. Researchers think this is because the mutated MC1R gene that all redheads have belongs to a family of genes that play a role in pain management.

  4. Redheads have less hair

    • They do indeed have fewer stands of hair on their head, but each strand is much thicker than that of a blond or brunette. This might make them look like they actually have more hair, especially if it is curly. Redheads only have 90,000 strands of hair on average, while brunettes have about 140,000. 

  5. Redheaded men have a lower risk of prostate cancer

    • It is unclear which factor this lower risk is directly related to, but studies have found that redheaded men were 54 percent less likely to develop prostate cancer in comparison to men with light brown hair. This could be related to the mutated MC1R gene, their higher vitamin D levels, or associated with sun exposure. Whichever factor it may be, it’s a big plus for them!

  6. Redheads bruise more easily 

    • There has been no found difference in a redheads hemoglobin concentration, platelet numbers or coagulation tests to explain this phenomenon. However, a 2006 study found that redheads reported more bruising than their black or brown haired subjects. 

  7. Redheads are NOT becoming extinct

    • Every year you see a new article claiming that redheads are going to be no longer. They base that argument on the assumption that recessive genes can disappear or die off, but that is not actually the case. They could become very rare, but the only way for redheads to become extinct is for all of them to die or fail to reproduce. And the tenacious redheads we all know and love will not allow that! 

  8. Redheads are more likely to develop skin cancer

    • It has been found that carrying the redhead gene adds an extra 21 years of sun exposure right off the bat. The two most common types of skin cancer are basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). Redheads are more than one and a half times as likely to develop BCC and more than 12 times as likely to develop SCC than those with non-red hair. So they really do need extra protection from the sun to keep their skin cancer free!

Doerfler, MD Laura B. and Hanke, MD C. William. “Redheads at Risk”. The Skin Cancer Foundation Journal 2018: 44-46. Print.