There are countless skin care products available to treat skin discolorations known as “hyperpigmentation”, such as brown spots and melasma. There is also just as much confusion and misinformation, surrounding topical Hydroquinone and Non- Hydroquinone products. The fact is they are both necessary, as each have a place in correcting and maintaing pigment irregularities.
I am a proponent for Hydroquinone and for good reason, when used correctly it is arguably the most effective topical for treating hyperpigmentation. I am also a proponent for Non-Hydroquinone skin brighteners, because I do not support using Hydroquinone indefinitely without pulsing on and off.
If you understand how hyper pigmentation occurs, you are better able to understand how to treat it. The process of producing pigment (melanogenesis) is complex, with many process, so I am giving the short version. When the skin has hyperpigmentation, it means that, there are melanocytes that are over producing melanin (pigment) AND that those pigment cells are not being evenly distributed to the skin cells called keratinocytes.
Something must first, trigger the increase of tyrosinase activity, this can be sun exposure, hormones or inflammation. Tyrosinase is an enzyme in the skin that controls the production of melanin. One of the main goals in treating hyperpigmentation is to inhibit the tyrosinase, so that it will not trigger the overproduction of melanin (pigment). Products that aim to do this use ingredients that we call “tyrosinase inhibitors”. Hydroquinone is a strong tyrosinase inhibitor, however there are also non-hydroqinone tyrosinase inhibitors that are effective.
Hydroquinone is a strong tyrosinase inhibitors and very effective at treating hyper pigmentation. There is concern, however that with extended use the skin may become resistant to the effects. This is why it is important to use hydroquinone under professional guidance. The general idea is to maximize correction, before you build resistance. Many dermatologists and skincare professionals are now recommending pulsing on and off hydroquinone. If you are using or plan on using hydroquionone products, I recommend you read “Hydroquinone: What you need to know, to maximize it’s benefits and prevent resistance”.
When you are pulsing off hydroquinone, you may want to use a non-hydroquinone skin brighter. Look for a brightener with tyrosinase inhibitors. Ideally, non-hydroquinone skin brighteners should be formulated with a combination of ingredients that will have an effect on the various stages of melanogensis (the formation of pigments). Antioxidants and exfoliants play a role in melanogensis and should be part of a skin care regimen, along with a tyrosinase inhibitor. I am including a short list of some commonly used ingredients in Non-hydroquinone brighteners.
Non-Hydroquinone Lighting/ Brighting Ingredients
Arbutin (Bearberry Extract)
Licorice Root Extract
Hydroxyphenoxy Propionic Acid
For best results begin by preparing your skin to best absorb the topical products you are using, this is done by properly cleansing and toning skin. Topical antioxidants and a broad spectrum SPF, are a MUST, because they help block the effects of “triggers”. We also recommend some type of chemical exfoliant, such as glycolic or lactic acid. These help by exfoliating melanin filled skin cells from the surface, which accumulate and cause pigment to be more dense, making it look darker. Retinoids such as tretinoin (Retina-A) work by inhibiting the transfer of pigment to skin cells, this blends pigment for even skin tone. Retinoids also work as a tyrosinase inhibitor. Finally, if you are not seeing the results you want with topical products alone, consult with a skin care provider to discuss which treatment options are best for you. Typically, we recommend chemical peels or PhotoFacials (IPL or BBL), depending on skin type and conditions being treated.
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Most of us are exposed to environmental stressors daily that can damage structural proteins within the skin such as collagen and elastin, as well as essential genetic DNA. This equals skin aging, with loss of elasticity, resilience, immune function and cancer resistance. Science has found in nature, a way to help protect fragile and vital structures in human skin, from extreme and daily stressors.
If you have never been to Arizona, then you probably have not seen a live Saguaro Cactus. The saguaro cactus is unique to the Arizona Sonoran Desert, as well as Sonora Mexico, and California along the Arizona and Mexico borders. The saguaro thrives in these extreme desert environments, because it is an extremophile that loves very dry, hot climates.
Extremozymes are protective enzymes derived from extremophiles, which are organisms that thrive in extreme environments, that would be detrimental to most life on earth. Extreme environments include places with extreme tempetures, PH or altitude. Examples are the deepest, dark parts of the ocean, Antartica or a dry desert. These extreme environments would otherwise denature typical enzymes, but extremophiles develop protective enzymes (extremozymes) that cushion and protect vital structures, kind of like bubble wrap. Many Extremozymes assist these organisms in not only protecting, but repairing DNA as it is damaged by environmental factors.
INNOVATIVE SKINCARE®’s Extremozyme® products utilize the survival advantages from these extremophilic organisms to protect and preserve skin from environmental damage and aging by combating moisture loss, dehydration, radiation, heat, cold, and free radical damage. We like iS Clinical “Youth Serum” and “Reparative Moisture Emulsion” which are both formulated with Extremozymes. Your skin care survival kit should also include an antioxidant serum and broad spectrum SPF. We recommend starting a skin care regimen with extremozymes, topical antioxidants and sunblock in your 20’s, because aging starts sooner than you think.
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CoolSculpting is a non-surgical fat freezing procedure that contours the body by safely and effectively freezing away unwanted fat permanently. It has become a popular option for those who do not have the time to recover from liposuction. CoolSculpting is commonly used to treat problem areas like loves handles, stomach rolls, back fat, inner and outer thighs.
The price for CoolSculpting varies greatly, depending on your areas of concern, the number of treatments needed and your ultimate goals. Typically, you’ll see a noticeable reduction of fat in the treated area after one visit, but you may appreciate even more fat reduction with additional treatments. About 20% of the fat cells are eliminated with a single treatment, most people should expect to do two treatment cycles on each area treated. Occasionally, more than two treatment cycles are needed to achieve your personal desired results
The biggest variable is the amount of applicators and the size of the applicators needed to address the area of concern. Multiple applicators are typically needed to treat each area, it is not possible to determine how many or which applicators are needed without an in office assessment. Most CoolSculpting providers offer special pricing with multiple applicators. Generally the more applicators needed, the greater the value with a lower per applicator price.
CoolSculpting is not something you will be able to price shop over the phone or on the internet. You need an in office consultation, so that you can be assessed to determine if you are a good candidate for Coolsculpting and if so which and how many applicators are needed to treat your specific are of concern. During your consultation you can work with your provider to create a customized treatment plan, that’s tailored to your body, your goals, and your budget. If you are interested in financing, ask if your provider will except http://www.carecredit.com
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If you have not yet heard of Ultherapy it is a non-invasive procedure that is intended to lift and tighten the skin. It sounds almost to good to be true, right. So, the question is, does it really work?
The short answer is, yes it does work, but before you make any decisions, you need to know what kind of results can be expected. First, non-surgical treatments will always give a non-surgical result. If you are hoping for a cheeper alternative to a facelift, mini-facelift or even lifestyle lift, you will be disappointed with Ultherapy or ANY non-surgical treatment. During a traditional facelift the surgeon address lax facial muscle, fat and repositions the skin. Ultherapy is not a facelift and a facelift is not a skin treatment. One procedure does not replace the need for the other.
As we age collagen production progressively declines, which leads to wrinkles and thinning skin. Not to confuse facial volume (fat) loss, with skin (dermal/ epidermal) thinning, they are different concerns requiring different procedures. Like many of the treatments used in the world of medical aesthetic, Ultherapy is used to stimulate collagen. What makes Ulthera so unique is the way it stimulates collagen, where it stimulates collagen, the amount of increased collagen and the duration that collagen production is up regulated. Initially the targeted tissue will contract causing a tightening effect. As the renewal process continues collagen production is up regulated, improving skin density and giving a modest lift. The increased collagen is seen at multiple levels of the dermis, most prominent in the deeper dermal tissue. This up regulation of collagen continues, on average of a year.
An average of 69.5% improvement in dermal thickness is seen after Ultherapy
Although, Ultherapy is currently the only non-invasive treatment that can claim to lift skin, there are other treatments that can tighten the skin. Skin tightening is generally seen when aesthetic treatments target the dermal layer of the skin and stimulate collagen production. Ulthera works by targeting deep into the dermal tissue and also to the top of the facial muscle, leaving the surface intact. This is important because other non-surgical treatments, like RadioFrequency (RF) and laser do not treat at the same depth. Although, RF treatments can target fairly deep into the dermal area, the targeted area is only heated to a tempeture that will cause tissue contraction, this helps to tighten the skin. The difference is that RadioFrequency (RF) treatments do not heat the targeted area to the needed tempeture to achieve optimal collagen synthesis. Laser resurfacing and fractional resurfacing treatments, do heat the target area to optimal tempeture and will definitely generate significant collagen synthesis in the upper-mid dermis, which is ideal for treating lines, scars and skin texture. The difference is that we can not treat as deeply into the dermis with laser resurfacing as we do with Ultherapy. Most importantly, RadioFrequency (RF) and laser do not target the top of facial muscle, where Ultherapy does. Ultherapy does work, very well actually. Ultherapy is most appreciated when it is part of a comprehensive approach to anti-aging.
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I can not tell you how many times I have been in the mall or a beauty store and heard a sales person give a shopper horrible advice on skin care. To the defense of the sales person, they probably are unaware they are giving poor advice, they are likely not trained skin professionals. Often the product they recommend cost just as much, if not more than the more effective cosmeceutical products used by skin professionals.
An in-depth consultation with an licensed Esthetician should be your first step to addressing aesthetic skin concerns such as aging. Even if you are just looking for professional advise on appropriate skin care to maintain your skin, a skin consultation is needed. Standing in the front office and talking to the office staff or even an Esthetician between appointments, does not cut it. Not everyone is qualified to give skin care advice, even the Esthetician can not give you the attention you need in 5 minutes. A full consultation is always the best way to go. We have put together a list of tips to help you get the most out of your skin consultation.
Select your Esthetician
An Esthetician is a skin care specialist, that has been educated and trained on skin health and beauty. They do not diagnose or treat medical skin conditions such as eczema, psoriasis, allergies or skin cancers. An Esthetician may work in a day spa, salon, med-spa or within a medical practice such as dermatology or plastic surgery. When selecting an Esthetician, be sure to ask about experience and training. Some Estheticians may have additional training or certifications to work in medical aesthetics. You should look for an Esthetician that fits your personal goals.
Be Prepared to Discuss Your Concerns
If you can help your Esthetician understand what you see, and what concerns you most, then they can better help you. We recommend you make a list of concerns and what you hope to improve. It may help to look in a mirror while creating your list. If you simply want to maintain your skin, we can help with that too. The more clear you are about your concerns, the more likely they will be addressed. You may have skin issues or signs of aging that do not bother you, your Esthetician does not want to offend you by suggesting that you improve something that you are content with. Estheticians understands that most people have a budget and we want to respect your money, so be sure to communicate the priority of your concerns.
What to consider:
Pigmentation Concerns Is your skin color even or do you notice irregular pigmentation such as Melasma, dark patches, freckles, age-spots, sun spots or pigmented scars.
Acne / clogged pores Do you have any cysts, pimples, black heads, white heads or clogged pores. Do breakouts correlate with menstral cyle or hair removal. How often do you break out.
Texture Is your skin smooth and even or does it feel rough or flakey. Does your skin look creapy, have fine lines or scars that are raised or depressed.
Vascular Issues Do you have Rosacea, broken capillaries, diffused redness or red spots. Do you flush easily?
Oil and Moisture Is your skin normal, oily, shiny, dry, tight and dry?
Aging concerns Do you have any lines, wrinkles, folds? Is your skin that lax or thinning. Is your facial volume plump and cohesive or do you see separation of the fat pads, hollowness of the face or under eyes, flat cheeks, or jowls? Do you have droopy or hooded brows?
Hair Even if you are only seeking skin treatments, let your Esthetician know if you experience unwanted hair, specifically facial hair and how you address it. Hair growth and hair removal methods may provide clues to skin issues. ( This applies to men and women) Some hair removal methods my be contraindicated to potential treatments or products. Estheticians specialize in hair removal methods, so they can provide you with or suggest the most appropriate hair removal methods.
Tell us what products you are using
Be prepared to talk to your Esthetician about the skin care products you have used in the past and are currently using. When filling out your consultation form, it is not enough to list a brand name or only including a couple products. We need a detailed list of the products you are using and it is even better if you bring the products in with you, so that we can read the ingredient list.
Not all skin care products or ingredients play well together, for example products with Benzoyl Peroxide can oxidize your topical antioxidants. Acne and anti-aging products usually active ingredients and if we mix too many, the skin may become very irritated. You may already be using something similar to what we would recommend and we do not want you to purchase something, if you already have it or something like it. Your Esthetician will try to work with your current products, when possible. Sometimes, however it may be necessary to start from scratch.
Tell us what you have done already
Think back to any cosmetic procedures or skin care treatments you may have had and make a list. Your Esthetician will need to know what procedures / treatments you have done. Some things should not be repeated too soon, while others my be contraindicated to each other. For example if you have had deep (full coverage) resurfacing procedures, your Esthetician will want to know because they can not be repeated too frequently. If you have recently had certain injectables, you may need to wait before having some procedures. If you have ever had any silicone injections or have you been on accutane, you need to alert your Esthetician.
Tell your Esthetician what you liked or did not like about the things that you have already done. If you had a good experience with something, that will provides a clue to how you respond to treatment. If you feel something did not work or you had a bad experience, we do not want to repeat that for you. Sometimes, your Esthetician may want to spend some time educating you on why you had that experience. Never assume anything is irrelevant.
Tell us a little more about you
Your Esthetician will want to know a little about your medical background and medications. Some medications may increase chance of bruising or cause photosensitivity. Do not forget to list any supplements or herbal treatments you may use. Remember to list any allergies, including food allergies, as some skin care products contain natural ingredients like pumpkin, papaya and pineapple. Medical conditions can effect how your bodies wound healing ability and how your skin responds to treatment. When listing medical conditions be sure to include any hormone therapy.
Your lifestyle and habits are important too. How do you exercise, are you on a restrictive diet, do you smoke, drink or use any other substance. We are not here to judge you, we need to take into consideration the variables that may influence how you will respond to treatment. If you have any special scheduling concerns, be sure to discuss them during your consultation.
Be clear on expectations
As you are discussing treatment options, be sure to clarify what you should expect. Often clients do not understand that they should expect some reaction with treatment or even some skin care products. Be sure you have an idea of what is normal and when you should be concerned. If you are having a treatment that involves any “down time”, your Esthetician will give you an idea of how long it will take to recover. Keep in mind, that this is just an estimated time frame. There are far too many variables that effect healing, it is impossible to predict exactly. It is also relative to what you consider to be “down time” and when it comes to your appearance being acceptable to return to work or social activities, everyone has different standards.
Before scheduling treatments, be sure you understand what typical results are. Often clients hear what they want to believe, expecting too much. Its tempting to hope that even if your Esthetician recommends a series of treatments, that you will be the exception. Sometimes we convince ourself that a non-surgical treatment will deliver a surgical result. We want to believe that one treatment can replace the need for others or that what we do at home isn’t that important. Try to keep your expectations realistic.
Be sure to find out about your consultation fee, often the consultation fee may be credited toward your first treatment. As a courtesy, many Estheticians offer a free consultation. This likely means they are not getting paid, so if you can not make your appointment, call to cancel or reschedule as soon as possible. A minimum of 48 hours prior to scheduled appointment is standard, this allows time to fill the space.
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In the world of medical aesthetics, hydroquinone is often a necessary part of skin care. It is the gold standard for treating dark skin irregularities known as hyperpigmentation. As effective as it is, there is a rising concern regarding the number of people who are using hydroquinone incorrectly, without on going professional guidance. Many of those who are using hydroquinone do not understand the risk of hydroquinone resistance or how to properly use it, as to enhance efficacy. It is important to use hydroquinone in a way to maximize it’s benefit, before the skin builds a resistance and how to properly transition off, to reduce incidence of rebound hyper pigmentation. Always seek a professional guidance before starting or continuing hydroquinone use. It should be used only under the strict supervision of a professional.
Why do we need Hydroquinone?
Hydroquinone is the single most effective topical ingredient for treating skin discolorations. Skin discolorations can include sun spots, Melasma and Post Inflammatory Hyperpigmentation (PIH), pigmented acne scars. When the skin is inflamed it can respond by over producing melanin, this inflammation can come from acne, injury, surgery or aesthetic procedures such as laser or chemical peels. UV exposure and hormones can also induce skin discolorations. In the world of medical aesthetics we are really dependent on the ability of hydroquinone to quickly correct hyper pigmentation. There are non-hydroquinone skin brighteners that are very good products, however they are not as effective as hydroquinone. That does not mean that botanical lighteners do not have a place, as you will learn, both hydroquinone and non-hydroquinone brighteners are important.
Resistance to Hydroquinone
Hydroquinone works by inhibiting tyrosinase, which is necessary for melanin production. It is believed that with extended hydroquinone use, the skin will compensate by increasing tyrosinase. This would causes the skin to become resistant to the effects of hydroquinone. When the skin becomes resistant to the effects of hydroquinone it will quit improving the hyper pigmentation. To prevent building resistance, it is not recommended to continue use for extended periods of time with out cycling off. It is usually recommended to cycle off hydroquinone after about 4-6 months. If needed, hydroquinone may be resumed after about 2 months. If you stop hydroquinone “cold turkey”, there is a risk of rebound pigmentation. To prevent rebound pigmentation, it is generally recommended to transition your skin off. While transitioning off and breaking from hydroquinone, continued stimulation with a retinoid is beneficial. When it is time to transition off your hydroquinone, you may begin to incorporate a non-hydroquinone skin brightener. There are several professional products that may be recommended. Exact regimens will vary individually, depending on skin condition and any skin treatments, such as laser treatments or chemical peels, that are planned. Do not attempt to cycle off hydroquinone without professional guidance!
Maximize Hydroquinone Effectiveness
When using hydroquinone to treat hyper pigmentation, the goal is to correct the condition before the skin builds resistance. In order to maximize effectiveness, we need to use a high quality hydroquinone product in the appropriate dosage, along with products that optimize penetration, assist in correction and protect from exacerbating factors.
We want to use enough of hydroquinone to reach correction, so a skin care professional needs to show you how to measure your hydroquinone and give you a time frame that you should expect to run out of product. Using hydroquinone every morning and night is a common protocol for treating facial skin.
We want the hydroquinone to have optimal ability to penetrate and work. Prepare the skin by cleansing with an appropriate cleanser. This would exclude anything that does not sufficiently clean the skin or leaves any occlusive film, this could inhibit product penetration. For this reason, I generally do not recommend cleansers like CeraVe or Cetaphil. Anything that is too harsh or active, should also be avoided, as we do not want to induce any unnecessary inflammation or irritation. After cleansing, an appropriate toner should be used, this will restore the skins PH balance after cleansing, preparing it for corrective skin care products. (astringent is not toner). Hydroquinone should be applied after toner, unless you have been instructed to use a Vitamin-C serum or other corrective serums. Always, confirm with your Esthetician or provider, the order your products should be applied.
When Hydroquinone is used with a mild exfoliant and Tretinoin (Retin-A), the pigment will be more evenly distributed. The goal is not just to suppress the production melanin (pigment), it is to have even distribution of the pigment. When the skin has hyper pigmentation, the melanocytes are not functioning properly. Not only is there an over production of melanin, but the pigment is not being evenly distributed to skin cells called keratinocytes. When Hydroquinone is used with Tretinoin, it works to evenly distribute the pigment. A mild chemical exfoliant will enhance the process by increasing the skin cell turnover. It is important that the exfoliant be appropriate to your skin type and personal skin care regimen, to reduce risk of any unnecessary inflammation. Here is the icing on the cake, tretinoin will also treat acne, increase collagen production in the dermis, as well as glycosaminoglycans such as Hyaluronic acid that bind to water and improve skin moisture. There is also evidence that tretinoin may positively effect gene expression in the skin. – Yes, please! I want all of that.
Sun protection is important for several reasons. 1) UV exposure stimulates the production of melanin, while hydroquinone is working to suppress it. It literally, defeats the purpose of using hydroquinone, if you do not have proper sun protection. 2) Hydroquinone, tretinoin and exfoliants can all cause photosensitivity of the skin. 3) Heat, including heat from the sun dilates capillaries in the skin and induces inflammation, which can exacerbated pigmentation problems. 4) UV exposure causes skin discolorations, free radical damage and breaks down collagen and elastin.5) UV rays damage DNA and causes skin cancer, and melanoma can be life threatening.
Your sunscreen should be an SPF 30 or higher and should have zinc oxide. Zinc Oxide can help by blocking some of the UV induced heat, that contributes to inflammation and exacerbates hyper pigmentation. Zinc also provides broad spectrum protection from UVA/UVB rays without the irritation occasionally seen with chemical sunscreens. Professional zinc products are more elegant and will look better on the skin. Using a moisturizer, BB Cream or cosmetic with an added SPF, is not enough. It is important to have an actual sunscreen, with high broad spectrum coverage. Sunscreen should go on after any moisturizer, it is the last thing you put on, but before makeup. Sunscreen needs to be used EVERY day!
Topical antioxidants are useful for many reasons, but in regards to skin discolorations we especially like topical Vitamin-C. First, Vitamin-C reduces oxidized dopaquinone, which helps further brighten the skin. Perhaps, more importantly, Vitamin C helps to reduce inflammation in the skin that can cause or exacerbate hyper pigmentation. Some antioxidants, including Vitamin-C also have photo-protectant ability, enhancing the effectiveness of sunscreen. They works by neutralizing the UV rays, rather than reflecting or absorbing UV rays like a sunscreen, so use them together to maximize your protection. We recommend using an l-ascorbic acid form of vitamin c, in serum form. A quality l-ascorbic acid, needs to be packaged in a glass bottle with a glass dropper, the bottle should be dark to reduce oxidation of the product.
Not all skin care products play well together and there are some skin care products that may be contraindicated to your personal skin care regimen. For example, you should not use any product that contains benzoyal peroxide with products that can oxidize, such as Hydroquinone and Vitamin-C Serums. Always inform your Esthetician or skin care provider of the products you are using, and do not add anything new without having it approved first.
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May is Skin Cancer Awareness Month. The American Academy of Dermatology launched a campaign for Melanoma Monday, and Who’s got your back. The American Academy of Dermatology states that the most common place for melanoma is the back. Melanoma is the most deadly form of skin cancer. Be sure to get your annual dermatology appointment to have your whole body checked for skin cancers and suspicious lesions. Also be sure you are applying your sunblock correctly. Sunscreen is safe and can protect your skin against skin cancer and premature aging. However, it is not as effective unless it’s applied correctly.
Follow these tips which were taken directly from the American Academy of Dermatologists website.
Choose a sunscreen that has an SPF of 30 or higher, is water resistant, and provides broad-spectrum coverage, which means it protects you from UVA and UVB rays. Follow these helpful tips when selecting a sunscreen.
Apply sunscreen generously before going outdoors. It takes approximately 15 minutes for your skin to absorb the sunscreen and protect you. If you wait until you are in the sun to apply sunscreen, your skin is unprotected and can burn.
Use enough sunscreen. Most adults need at least one ounce of sunscreen, about the amount you can hold in your palm, to fully cover all exposed areas of your body. Rub the sunscreen thoroughly into your skin.
Apply sunscreen to all bare skin. Remember your neck, face, ears, tops of your feet and legs. For hard‐to‐reach areas like your back, ask someone to help you or use a spray sunscreen. If you have thinning hair, either apply sunscreen to your scalp or wear a wide‐brimmed hat. To protect your lips, apply a lip balm with a SPF of at least 15.
Reapply sunscreen at least every two hours to remain protected, or immediately after swimming or excessively sweating. People who get sunburned usually didn’t use enough sunscreen, didn’t reapply it after being in the sun, or used an expired product. Your skin is exposed to the sun’s harmful UV rays every time you go outside, even on cloudy days and in the winter. So whether you are on vacation or taking a brisk fall walk in your neighborhood, remember to use sunscreen. For more skin cancer prevention tips, see a board-certified dermatologist.
People who get sunburned usually didn’t use enough sunscreen, didn’t reapply it after being in the sun, or used an expired product.
Your skin is exposed to the sun’s harmful UV rays every time you go outside, even on cloudy days and in the winter. So whether you are on vacation or taking a brisk fall walk in your neighborhood, remember to use sunscreen.
And remember, everyone is at risk for skin cancer. To protect your skin, the American Academy of Dermatology recommends that everyone:
Seek shade when appropriate, remembering that the sun’s rays are strongest between 10 a.m. and 2 p.m.
( I may be one of the only parents who try and adhere to this time frame about 95% of the time. I will not allow my children to swim during this peek time when the suns rays are the strongest. I feel that it is just a better idea to wait until later in the evening to swim or spend extended periods of time in the sun.)
And remember, everyone is at risk for skin cancer. To protect your skin, the American Academy of Dermatology recommends that everyone:
Seek shade when appropriate, remembering that the sun’s rays are strongest between 10 a.m. and 2 p.m.
Wear protective clothing, such as a long-sleeved shirt, pants, a wide-brimmed hat and sunglasses, where possible.
Generously apply a broad-spectrum, water-resistant sunscreen with a Sun Protection Factor (SPF) of at least 30 to all exposed skin. “Broad-spectrum” provides protection from both ultraviolet A (UVA) and ultraviolet B (UVB) rays.
Wear protective clothing, such as a long-sleeved shirt, pants, a wide-brimmed hat and sunglasses, where possible. ( and we are that family that is out at the lake wearing those long sleeved uv protective shirts)
Generously apply a broad-spectrum, water-resistant sunscreen with a Sun Protection Factor (SPF) of at least 30 to all exposed skin. “Broad-spectrum” provides protection from both ultraviolet A (UVA) and ultraviolet B (UVB) rays. ( The ZO Skin Health line just came out with a face and body spray spf 50, and water resistant that I’m excited about!)
For more skin cancer prevention tips, see a board-certified dermatologist.
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Décolletage is what we call the neckline, or more specifically the area made up of the neck, chest and cleavage. If we neglect this area between our face and breasts, it is sure to age us. Although we can cover up our décolletage, we would certainly be limiting our style and where is the fun in that.
The décolletage is a special concern, because it tends to suffer more sun damage than other areas and women also tend to develop lines between the breast while sleeping on their side. Luckily, there are plenty of options to improve this area, but we have to be patient as correction for non-facial skin is much slower than it is when treating the face. When we treat the décolletage or any non-facial area, we need to treat more conservatively and thus, more often. The skin cell turn over for non-facial skin tends to be slower, so this means the recovery process will take longer, which will require more time spaced between treatments. When treating the décolletage you should treat early and often. Slow and steady wins the race.
When it comes to skin care and anti-aging, the best approach is a comprehensive one. One treatment does not necessarily replace the other. Your skincare provider should work to help you understand which treatments are best for you and the time line that treatments may be done. When budget is a concern, you will need to decide which concerns are a priority for you.
Topical Skin Care
The first step is to use effective skin care products on your neck and chest, every morning and every night, just as you would your face. Most of the skin care products that are used on the face, can also be used on the chest. Some topicals, such as hydroquinone and retinoids need to be used less frequently on non-facial skin to avoid irritation. Some products should be used daily, such as topical antioxidants and an SPF 30 or higher. There are some great products formulated specifically for the neck and chest. Revision skin care formulated Nectifirm for firming the neck and décolletage. NIA 24 Sun Damage Repair for Décolletage and Hands, is formulated with patented Pro-Niacin to repair damaged skin. Consult with your Esthetician, to determine the appropriate protocol for you.
Treatments that use Intense Pulsed Light work to treat brown spots and redness. There is also research to suggest that ongoing treatments will positively effected gene expression in the skin to mimic that of a younger person. Generally a series of 3-5 treatments are recommended, scheduled 3-4 weeks apart. For enhanced results Levulan may be applied prior, this is known as PhotoDynamic Therapy.
Medium depth chemical peels that reach the papillary dermis or upper reticular dermis, such as the Obagi Blue Peel or ZO controlled depth peel will improve skin discolorations, improve texture, laxity, lines and stretchable wrinkles. A medium depth peel on the chest, may take up to 14 days for peeling to be complete. On the up side, peels on the face generally do not look bad during the peeling phase and are easy to tolerate. These peels can be done as often as 4 times a year, however I find that once a year is optimal when combined with other treatments.
Ultherapy is the treatment of choice for the lines that develop between the breasts. Ultherapy works at a deeper level than any other non-surgical treatment, to lift and tighten skin. Ultherapy uses focused ultrasound to target deep into the dermis and even the top of the muscle. Like many other aesthetic treatments, Ultherapy works by creating a wound healing response, but because the targeted areas are at a deeper level we see more tightening and lifting. The increased collagen production in the treated area, can be seen a year post treatment. Most people should plan on repeating this treatment once a year, although younger patients may be able to stretch it out to every two years. Those with advanced photo damage, or who desire more improvement may choose to repeat the treatment in six months. Pain medication may be prescribed, in which case you will need to arrange for someone to bring you in to your appointment and take you home.
Non facial skin does not respond well to “full coverage” ablative laser resurfacing. Non-ablative or sublative fractional resurfacing treatments, such as E-Matrix or Fraxel are more appropriate for treating non-facial skin. These treatments reduce lines, wrinkles and smooth skin texture. Like many other aesthetic treatments, fractional lasers work by creating a wound healing response in the skin, that stimulates the fibroblast in the skin to up regulate the production of collagen. Because laser treatments create heat, we appreciate a different type of wound healing response than we do with other treatments such as chemical peels, micro needling, which is why we see the up regulation of collagen for longer periods of time post treatment.
Fractional lasers generally work in the deeper layers of the skins dermis, an area which is not effected by chemical peels or IPL treatments. The frequency and number of treatments will depend on the level of treatment performed, level of correction desired and condition of skin.
Micro-Needling Collagen Induction Therapy
Aesthetic professionals use micro-needling pens such as the Eclipse or Dermapen, to deliver tiny needles into the epidermal and dermal layers of the skin creating micro-injuries. This begins a natural wound healing or renewal process that will stimulate collagen production in the treated area. There is little to no down-time, and it is surprisingly comfortable. Although, micro needling treatments do not deliver the same level of correction to skin texture as fractional lasers, they are the treatment of choice for scars and stretch marks. Micro-needling is also a good option for early intervention or in between other aesthetic treatments.
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“Does CoolSculpting REALLY work”, this is a question people ask me all the time. I think the idea of removing fat permanently, without surgery seems hard to believe. Some people notice great results, while others may not see desireable results. So…why does CoolSculpting work for some and not others.
How CoolSculpting works
CoolSculpting is a non-surgical device that works by cooling selected areas of fat to a tempeture the causes the fat cells to go into apoptosis. Apoptosis is a programed cell death, it’s like your fat cells commit sucide. With each treatment cycle we expect 20% of the fat cells to die. You may see improvement 8 weeks after your first treatment, but the fat cells will continue to die up to 4 months post treatment.
You may see a noticeable reduction of fat in the treated area after one visit, but you may appreciate even more fat reduction with additional treatments. Most people should expect to do two treatment cycles on each area treated. Occasionally, more than two treatment cycles are needed to achieve your personal desired results.
Coolsculpting uses something we call applicators that pull the fat bulge in and hold it in place during treatment. It usually take multiple applicators to treat a specific area. For example a stomach may require 3 applicators to treat the desired area, and the sides may require 4 applicators. The exact number of applicators needed to treat an area will vary by individual.
What CoolSculpting will not improve
– CoolSculpting and other procedures like liposuction only treat adipose fat, which is the fat above your muscle. Cosmetic procedures do not treat visceral fat, which is the dangerous fat that surrounds your internal organs. The visceral fat needs to be reduced via diet.
– CoolSculpting will not reduce loose or excess skin, it is not an alternative to a tummy-tuck or body lifting procedures.
– CoolSculpting is not used to treat cellulite. Treatments like VelaShape that us RF to reduce the size of fat cells and improve skin quality are better for cellulite treatment.
Why it does not work for some people
Occasinally, someone will tell me that they have a friend who had CoolSculpting and it didn’t work. The truth is, it most probably DID work, but it may not have worked enough or was not the best treatmentfor actual concern. If someone is confusing skin for fat, they will be disappointed with results. If they have a large amount of visceral fat, reducing the adipose fat will not make enough of an impact. While there are those who were not good candidates, the most likely reason someone may feel like it didn’t work is because they didn’t have enough treatment. They probably needed more applicators to treat the area of concern and may have needed an additional treatment to make an impact that is appreciated.
When I had fat transfer, the doctor used liposuction to remove fat from my abdomen to inject into my face. Now, I know for a fact that the fat was removed from my body, but I did not have any improvement in body conturing. To conture my shape he would have needed to suction out more fat. This does not mean that the liposuction didn’t work at removing fat, it means that MORE fat removal would have been needed to improve my shape. This is usually the case with CoolSculpting, it worked, but more treatment is needed for the desired results.
It is important to keep realistic results, make sure that you understand the amount of area that is being treated. Do not assume that you are the exception, and will only need one treatment. If you have had a treatment and were not satisfied with the results, follow up with your provider to see if further treatments are needs or if perhaps another procedure would be better.
YES, CoolSculpting does work and well.
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A serum that claims to give you the “best of both worlds”, how perfect is that?! Youth Serum is designed to provide an instant smoothing and tightening effect, and long term wrinkle reduction (via collagen production). Could this Youth Serum be the fountain of youth we are all searching for?
I think expecting any single skin care product to be “THE” fountain of youth, may just be setting you up for disappointment. I believe that the fountain of youth is a full comprehensive approach to anti-aging, which would include skin care products along with aesthetic treatments, healthy lifestyle, diet, excersise and what ever fits your personal beliefs towards a healthy mind and spirit. With that said, I think it is fair to say that Youth Serum is one of those things that will add to our fountain youth.
This serum is appropriate for all skin types, espesially when anti-aging is a concern. As someone who works in medical esthetics, I am very interested in the role this product plays in wound healing, tissue remodeling as well as it’s anti-tumor effect and ability to protect DNA from the damaging effects of radiation. I think this product would be very beneficial for those with thin or impaired skin that may have reduced wound healing ability due to medical conditions or treatments.
This serum uses intelligent proteins that target damaged sites, strengthen dermal structure, to smooth fine lines and firm skin. YOUTH SERUM’s safe, bio-identical growth factors gradually rebuild lost collagen to reduce fine lines and wrinkles long-term. The patented Extremozyme® technology, combined with a powerful blend of antioxidants, including vitamins A, C, E, and centella asiatica, encourage cellular health, provide UV photoprotection, and prevent environmental damage. The result is a more youthful, vibrant, and resilient complexion.
• Clinically proven to increase collagen synthesis
• Contains safe growth factors that shield skin from cancer development, improve skin firmness and elasticity
• Helps prevent DNA damage (Extremozyme technology)
• Excellent for use under makeup
Copper Tripeptide-1 Growth Factor – Copper Tripeptide-1 sequence is found naturally in your bodies collagen, and it stimulates the synthesis of new collagen. This is a bioidentical growth factor, which means that your body recognizes it and it can be put to use immediately. This growth factor has been shown to prevent tumors, helping to protect skin from cancer development. It stimulates collagen production, which restores the skin’s structure and smoothes wrinkles over time.
Extremozymes – Think of them like “extreme” enzymes, these enzymes are harvested organisms that are able to withstand extreme conditions.These enzymes work to nuture skin and prevent free radical damage with powerful antioxidants. Clinically proven to repair and protect fragile proteins and DNA components.
Intelligent Peptides & Proteins – Primarily pseudoaltermonas ferment extract, which is a glycoprotien from the Antarctic Sea. Clinically proven to adhear to damaged sites, providing targeted regeneration.
Active Algae Extracts – A potent intertidal seaweed extract, that is a rich source of a rare amino acid found only in collagen – which triggers the epidermis to repair collagen loss.
Asiaticoside, Asiatic Acid, & Madecassic Acid Sourced from Centella Asiatica – Efficacious antioxidants that stimulate collagen synthesis and improve microcirculation, capillary flow and vascular tone, to promote wound healing and reduction of scar tissue.
Vitamin A, C & E Blend – Powerful vitamin antioxidant blend.
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