Unless you’re going to have your body checked for squamous and basal cells, the key to going to the dermatologist is to be at your absolute ugliest. Visually, you need to be screaming for help. It’s the only way you’ll really be taken seriously. When the sensitive skin around my eye looked as though it was puckering up for a kiss, I was urgently treated, even if I was treated like a troll. Had I applied a coat of mascara and brushed on some bronzer, it wouldn’t have seemed as dire.

I’m going today, barefaced, just a thin coat of spf. Red blemishes, untouched. "Fix me," I’ll say to the technician–yeah, that’s right, to see an actual M.D. at Westlake Dermatology, you need a standing appointment made months in advance. It’s a medical spa, offering everything from chemical peels and microdermabrasion to skin lightening systems and PhotoFacials. Who doesn’t like the idea of "skin resurfacing" and treatments designed to stimulate collagen growth? They offer mesotherapy (where your fat is injected and subsequently "melts away") and VelaSmooth (basically they vacuum your skin hoping to break up the fat and diminish cellulite). While all this sounds like something I should maybe weigh, all I can really think is, that’s for skinny people with problem areas. It’s not for the fatties who really need it. I mean, one can only melt away (or even reach) so much fat. And what good is it if I’m going to continue to eat and live as I do: like a normal person who loves food? Problem areas. As if.

I don’t want Botox–not that I’m against it, at all, I just don’t love the idea of temporary, of having to rush back for another dose in a few months, what’s the point?–but I am hoping the technician takes one look at me and says, "You know what will make a world of difference?" I think we’re all looking for that, for someone to instantly know what to do, someone confident and masterful, someone who’ll get it right.  We rarely believe that someone is us. And when we do, when we trust ourselves and believe we have to know ourselves better than the doctors and technicians with names like Fig, Piper, and London, we’re proved otherwise, that we couldn’t have been more wrong. Previously, with a different practice, when I went in with the puckered eye and was told it was contact dermatitis, that I was allergic to something, I glossed over all the doctor’s warnings about my shampoo, soap, laundry detergent, and body and facial creams. It couldn’t be any of that. I’d been using the same brands for years. Yeah, yeah, people can develop allergies later in life. Please, I thought, I’m no ninny, now let’s roll up our sleeves and get down to it. I rolled off my shirt and succumbed to a "patch test," where my skin was exposed to chiclet-sized ingredients found in everyday products, from essential oils and fragrances to dyes. Everything came back negative. In the end, they couldn’t find a cure. I eventually found the culprit. I’m terribly allergic to Tide. Now, I feel dumb and fragrance-free.

Still, I’m looking to make a fresh start today at the medical spa, looking forward to all their products (see any worth recommending?) promising to diminish this and smooth that. To plump, lighten, and correct all without the use of a laser, knife, or needle. Which reminds me, I think one of my readers a while back sent me a link to her blog, where she showed before and after pictures of her face and how lasers ruined her. Light therapy maybe. Pieces of living tissue had to be surgically transplanted onto her face, and grafts later, she was no closer to the beauty she’d imagined for herself, wishing she’d never been so discontent. There’s a fine line between upkeep and keeping up (as evidenced by Ugly Rivers). And it’s sometimes hard to know when to throw a reception for your fine lines and appreciate your genetics just as they are.

*In the coming days I’ll let you know what was "prescribed" and give my immediate reviews