The Unexpected Way NYC Dermatologist Dr. Macrene Alexiades Avoids Getting Wrinkles

As she drove down the coast of California from Big Sur to San Francisco (where she’d be speaking about controversies in lasers), The Derm-ScientistTM Macrene Alexiades, MD, internationally board-certified dermatologist in NYC, wasn’t worried about the winding roads or precipitous cliffs; she was worried about UV exposure. “The window was open a little bit to get some fresh air and the sun was just kind of beaming right through the window onto me,” she recalls. “I was like, ‘I’m going to get melasma.’ It’s the only thing I could think about the entire nine hours.”

But chat with Dr. Macrene, as everyone calls her, for even five minutes, and you’ll know there’s a fatal flaw to her story: There’s no way her mind was that quiet for nine hours. Dr. Macrene is a whirlwind of words and an intellectual force to be reckoned with. She has more degrees, awards, board memberships, accolades, and pursuits than your hard drive has gigabytes. Here are just a few highlights: three degrees from Harvard® (a BA in Biology, an MD, and a PhD in Genetics); she was a Fulbright ScholarTM in bioengineering; she’s an Associate Clinical Professor at the Yale® School of Medicine; she has published numerous articles in the fields of science, dermatology, and laser surgery; she is the head of a research clinic; and has a private practice on the Upper East Side. She’s also an artist, and not in the “she’s an artist about how she treats her patients” kind of way; she actually paints and sculpts. Oh, and she’s the mom of two: a daughter who’s currently a student at Harvard, and a son in high school (the two of them toured Stanford University® on her California trip). 

Dr. Macrene’s latest success is the relaunch of her seven-piece skincare line, MACRENE activesTM, an even more scientifically sophisticated spinoff of her original cult-favorite line, 37 Actives®. Like everything else she does, the collection benefits from her relentless pursuit of perfection and her deep desire to deliver the best possible results for her patients. Keep reading for more insight into her brilliant mind, her life in and out of the practice, and more.


Spotlyte: Do you have a philosophy about how you approach your patients? 

Dr. Macrene Alexiades: If it’s a pyramid structure, the patient is at the top. I look at everybody who works for me as supporting the patient, taking care of the patient. We first and foremost make sure that the patients are seen in a timely fashion; people get in the door when they need me. Unfortunately, sometimes my kids feel like they’re second banana, because I will often say, “Listen, I have a big case. This is the priority right now.” Their needs have to wait. I told them, that’s what you sign up for if you’re the spouse, sibling, child, or parent of a doctor; medicine becomes your life’s meaning, and you really have to focus on vocation.

Spotlyte: Are your kids used to mom in this mode? 

MA: They are. But just like my work has time cut out and dedicated with intensity, they do, too. For example, the college tours. I’m going on these tours with my son, and I’m not just hanging out; I’m sitting in and I’m absorbing. My daughter is a philosophy major at Harvard, and — let’s just put it this way — I know an inordinate amount of information about Kierkegaard. 

Spotlyte: Who would you say is your typical patient?

MA: Most of my patients are probably between the ages of 20 and 60. I would say that the majority of my patients are probably millennials at this point. They know my talent for making them look like they’ve had nothing done. They see what is happening to their friends, who are being exaggerated and becoming, at all times, Instagram®-ready. 

Spotlyte: So if I’m 35 years old, and I don’t want to exaggerate the features that I have, am I coming to you for preventative skincare help?

MA: I offer a 360-degree approach, in that the products I’ve created are designed to replace procedures, ultimately. If you start young enough, the active ingredients turn on the genes that you need to prevent, restore, and repair damage, and revert the skin back to its original program. You have to start them in a timely manner, and you have to use them twice a day religiously. You have environmental insults such as UV, pollution, and the intrinsic aging of genetics, and ultimately you lose collagen, elastin, hyaluronic acid, etc. My job is to replenish those things using the tools in my tool kit. The active ingredients are the cornerstone, then the procedures that will turn those genes back on. I use a lot of devices for that. 

Spotlyte: You have a lot of tools at your disposal. We don’t think we’ve seen that many lasers in our lives as in your office.

MA: I have 40 lasers in my office. You’ll see there’s an assortment of six or seven or eight in each room. The ones that I’m not actively using on a daily basis, we put in another room in the back so I don’t have to sift through them each time, but they do get resurrected for cases. 

Spotlyte: What would you say is the workhorse machine in your office?

MA: I have colleagues who tell me their Vbeam® [a pulsed dye laser for redness] is going from morning ‘til night. That was true for me 20 years ago, when we only had a handful of devices, but not anymore. It changes from month to month or year to year. Right now, I would say the genre I’m doing most is radiofrequency, because I have devices that do both the microneedling and a tripolar [radiofrequency] device that tightens. People start to lose that elasticity to their tissue starting in their mid-thirties; if you catch it early, you [can help] prevent the need for a facelift down the road. I’m telling you, it really works.

Spotlyte: That’s twice that you’ve mentioned starting early. What if you are a woman in your fifties or sixties — are you going to see those changes as well? 

MA: Once you’re in your fifties and sixties, you have to do something more aggressive. The Profound® device, which is very deep microneedles with radiofrequency, is the only device that comes close to plastic surgery; it gives you [a milder] result of a lower face lift. But there’s [about] a week of downtime. Then you need to do more: You do filler, and maybe you’ll do a second Profound treatment six months later. You may need to do it more than once to catch up.


Spotlyte: Do you get injectable wrinkle reducers or fillers?    

MA: I haven’t really needed to do anything as far as filler goes yet. And I don’t have a problem with injectable wrinkle reducers, but I don’t use them on myself. I do have frown lines. I’m not free of wrinkles; you can see that they’re there. What I’ve done is I basically have just decided I’m going to not frown, and I’m not going to lift. If I’m very stressed out and the staff sees that I’m doing it, they will tell me, “You’re stressed out. You’re frowning.” Then I put my hands on my head to stop myself.

EDITOR’S NOTE: Injectable wrinkle reducers temporarily smooth the look of moderate to severe wrinkles in certain areas of the face, including the forehead, frown lines, and crow’s feet; they should not be used more frequently than every three months. Injectable filler is a temporary treatment that adds volume to areas of the face such as the lips, cheeks, and laugh lines. Like any medical treatment, both injectable wrinkle reducers and injectable fillers have potential risks and side effects. Talk to a licensed provider to see if they’re right for you. 

Spotlyte: Let’s talk more about your new line. 

MA: I reformulated the entire line because I wanted it to be the cleanest line on the planet Earth. When I started 10 years ago, I was the first doctor’s brand and scientific brand to be paraben-free, propylene glycol-free, fragrance-free, free of any animal-derived ingredients, etc, with USDATM-certified organic actives. That was really forward thinking for then, and a lot of people followed suit, so now I’m taking it to another level. Now it’s free of silicones, no acrylates, no glycols at all, no nothing. I always was sulfate-free, I was always phthalate-free, I was always paraben-free. But there were trace ingredients — polysorbate 20, EDPA — that were in some of my peptides, so I sourced new peptides.

Spotlyte: Your original product line had 37 actives in the formula. How many actives are in the new products?

MA: Each of my products has 50 active ingredients, very specially chosen to actually deliver results. They’re fantastic active ingredients. I really believe that I can accomplish it using all these ingredients, which you’ll now be able to see on the website in excruciating detail. 

The goal here is for people to understand, just like you brush your teeth three times a day, you want to do the same care for your skin. It defies logic that people expect to do nothing at home and show up to the dentist twice a year and not have cavities. Of course not. It’s the same thing with skin. If you do you work at home, theoretically you can show up to my office and not need procedures. I have covered my face with hundreds of active ingredients twice a day, and I’m living proof that stuff works.

Dr. Macrene Alexiades is a paid Allergan® consultant.