Skin Tips from an Esthetician

Treating everything from acne to aging in a med spa

| Published: |

Photo by Tai Randall

The room in the Bethesda office where Susette Lapina gives facials and chemical peels includes spa touches such as soothing music and hot towels. But sun damage and acne, not relaxation, are the top reasons people schedule appointments. Lapina’s patients, who range in age from 11 to 78, tend to be mostly female, but she also sees a lot of male teens. “The boys are hilarious,” says Lapina, a licensed esthetician at Rockledge Med Spa, part of The Dermatology Center. “The extractions of blackheads and whiteheads can be a little painful, and if we use a little treatment for acne, that can sting a little bit. Those facials are not relaxing. One boy said to me, ‘Are you going to put cucumbers on my eyes?’ I was like, ‘No honey.’ ”

When skin issues are especially challenging, Lapina, 53, feels fortunate to work in a setting that combines a doctor’s office with spa services. Patients come in for everything from customized facials and microdermabrasion—a noninvasive skin-polishing procedure—to mole removals, Botox and liposuction. For pigmented lesions, or dark spots, the Rockville resident might turn to a chemical peel to slough off dead skin and reveal a smoother layer—a treatment not typically performed in day spas. “Because it’s a med spa, we can use slightly stronger stuff than in day spas,” Lapina says. “We work under the doctor’s supervision.” The collaborative approach means that her patients might also see one of the practice’s dermatologists for a remedy such as photo rejuvenation therapy, which uses laser technology to treat age and sunspots, facial veins and other skin problems.    

Growing up in London, Lapina was always interested in cosmetics and skin care. As a little girl, she’d watch her mother put on makeup, and she remembers being thrilled when her mom would let her wear lipstick. Once her own two daughters were in school, Lapina started training to become an esthetician. She moved to Montgomery County in 2001—her husband is American and his career brought the family to the U.S.—and started working at Rockledge Med Spa three years later. Her favorite part of the job? Getting to know her patients. “I see some whole families,” she says. One young woman has been coming in since middle school and recently invited Lapina to her wedding. A group of women in their late-70s visit her monthly for facials. “One of them came in and she belongs to a book club and she told [the others] about me,” Lapina says. “They’re very sweet—I treat them like queens.” 

In her own words…

Making an Impact
“I had a lady come in and she said, ‘My husband said I have a huge blackhead on my back.’ I took a look and I knew it wasn’t a blackhead. But I’m not a doctor. I don’t diagnose. I said, ‘I’d like you to have it looked at.’ And it was skin cancer. She came back and said, ‘Thank you so much.’ ”

The upkeep
“It’s just like going to the gym. If you go to the gym and you get in good shape and then you think, oh, I’m in good shape, so you don’t go anymore. If you’re going to spend money on good products, you want to maintain it. I’m not saying you have to come every two weeks, 
but maintenance is good.”  

The no-no’s
“The biggest one is when I say, ‘What do you use on your skin?’ [And the answer is:] ‘I use soap.’ I’m like, oh dear. I want to say, well that strips your skin and you’ll be so dry, but I don’t. In a nice way, I say, ‘Well let’s stop using the soap.’ Someone might say, ‘I stuck honey on my face last night.’ I’ll say, ‘Well that probably feels good, but let’s do something that’s going to actually help.’ Change them in a gentle way.”

Spring refreshers
“A lot of people get very dry skin in the winter, going from the extreme cold to the heat inside, so we do a lot of hydrating things. Hydrating facials, light chemical peels. Winter and early spring are good times to have a chemical peel—we don’t like to do them in the summer.”

Treating her own skin
“[My challenge] is redness. Ruddy English skin—that has been my thing. I use very soothing, calming products and every now and then I’ll do a treatment. I use a lot of the SkinMedica products. I use a good cleanser, some anti-aging products, some good sunscreen. I’ve had broken blood vessels repaired. I’ve had Botox.” 

On home remedies
“I think it can get murky if you start telling people they can mix this or do that [on their own]. Having already-formulated products—especially in a medical office—these products are all tested. I don’t think there’s anything wrong with dabbing a little bit of rosewater on your face, but I don’t know what that’s going to do so I like to recommend what I use, what I know, what I’ve been trained on.” 

Associate Editor Kathleen Seiler Neary can be reached at


Back to Bethesda Magazine >>


Leading Professionals »

Dining Guide