Nurse practitioner Laura Balkian takes a skin-first approach to cosmetic dermatology. We asked her what she looks for in a patient’s skin, why consistency beats intensity, and where she thinks skin health is heading next.
Meet Laura
From a young age, Laura knew she wanted to become a nurse. She went straight into nursing school after high school and began her career as a pediatric nurse at one of the country’s leading children’s hospitals. After three years at the bedside, she continued her education to become a nurse practitioner, later working in anesthesia before transitioning into cosmetic dermatology.
Her interest in skin began long before her career in cosmetic dermatology. As a teenager, she struggled with cystic acne and became determined to understand what actually worked—and why. That curiosity led her to research products, ingredients, and treatments, eventually becoming a natural extension of her career.
Today, Laura’s approach is centered on skin health, subtle results, and helping patients feel like themselves. She is passionate about continuing her education and understanding the research behind treatments, skincare, and supplements—and how they fit into the bigger picture of long-term skin health.
When you first look at a patient’s skin, what are you assessing that the average person might not know to look for?
I’m really looking at the whole picture. Texture, pigment, redness, hydration, sun damage and overall skin quality. Sometimes what someone thinks needs Botox or filler is actually more of a skin quality issue. I’m very skin first in the way I approach aesthetics.
We often hear about treating the visible signs of aging, but what does skin longevity mean to you from a clinical perspective?
For me, it’s not about trying not to age. It’s about keeping your skin as healthy as possible as you do age. Protecting collagen, minimizing sun damage and keeping the skin barrier healthy all play a big part in that.
You work with everything from injectables and lasers to chemical peels and microneedling. Where do at-home skincare and daily habits fit into the results patients are trying to achieve in-clinic?
They’re the foundation. I love in office treatments, but what you’re doing every day matters just as much. Skincare, sun protection and your everyday habits all work together, and I think the best results come when we’re supporting the skin consistently, not just when we’re treating it in office.
How do outside factors like nutrition, sleep, stress, hormones and sun exposure play into someone’s overall skin health?
All of it can show up in your skin. Hormones, stress, sleep, nutrition and sun exposure can all affect how our skin looks and functions. I think we’re understanding more and more that skin health isn’t just about what we put on our face.
We hear the term “skin barrier” constantly. Clinically, what is the skin barrier actually doing, and how can someone tell when theirs may be compromised?
Your skin barrier is basically your skin’s first line of defense. It helps keep moisture in and irritants out. If your skin suddenly feels tight, dry, irritated or products you normally use start to sting, that’s usually a sign to simplify things and give your skin a break.
What’s one skincare belief you wish people understood with a little more context?
That more is not always better. More products, stronger actives and more treatments don’t necessarily mean healthier skin. Sometimes simplifying what you’re doing and focusing on the basics is exactly what your skin needs.
When speaking with a patient about preventative skin health, what is the one treatment you recommend most often, and why?
Probably microneedling. I love that it works by stimulating your own collagen and improving overall skin quality without changing the way you look. It’s one of those treatments that makes sense to me for maintaining your skin over time.
If someone wants to think about their skin five or ten years from now, rather than simply treating what they see today, what would you encourage them to prioritize?
Consistency. Daily sunscreen, a good routine that works for your skin, supporting your overall health and treatments that help maintain skin quality over time. I think the small things you do consistently for years matter so much more than doing something aggressive every once in a while.
Given your background as a Nurse Practitioner, how has that clinical foundation shaped the way you approach skin health today?
I think it’s made me more conservative and very assessment driven. I want to understand what I’m seeing and why before recommending something. Just because we can do a treatment doesn’t always mean someone needs it.
What do you think the next frontier of skin health will be?
I think we’re going to look at skin health much more from the inside out. I’m really interested in the growing conversation around things like collagen supplementation and how what we’re doing internally can complement our skincare and in office treatments. I think it’s less about finding one magic thing and more about supporting our skin from all sides.
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If you had to pick just five, what are your ultimate skin and wellness essentials?
SPF every day, a retinoid, vitamin C, movement and taking care of myself from the inside too. Sleep, nutrition, hydration, all the things I’m definitely not perfect at, but notice a difference when I prioritize them.