Poikiloderma – Discoloration to the Neck and Chest

“Poikiloderma” is the fancy name for photo-damage to the neck and chest areas. This condition has a distinct look of red, brown, and even white...

Ever wonder what to call that v-shaped sun damaged area on your chest? The one that you wish you could even out so that it doesn’t show when you’re wearing that new off the shoulder dress.

Poikiloderma Discoloration on Neck and ChestPoikilodermais the fancy name for photo-damage to the neck and chest areas. This condition has a distinct look of red, brown, and even white areas. The texture of the skin can also appear leathery with time. Men generally have this condition on the sides of the neck whereas women tend to get it mostly on the chest in the V-neck shape.

At Celibre Medical, we use a combination approach to treat the condition. This includes the pulsed dye laser (VStar/VBeam) for red pigment, q-switched lasers for brown and BBL (Broad Band Light) to for overall evening in color.

Some signs that you may have Poikiloderma:

*Red, brown, or both colors

*Areas of light skin (most severe form of sun damage where skin has lost pigment)

*Rough texture

*Leathery appearance

*Sides of neck, back of neck, chest

Treatment Plan:

*Responds best to laser and BBL treatments that target the red and brown color separately

*Laser first and then BBL (Broad Band Light) for evening the tone

*Determine which color should be addressed first.  Our goal is to “take off one thing off the plate first.” Meaning, remove the red before addressing brown or vice versa.

*Laser every 4-6 weeks

*Average is 6 to 8 treatments using 3 different laser/BBL devices

*Some Social downtime expected with bruising of skin often required to remove redness.

If you are not liking the changes you are seeing with your neck, you are in good company. We know this by the numerous infomercials that cater to this topic.

Besides a plethora of skin care products that claim to help, we are inundated with treatment options using Ulthera, Radiofrequency, Lasers, IPLs, microneedling, PRP, to just name a handful. But what about Kybella?

The new kid on the block is Kybella – an injectable medication similar to old school mesotherapy. With a huge marketing push, Allergan has launched this as a way to address the infamous “waddle” or “Turkey Neck.”

The concept with Kybella is that the medication will basically dissolve fat through an inflammatory process that is initiated upon injection. This procedure involves numerous injection points (up to 60 each visit), causes profound swelling of the neck for several days, and can lead to some concerning complications with the most serious being nerve injury in the mandibular area.


In addition to the risks and discomfort involved, treatments are very pricey with a price tag of $1300 to $2000 PER TREATMENT. The average patient requires more than one treatment, so the treatment program is quite an investment. Further, the best “responder” is generally a patient that does not have significant laxity (extra, hanging, redundant skin). Hmmm…it would seem like the person that has the biggest need may not be the best candidate after all for Kybella.


Regardless of which treatment plan a practice claims to use in treating the delicate area of the neck, there are risks vs. benefits for all options. Safety and efficacy should go hand in hand. Just because something is “new” does not translate to a good treatment option. Even non-invasive options carry risks and should be considered when considering a treatment plan.

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Botox $8.00 per unit? Dysport $3.00 per unit? Restylane for $350.00 per syringe?

We all recognize that price is important. However, most will agree that cheaper doesn’t necessarily equate to better. In fact, we would even argue that cheaper, in most cases, doesn’t even equal adequate.

We often hear stories of Groupon deals wherein the Botox “did not last.” In one serious case, a patient was injected with a dermal filler obtained overseas that resulted in a serious tissue infection.

No business or practice will operate in a manner to lose money. To support pricing that is significantly below the standard in our profession, many corners may be cut. Short- cuts and compromising standards in a medical profession does not bode well for patients and also calls into question the ethics of the medical professional.

What consumers may not realize is that it is illegal for a medical practice to purchase, obtain, use, or distribute Botox, Dysport, or any injectable dermal filler from anyone other than the manufacturer in the United States. Because of this widespread problem, regulations and enforcement are finally equipped to catch up with those placing patients at risk and degrading the aesthetic medical profession. See the below link for a widespread operation that targeted numerous local and non-local medical professionals illegally purchasing their products.

You may be wondering right about now if it’s worth risks vs. the potential benefit of saving money. If the only negative outcome is a short or substandard duration with your Botox, then you are still not saving money. However, please consider that illegally obtained products cannot offer a guarantee of sterility, proper handling, or that you are even receiving a safe product. If something goes wrong, the insurance carrier for the injector will not cover the adverse event. Finally, if we cannot trust our physician and nurse to obey the law in one area, it calls into question everything as it pertains to ethics and integrity.

We recognize that we are not the cheapest, nor do we strive to be. Our goal is to offer competitive pricing with a safe, appreciable outcome, and most of all…remain a trusted name in aesthetic medicine.




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“Frustrating” may be an understatement for the many women (fewer men) that struggle with this very common skin condition.  In fact, this is the most common pigmented skin condition we treat in our practice.  Similar to acne, this condition is oftentimes an emotional one being that both are considered non-curable and chronic and linked to a hormonal influence.  However, both are manageable with good options for improvement.

Melasma comes from within.  Meaning, the cells of color (melanocytes) develop on the surface of the skin, creating brown shades of color represented as patches in typical locations such as the forehead, bridge of nose, cheek bones, and upper lip.  The onset may be insidious over time or may develop within a very short amount of time – weeks even.

If we understand that the discoloration is in response to hormonal influences and genetic predisposition, we must also recognize that there also triggers that exacerbate or “feed” the condition.  Specifically, heat, humidity, and UV radiation (sun light).  Living on planet earth, we cannot avoid all of these elements at all times and still enjoy our lives and activities.  However, we can modify our routine while seeking a treatment regimen.

If heat, humidity, and light radiation all work to worsen melasma, we would never want to use a laser option as this is pure light and heat!  Unfortunately, numerous medical professionals continue to use their lasers or IPLs as a treatment option and usually doing a disservice to their patient.  In the event there is initial improvement of color, research over the many years will confirm that melasma will almost always return within 6 months and, in many cases, return with a vengeance.  Besides this disappointing result, lasers are a much bigger expense than a topical option.

In our practice, using a topical ingredient of hydroquinone has offered a 95% success rate with our melasma patients.  Success being improvement/control vs. cure.  Our success rate is also based upon educating our patients on how to manage their condition, using only fresh hydroquinone that is not pre-made, and avoiding the use of lasers and heat for melasma.

As we enter into possibly another hot summer wherein the elements are wanting to trigger your melasma – don’t fret.   Pull out the hat, sunscreen, hydroquinone, and enjoy your activities.  You are in good company.

Melasma Treatment Get Rid of Melasma
* Melasma Before and After Pictures

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In the world of cosmetic dermal filler treatments, the arrival of cannulas as a replacement for needles became a popular option among injectors.

The concept was to have a flexible plastic tubing/sheath that was threaded into a puncture site to then inject the filler product. It’s the same process that is used when an intravenous catheter is used to administer medication. The theory was that the tubing would eliminate or minimize bruising by avoiding puncture of blood vessels while at the same time reducing potential complications such as injecting product directly into a blood vessel.

We have not found that cannulas are superior, or even equal, to needles, and here is why:

  1. A large bore needle is still needed with cannulas to create a point of entry large enough to thread the cannula into. This alone creates a risk for bruising and is quite uncomfortable.
  2. There is less control of the placement of product with cannulas as well as limitations of the artistry needed in delicate areas.
  3. There is evidence that cannulas may still puncture a blood vessel or even break or dislodge the tip of the catheter.
  4. A safe and experienced injector has several methods to determine that a product is not being injected into a major blood vessel.
  5. It is our belief that the controlled trauma of the needle offers value in the collagen-induced injury response – a good thing.

As with all things, Celibre Medical relies on what is tried and true vs. what is new.

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Our Unique Patient Stories

Every patient that visits Celibre Medical has a unique story to tell. Although many come to look refreshed and younger, others have an emotional skin condition that compels them to consider cosmetic treatments. Of the thousands of patients we have treated for every type of cosmetic injections and laser resurfacing procedures we offer, we’d like to share two of our patient’s stories with you. Meet “Sylvia” and “Jeff”.

She Wore a Dress!

“Sylvia” is a young patient that came to us with concerns over numerous, dark brown scars over her entire lower legs. When she was younger, Sylvia lived in an area that had many mosquitoes. Over the years, these relentless insects left her with many hyper-pigmented (dark brown) scars. Although these were easily covered by wearing pants, this was not an option any longer as she prepared to be part her friend’s wedding. Knowing that the special occasion was nearing, Sylvia began laser treatments to gently and progressively fade the scars. On her last visit, Sylvia shared with us, “I finally wore a dress for the first time in years!”

Before Scar Removal PictureAfter Scar Removal Picture
Scar Removal Before and After Pictures


Good results shouldn’t cost a small fortune

“Jeff” came to us with concerns over several sun spots that had developed to his bottom lip. Although not very noticeable to others, he was self-conscious of these brown spots. Jeff first went to a consultation at another facility and, incredibly, was quoted $10,000 to remove these spots. There was no information given, options discussed, nor any sense of concern or consideration regarding how important this issue was to him. Fortunately, he had the good sense to believe there had to be a better way. That’s when Jeff found Celibre Medical. After 3 treatments spaced 4 weeks apart and with no downtime – the brown spots were completely resolved. More importantly, these outcomes were reached with only a few hundred dollars invested.

lip spots Before Pictureremoving lip spots before and after pictures
Sun Spots Before and After Pictures

At Celibre Medical, we focus on patient education. We want our patients to understand and participate in the decisions that make up their care plan. To this end, our knowledgeable medical staff are here to help you weigh the benefits and risks of our Laser treatments.

Our team would be pleased to offer a complimentary consultation to address your skin care goals. A good starting place is to gather information and view some of our patients before and after photo gallery.

At Celibre Medical, we stay at the forefront of research and best practices so that we may offer the most appropriate and effective cosmetic injections and laser resurfacing treatment plans for our valued patients.


Please contact us for your FREE consultation! Contact Celibre Medical

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The role of lasers for acne treatment is twofold. First, lasers kill acne bacteria. Without bacteria, acne lesions cannot form. P.acne bacteria is naturally occurring in the skin and by using heat energy from lasers, acne bacteria is controlled. It is important to realize that controlling acne bacteria is only a temporary solution for controlling acne, and acne bacteria can and may return in a short time. Because acne bacteria are naturally occurring in the skin, any solution for controlling acne by killing acne bacteria (like antibiotics, blu-u light treatments or topical creams) will need to be repeated often to control the acne.

A longer term benefit of laser acne treatment is the control of the amount of oil produced by the sebaceous (oil) gland. By controlling and limiting the amount of excess oil produced by the sebaceous gland, it is less likely that future acne will form. Excess oil contributes to blocked pores and this in turn leads to acne lesions. Using lasers, it is possible to shrink the sebaceous gland so that it does not produce as much oil in the future and therefore leads to less acne. Although the amount of oil production after laser treatment varies from patient to patient, we find that using lasers allows us to achieve a significant reduction in the amount of active acne for between 70% and 80% of patients we see.

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If you’re seeing spots, it may be time to see a doctor. We’re not talking about an eye specialist, but a skin and laser practitioner. Many people mistakenly think that they develop spots on their skin (age spots, sun spots, freckles, moles, liver spots, etc.) only when they get older. The truth is that the sun damage and exposure from years past, even childhood, can show up as unwanted brown spots on your skin as an adult.

age spot removal los angeles before and after laser picturesage spot removal los angeles before and after laser picturesSo, what can help? Class IV medical lasers are an extremely effective way to get rid of unwanted age spots because they can specifically target the melanin or pigmented cells within them. If you’ve noticed a change in the quality of your skin (rougher, thicker , etc.) along with your spots, you’re not dreaming. These changes often accompany the appearance of spots due to years of accumulated UV damage. Fortunately, Class IV medical lasers can stimulate the production of new collagen which can dramatically improve overall texture and tightness.

Laser treatments for these conditions are relatively quick and painless—usually around 30 minutes. Best of all, they have a limited recovery, so you can get right back to your life afterward. Our q-switched lasers for brown spots are safe for  all skin types (colors) so anyone is a candidate for treatment.

If you’re tired of seeing spots, come and see us today. We’ll not only help your skin look clearer, but we can help it look smoother and tighter too.

Sun spot removal before and after pictures

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In previous blog articles, we’ve addressed how small amounts of Botox Cosmetic can dramatically improve if not completely resolve the fine lines that develop above the upper lip area – the smoker’s lines.

In addition to Botox injections, use of cosmetic dermal fillers such as Juvederm or Restylane can augment the outer border of the upper lip to minimize the appearance of the lines by adding volume and stretching the skin that has the wrinkles. For deeper wrinkles, injecting a small amount of dermal filler (Restylane or Juvederm) into the actual wrinkles will help fill these areas.

los angeles botox for smoker's lineslos angeles botox for smoker's linesAnother newer technique is to place the Restylane or Juvederm dermal filler product in a horizontal fashion and stretch the skin at the same time.

This does not require much product, produces moderate to dramatic results immediately, and is ideal for those wrinkles that extend farther above the lip.

In many situations, it is a combination of Botox injections with Restylane or Juvederm that create the best solution for resolving smoker’s lines. In some cases it is only by using both Botox and the dermal fillers that we can meet the patient’s goals by re-shaping the mouth through relaxation of the muscles above the lips as well as adding volume and support to the upper lip.

At Celibre Medical, we practice injection techniques that result in a natural and appealing look. Make certain that your practitioner understands and practices the newer Botox and dermal filler techniques and concepts presented here to get the best resolution of your smoker’s lines.

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  • 5 star ratingLori was so knowledgeable and accommodating! She suggested a non surgical brow lift and it did wonders to help my... Read More

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    5 star ratingCustomer service- clarifying conversations- the desired results! These are some of the proficiencies you'll encounter with these skilled professionals. They... Read More

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  • 5 star ratingLori is absolutely remarkable. She works miracles on my look. When I leave I look 10 yrs younger and it's... Read More

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    5 star ratingI've been going to Celibre and getting treatments from Lori for over 10 years now. I've had dysport, fillers, and... Read More

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    5 star ratingI just recently had the profractional laser done at Celibre in December. It has literally shaved 10 years off... Read More

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  • 5 star ratingI highly recommend Lori for any skin concerns or treatments that Celibre offers! She took the time to listen to... Read More

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    5 star ratingI normally do not write reviews but I have to say that Celibre is the best. The office staff... Read More

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    5 star ratingI am so impressed with the service and quality from Celibre. I drive an hour for injections from Lori Haney.... Read More

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  • 5 star ratingThe staff here are very welcoming and informative! I'm the type to ask to ask questions on anything new I... Read More

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    5 star ratingThank you Celibre for making me feels so much better! Lori is a miracle worker! Fine lines so improved... Read More

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    5 star ratingAlthough I'm new fairly new to Celibre, I've been very pleased with the service so far. Honesty is very important... Read More

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  • 5 star ratingI loooove how the Celibre's staff is so knowledgeable in facial construction, symmetry & features and don't focus just on... Read More

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    5 star ratingBeen here several times for laser tattoo removal with Kevin. Face tattoos are painful to remove. Kevin's communication with you... Read More

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    4 star ratingCalled for a consultation and spoke with Kevin I told him I was interested in my smile lines so he... Read More

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    Lauren C. Avatar
    Lauren C.

    5 star ratingAwesome Staff and love the laser hair removable service... best thing I've done so far!!!

    Jackie A. Avatar
    Jackie A.
  • 5 star ratingOmg !!! What to say... I have a birthmark on my face and tried my whole life to get rid... Read More

    Coco C. Avatar
    Coco C.

    Went in to have some small skin tags removed as well as have some botox injected into my forehead...I didn't... Read More

    Jake Haney Avatar
    Jake Haney

    5 star ratingWhat an amazing experience!!! Not only did I love my results (which can we be honest, that's why we are... Read More

    Faith P. Avatar
    Faith P.
  • 5 star ratingVery professional and patient! They will educate you, and answer all of your questions.

    Wendy R. Avatar
    Wendy R.

    5 star ratingI had gone to Celibre 10 years ago and had a great experience- so I decided to go back and... Read More

    Andrea O. Avatar
    Andrea O.

    5 star ratingI had gone to Celibre 10 years ago and had a great experience- so I decided to go back and... Read More

    Andrea O. Avatar
    Andrea O.
  • 5 star ratingVery clean, kind friendly staff, provided me with a lot of preliminary information. I had a lot of questions and... Read More

    Sarah D. Avatar
    Sarah D.

    5 star ratingLori is an angel from heaven. I mean it!!

    I am a first time injector and was relatively nervous about...
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    Erin M. Avatar
    Erin M.

    5 star ratingLori is an angel from heaven. I mean it!!

    I am a first time injector and was relatively nervous about...
    Read More

    Erin M. Avatar
    Erin M.
  • 4 star ratingI had a great experience here. The staff is very friendly and welcoming. Nurse Kevin used Restylane to fill under... Read More

    Tiffany C. Avatar
    Tiffany C.

    5 star ratingStars to the moon for this wonderful place. Talk about an educated and highly skilled staff. I was beyond satisfied... Read More

    Nikki N. Avatar
    Nikki N.

    5 star ratingI love this place and the people that work here. Lori is the BEST! She takes the time to explain... Read More

    Rilee S. Avatar
    Rilee S.
  • 5 star ratingI called to ask for information. Very pleasant experience, not put in hold, very helpful and not pushy about making... Read More

    Esther L. Avatar
    Esther L.

    5 star ratingThe wait is finally over! I've been searching for a great place to help me take care of my skin... Read More

    Colleen B. Avatar
    Colleen B.

    5 star ratingGreat service and results. Lori was great at getting the look I wanted.

    Anita K. Avatar
    Anita K.
  • 5 star ratingI am blown away. The Office is lovely, the receptionist super nice, even the owners is hot, but really it's... Read More

    Meredith J. Avatar
    Meredith J.

    5 star ratingI had an amazing experience there. After going back and forth with one of the owners, Kevin, to make... Read More

    Sandra C. Avatar
    Sandra C.

    5 star ratingI highly recommend Celibre as a great place for laser treatments. Office is peaceful, front desk Associate friendly and waiting... Read More

    Téa M. Avatar
    Téa M.
  • 5 star ratingThis place is great. The staff is very friendly. Nurses are kind and personable. They meet great... Read More

    Jonathan Z. Avatar
    Jonathan Z.

    4 star ratingI didn't even know this place existed, only came in to accompany my mom for her visit. They offer free... Read More

    JeL C. Avatar
    JeL C.

    5 star ratingHave seen Lori twice for laser treatments on face. Everyone is very friendly and Lori is not only professional,... Read More

    Sofia Y. Avatar
    Sofia Y.
  • 5 star ratingI had a laser treatment on January 2017 with Lori Haney. After a month I came back to see Lori... Read More

    Rowena P. Avatar
    Rowena P.

    First of all, Lori Haney, the RN, is the kindest and most genuinely concerned medical professional I've ever had the... Read More

    Fatima Safi Avatar
    Fatima Safi

    5 star ratingI found celibre here on yelp, i was looking for a dermatologist and i went with the one with the... Read More

    Ana M. Avatar
    Ana M.