April has been designated as “Rosacea Awareness Month” by the National Rosacea Society (NRS). Rosacea is a progressive skin disorder commonly characterized by flushing and persistent redness on the central portion of the face and visible blood vessels. It has been estimated more than 16 million Americans are affected by Rosacea. The effects of Rosacea can go beyond this visible symptoms, often causing discomforts such as stinging and burning. For the majority of rosacea suffers it effects self esteem, going as far as to effect professional interactions.
What is Rosacea
Rosacea is a progressive skin disorder with symptoms including flushing, redness, visible blood vessels, burning, and stinging. Rosacea can also cause acne like symptoms, such as little bumps called papuals, often refereed to as Acne Rosacea. In more severe cases, there is a thickening of the skin and the nose can present as bulbous with irregular nodularities and enlargement, known as Rhinophyma. There is also a subtype of Roscacea, known as Ocular Rosacea, where eyes are red or bloodshot with burning and stinging. Rosacea is a progressive disorder and, left untreated, will worsen in severity with time. Those with Rosacea often experience flare-ups, which can last for months. Only a doctor can diagnose Rosacea. If you suspect you have Rosacea, see a dermatologist.
What causes Rosacea
The exact cause of Rosacea is not completely understood. Suggested possibilities include auto-immune disease or defects in the nervous system which effects blood vessels or Demodex mites. It may be something there is a genetic predisposition to. What we do know is that there is a strong vascular component to Rosacea. We also know that there are “triggers” such as heat or spicy foods that can trigger flare-ups.
It is important to understand that there is not a cure for Rosacea, but it is something that can be treated to reduce severity and symptoms. First, those with Rosacea should work to understand what their specific triggers are. Avoiding triggers can reduce the frequency and severity of flare-ups. Finding skin care products that do not aggravate rosacea can be tricky. Consult with a Dermatologist and Esthetician for skin care recommendations appropriate for Rosacea skin.
Intense Pulse Light (IPL) remains the most effective treatment for addressing the redness and visible dilated blood vessels seen with Rosacea. Vascular lasers, such as a KTP or Yag, can be used to treat facial veins that are well visible and can be traced. Typically, 3-6 treatments are needed, scheduled about 3 weeks apart. Because there is no cure for Rosacea, a series of treatments may need to be repeated annually, depending on severity.
Botox injections have been shown to be effective when injected superficially in very dilute concentration to reduce the redness and flushing of Rosacea. Redness may be reduced for 3-6 months after injections. This treatment is currently considered “off-label”.
Facials will not correct any vascular component of Rosacea, but the appropriate facial can calm and sooth skin. Consult with your Esthetician Facialist for recommendations.
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The Skin Games is a national competition where Estheticians compete for the title of “Best Skin Care Profesional” or for those new to the industry “Best New Artist”.
I was excited to participate in the skin games, this year. It is great for Estheticians, like myself to have this platform to showcase our talents. It has also been a learning experience, to see the methods used by other professionals. After seeing all the treatment videos, I look forward to meeting the other Estheticians at the live show, this April. To up the cool factor, this years show will be hosted by Bobby Brown and Athena from “Ex-Wives of Rock”. Sharise Neil and Blue Dixon from “Ex-Wives of Rock” will also be at the red carpet event, that will be after the award show. You do not have to be a player or even an Esthetician to attend the live show, during the day there will also be an all day event with vendors, live demonstrations and beauty swag. What a great excuse for a girls trip, …. industry guys trip too. As a finalist in this years games, I hope to see some of my Esty friends at the live show.
How To Play
Estheticians may enter in the categories of Hyperpigmentation, Anti aging, Acne / Problematic Skin or Best New Esthetician. The catch is you have to abide by the laws governing the state of California. Regulations differ by state, and in many of the states outside of California, Estheticians do laser and energy based treatments if they have an additional certification or if they are a Master Esthetician. The good news is, for those of us who work in Medical Esthetics, there is an “OPEN” category where Estheticians can follow the scope of practice governed by your state rules and regulations. Medical Esthetics is such a huge part of our industry, with Estheticians working in med-spas or for dermatologists, plastic and reconstructive surgeons, even gynecologists. I have no doubt that expanding The Skin Games to include Etheticians in the med-spa industry will attract a lot of Estheticians to compete and draw a lot of exciting vendors to the live show.
Each player selects a model,puts together a treatment plan, then submits 8 short videos, one per week to document treatments. Players also submit before and after photos of model to show results. A panel of judges will determine the winner based on photos, treatment plan and results. Friends,family and clients can also vote for their favorite player, the “Peoples Choice” award.
The Live Show
The live show is in San Ramon, California on April 23rd. Players will be awarded during the live show. Before the show, Estheticians can enjoy the beauty festivities with treatment demonstrations and check out the vender booths from various skin care lines. This is also a good opportunity to socialize and network with other professionals in the industry. If you are at this years show, please stop and say hi to Kristy Harris.
Copper Tripeptide-1 has been shown to play a role in stimulating the production of collagen, aid in wound healing and tissue remodeling. It also has Antioxidant, Anti-Inflammatory, Anti Microbial and Anti-Tumor Effects.
What is Copper Tripeptide-1
Copper Tripeptide-1 is naturally occurring in the body, it is composed of the amino acids Glycyl-histidyl-lysine, which spontaneously binds to copper, also known as GHK-CU. Copper Tripeptide-1 has many benefits within the human body, however levels decrease with age. Given the benefits that it has for renewing, repairing and protecting the skin, it makes sense that this would be used in cosmeceutical skin care products.
Copper Tripeptide-1 is used topically for anti-aging and firming of the skin. As we age our skin becomes progressively thinner, this is due in part to the declining production of collagen in the dermis and keratinocytes in the epidermis. As we age the skins ability to protect and repair itself also declines and this contributes to the degradation or breakdown of collagen. Copper Tripeptide-1 plays a role in stimulating collagen production and in the proliferation of keratinocytes. This is very promising for anti-aging skin care
Wound Healing and Tissue Remodeling
Copper Tripeptide-1 is seen to play a role in accelerating wound healing and improved tissue remodeling. Studies done on diabetic wounds, showed that wounds healed up to three times faster and had a lower incidence of infection, in the presence of Copper Tripeptide-1. This is relevant to anti-aging, because as we age the levels of GHK-CU decrease, which can affect the ability for skin to repair and renew it’s self. Further more, many of the treatments used to improve skin appearance, take advantage of the skins wound healing ability to increase the production of collagen, elastin and hyaluronic acid. The more effective the skins wound healing ability is, the more effective the treatment may be.
Anti-Tumor and Protective Ability
Radiation from sun exposure and cancer treatments have damaging effects on DNA and induce aging. Copper Tri-petide-1 (GHK-CU) helps to protect DNA from these damaging effects. Tumor cell lines died in the presence of Copper Tri-peptide, however healthy cell lines were protected. Skin fibroblasts, are “master cells” responsible for producing collagen, elastin and hyaluronic acid. Fibroblast exposed to radiation have been shown to restore their function when in the presence of (GHK-CU).
Antioxidant, Anti-Inflammatory and Anti-Microbial Effects
Intrinsic antioxidants, are antioxidants that the body makes, they can not be obtained with diet. With age, the production of these intrinsic antioxidants declines. Some of these intrinsic antioxidants are induced by Copper Tripeptide-1. It also has anti-inflammatory and anti-microbial effects during wound healing and tissue remodeling stages.
Skin Care Products with Copper Tripeptide-1
Topical products with Copper Tripeptide-1 may be useful for post procedure skin care to enhance results. They definitely look to be a promising as part of an anti-aging skin care regimen, especially when used with other power house products such as retinoids, anti-oxidants and most importantly broad spectrum sun protection.
Innovative Skin Care has added Copper Tripeptide-1 to many of their iS Clinical line of skin care products, including the most recent “Youth Serum” which is quickly becoming an A-list favorite. It is also found in Super Serum Advance +, Reparative Moisture Emulsion, Youth Intensive Cream, Youth Complex and Youth Eye Complex.
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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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