Dermatology Institute is home to world renowned dermatologists Dr. Peter Rullan and daughter Dr.Jennifer Rullan. Dr. Peter Rullan has been training other dermatologists in advanced cosmetic procedures for over 30 years. He has performed over 10,000 chemical peels his first years in practice and now after 40 years in practice has developed the most safe, advanced and effective treatments for healthy looking skin and for acne scarring. He has published hundreds of research and discovered new cosmetic techniques and procedures to better treat acne scars. Patients fly into San Diego to see Dr. Peter Rullan from around the world after learning about his techniques from the internet without any marketing.

His daughter Dr Jennifer Rullan has been in private practice since 2013 and has been mentored in these advanced technique since her residency in dermatology. She later became a mentored for leadership by the American Society for Dermatologic Surgeons and she created a national training videos for dermatologists learning advanced chemical peels. She has taught numerous live chemical peel courses for advanced cosmetic dermatologic surgeons, and teaches courses at national and international conferences. She has injected thousands of syringes of fillers, neurotoxins, and has over 14 years of laser experience. She is well known for natural lips and peeling off the most difficult wrinkles. Her cosmetic eye, kind bedside manner, natural results and safety protocols make her a highly sought after cosmetic dermatologist.

Dr. McKesey is a cosmetic and medical dermatologist with a particular focus on treatment of brown spots, melasma, and using lasers to treat birthmarks at all ages. Patient’s love her lip filler technique to give glowing juicy lips or lips which look natural and rehydrated. She has trained across the world with dermatology leaders in Texas, Singapore, Washington, DC, Maui, San Diego and Los Angeles. She uses finesse to perform fillers and biostimulatory procedures to enhance beauty while still looking natural.

Brown Spots

Brown spots, also known as hyperpigmentation or age spots, are common skin concerns that many people want to address for a more even skin tone. There are several cosmetic treatment options available to help reduce or eliminate these spots. Here are some popular methods:

1. Topical Treatments:

  • Hydroquinone: A skin-lightening agent that inhibits melanin production, often considered the gold standard for treating hyperpigmentation.
  • Retinoids (Retinol, Tretinoin): These promote cell turnover, encouraging new, even-toned skin to replace the pigmented cells.
  • Vitamin C: An antioxidant that brightens the skin and inhibits melanin production, helping to fade dark spots.
  • Alpha Hydroxy Acids (AHAs) & Beta Hydroxy Acids (BHAs): Chemical exfoliants that slough off dead skin cells, revealing fresher, more even-toned skin.
  • Niacinamide: Known for its anti-inflammatory properties, this can help lighten dark spots and improve overall skin texture.

2. Laser Treatments:

  • Fractional CO2 Laser: Targets deep pigmentation and stimulates collagen production, improving skin texture and tone.
  • Pulsed Dye Laser: Effective for targeting superficial pigmentation and redness, often used for sun spots or rosacea-related discoloration.
  • Intense Pulsed Light (IPL): Uses broad-spectrum light to target pigmentation and improve skin tone, often used for age spots and sun damage.

3. Chemical Peels:

Chemical peels use acids (like glycolic acid or salicylic acid) to exfoliate the skin, removing the outer layer and revealing fresher skin underneath. They can be customized to treat different types of brown spots, including age spots, melasma, and sun spots.

  • Microdermabrasion: This procedure involves gently exfoliating the skin’s surface using fine crystals or a diamond-tipped wand, which can help to reduce the appearance of brown spots and improve skin texture over time.
  • Cryotherapy: A treatment that uses liquid nitrogen to freeze and remove dark spots. This can be effective for localized pigmentation like sun spots or age spots.
  • Microneedling: Tiny needles are used to create micro-injuries in the skin, stimulating collagen production and improving the skin’s ability to shed pigmented cells.

Each of these treatments has its own benefits and considerations depending on your skin type, the type of brown spots you’re treating, and your overall skin care goals. Consulting with a dermatologist can help determine the best option for your specific needs. Additionally, using sunscreen consistently is crucial to prevent new spots from forming and to protect the results of treatments.

Acne Scars

Acne scars can be a persistent reminder of past breakouts, but there are several effective treatment options available to reduce their appearance and help restore smoother skin. At Dermatology Institute we have one of the greatest doctors in the world for treating acne scars, Dr. Peter Rullan. He has also trained his daughter and Dr. McKesey on advanced techniques not known to other specialist. Our doctors train doctors from around the world on these procedures. Each treatment is customized and modified to individual needs and scar types. Treating scars is complex, however, using multiple modalities at a time has shown to be the most effective. As a dermatologist, here’s an overview of the treatment options for acne scars, categorized based on the type and severity of the scars:

1. Topical Treatments:

  • Retinoids (Tretinoin, Retinol): These Vitamin A derivatives promote skin cell turnover, helping to fade pigmentation and improve skin texture. Over time, they can help smooth out surface irregularities and reduce the appearance of scars, particularly for mild acne scars.
  • Hydroquinone: Often used for pigmentation issues, hydroquinone lightens dark spots left behind by acne scars (post-inflammatory hyperpigmentation). This treatment is especially helpful for red or brown spots, but it may take several weeks to see noticeable improvement.
  • Alpha Hydroxy Acids (AHAs) & Beta Hydroxy Acids (BHAs): These exfoliating acids help remove dead skin cells, allowing new, healthier skin to emerge. They can also reduce the appearance of shallow scars, improve texture, and even out skin tone. AHAs are generally better for dry or sun-damaged skin, while BHAs (such as salicylic acid) are ideal for oily or acne-prone skin.

2.  In-Office Treatments performed by Board Certified Dermatologists:

  • Chemical Peels: A chemical solution is applied to exfoliate the outer layer of skin, which encourages the shedding of damaged skin cells and helps reduce pigmentation. For deeper scars, a stronger chemical peel (like a TCA peel) may be recommended to stimulate collagen production and promote healing.
  • Microneedling (Collagen Induction Therapy): In this procedure, tiny needles are used to create controlled micro-injuries in the skin, stimulating collagen and elastin production. This helps to improve the texture and appearance of scars, especially rolling scars or shallow pitted acne scars. Microneedling is often combined with serums to enhance its effectiveness.
  • Laser Treatments:
    • Fractional CO2 Laser: This laser resurfacing treatment targets both the surface and deeper layers of the skin, stimulating collagen and improving skin texture. It’s particularly effective for deep acne scars, such as ice-pick scars or boxcar scars.
    • Erbium Laser: A gentler alternative to CO2 laser, the erbium laser is ideal for more superficial acne scars, working to resurface the skin and promote collagen formation with less downtime.
    • Pulsed Dye Laser (PDL): Effective for treating redness and hyperpigmentation caused by acne scars, PDL targets blood vessels under the skin, helping to reduce the appearance of redness, while promoting skin healing.
  • Dermal Fillers: Injectable fillers, like hyaluronic acid or poly-L-lactic acid, can be used to fill in deep acne scars, particularly rolling or boxcar scars. These fillers provide an immediate smoothing effect, though results may last from several months to a year, depending on the type of filler used.
  • Subcision: For deeper scars, subcision involves using a needle to break up the fibrous bands beneath the skin that tether the scar to deeper tissue. This releases the scar and allows the skin to lift, improving its appearance.   Unique to our office, is that we perform subcision with a blunt canula and we use tumescent anesthesia for a more comfortable and safe experience.

Our most POPULAR TREATMENTS include
“THE RULLAN QUATRO”
“THE RULLAN TRIO”
“THE PHENOL-CROTON OIL DEEP CHEMICAL PEEL”
“THE RULLAN QUATRO”
This includes phenol or carbolic acid 89% CROSS (chemical reconstruction of skin scar by applying the acid to ice pick scars in the center or edges of a box scar), subcision for dermal tethering of scars, erbium resurfacing laser, and fillers into atrophic depressed scars.