Anti aging services

  

  

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Val Answers Your Top 20 Skincare Questions

  

  

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You've consistently honored Ask Val with your most pressing beauty questions, from the straightforward (do I really need an SPF if I'm inside all day?) to the strange (though my skin is dry, my eyelids are oily—what's up with that?). Here are some of our favorite skincare dilemmas along with their bottom-line solutions.

Q: Which do I put on my face first, sunscreen of moisturizer?

A: What you apply first depends on the kind of sunscreen you use. A physical block (containing titanium dioxide or zinc oxide) can be applied over your moisturizer. But a chemical sunscreen (avobenzone or oxybenzone), which works by interacting with your skin to absorb the sun's rays, must penetrate whatever is already on your face in order to be effective, says Heidi Waldorf, MD, associate clinical professor of dermatology at Mount Sinai School of Medicine. So it's smart to apply this type before anything else.

Keep in mind: In summer, unless your skin is very dry, you can probably use just one product: a moisturizing sunscreen. I like PCA Skin Protecting Hydrator SPF 30 ( $34, pcaskin.com for stores) and Yes to Cucumbers Soothing Daily Calming Moisturizer with SPF 30 ($15, yestocarrots.com)

Keep reading: What's the best moisturizer for you?

Q. How can I get rid of the deep vertical lines on my upper lip?

A: Those lines are really the only thing I don't like on my face. (Unless you count the spaghetti sauce I discovered on my chin after dinner the other night. I didn't much like that, either.) A three-step approach works well to eliminate the lines, says Deborah Sarnoff, MD, clinical professor of dermatology at New York University Medical Center. Injections of a filler like Juvéderm or Restylane can fill them in. A very small amount of Botox, injected into the sides of the mouth, can prevent the kind of puckering that helps to cause them. Finally, one treatment with a fractional CO₂ laser can get rid of them for more than ten years (with three days to a week of redness and swelling and a cost of $1,500 to $4,500).

Keep in mind: If you choose to go this three-pronged route, it's critical that you see a board-certified dermatologist or plastic surgeon experienced in the treatments (too much filler can look unnatural—as I'm sure you've observed—and too much Botox around the mouth can affect your shpeesh).

Keep reading: What are your skin treatment options?


This article is part of Oprah.com's 2011 Feel Good Challenge. Join now—and move closer to the life you want!

Q: How can I figure out my skin type? 

A: It's easy. Wash your face with a cleanser designed for normal skin; rinse well, and pat dry with a soft towel. Now pick up a copy of Alan Bennett's The Uncommon Reader. It's a short, funny book, and if you're undistracted you can probably finish it in about an hour—exactly when your skin will be ready to evaluate. How does it feel? If it's tight, ashy or flaky, your complexion is dry, says Susan Taylor, MD, assistant clinical professor of dermatology at Columbia University. If you're oily only across the forehead, down the nose and on the chin, you've got combination skin; and if you need to blot your whole face with a tissue, you're oily. If your face feels irritated or slightly itchy, you likely have sensitive skin.

Bottom line: Once you've established your skin type, repeat the test four times a year, because your skin probably changes seasonally.

Keep reading: Top 10 skin myths—a dermatologist tells all

Q: Why isn't there a way to get rid of acne immediately and permanently? 

A: Hear, hear! We've pretty much figured out how to dissolve fat, prevent wrinkles, shoot people into space (and even bring them back); how hard can it be to get rid of acne? Actually, harder than you'd think, because acne results from a complicated process involving a plugged pore, oil, bacteria and inflammation, and it's also influenced by genetics and hormones, says Katie Rodan, MD, clinical associate professor emeritus of dermatology at Stanford University School of Medicine. A shot of cortisone directly into a pimple reduces inflammation in a day or two, and the oral prescription medicine isotretinoin can give long-lasting results with cystic or severe acne, but the best way to prevent acne is by using a combination of ingredients that address each step in the breakout process, including salicylic acid to disrupt the plug, benzoyl peroxide for protection from bacteria and sulfur for its anti-inflammatory effect. Recent research shows that milk and milk products may aggravate acne, so it might be wise to avoid them.

Bottom line: You can treat the superficial causes topically, but because acne involves genetics, the only permanent solution will involve gene therapy—and we're not there yet.

Keep reading: Val's adult acne cures

Q: Do more-expensive skincare products have some kind of "professional strength"?

A: Price alone has nothing to do with the strength and effectiveness of skincare products, says Cheryl Burgess, MD, medical director at the Center for Dermatology and Dermatologic Surgery in Washington, D.C. A drugstore mask or moisturizer can have the same concentrations of active ingredients as one from a department store or spa. But there is a correlation between the strength of a product and whether it's prescription or over-the-counter, says Burgess. A prescription product will likely contain a higher concentration of active ingredients than an OTC formula.

Bottom line: The price and strength of a product do not necessarily correlate.

Keep reading: The facts about cosmetic procedures

Q. I'm 26. When should I start using anti-aging products?

A: The day before yesterday (and I wish I'd followed my own advice). Leslie Baumann, MD, director of the Baumann Cosmetic and Research Institute in Miami Beach and author of The Skin Type Solution, says she tells patients as young as 18 to use ingredients that have been shown to slow the effects of aging. When it comes to wrinkles, prevention is key, so it's important to conserve collagen, hyaluronic acid and elastin, all of which keep skin looking plump and firm. Retinoids and antioxidants help preserve all three. For nighttime, Baumann suggests using a prescription retinoid product like Retin-A, Tazorac, Differin or Renova—in conjunction with a daily moisturizer containing antioxidants like idebenone, coenzyme Q10, lycopene, vitamin C, vitamin E and ferulic acid. She points out that the best anti-aging product is sunscreen, used every day, even indoors (where UVA rays can work their bad chemistry through windows).

Bottom line: If you're old enough to ask the question, you're old enough to be using anti-aging products.

The Wrinkle Report

  

  

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O, The Oprah Magazine  |  From the June 2004 issue of O, The Oprah Magazine

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The facts about skin treatments

  

  

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By Jenny Bailly
O, The Oprah Magazine  |  From the March 2007 issue of O, The Oprah Magazine

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Peels

What they are: Doctor- or aesthetician-administered treatments that use either a chemical (hydroxy acids or trichloroacetic acid) or mechanical process (microdermabrasion) to lift away the upper layers of the skin.

How they work: For a chemical peel, an acid solution is painted on the face like a mask. The higher the concentration (or the longer it is left on), the more layers of skin that will be peeled away. Microdermabrasion uses aluminum oxide crystals to buff away dead skin cells. "Many women need more exfoliation around the nose, mid-forehead, and chin, and with mechanical exfoliation, it's easier to focus on those areas," says Heidi Waldorf, MD, associate clinical professor of dermatology at the Mount Sinai School of Medicine. Some doctors are praising a newer system called Vibraderm, which uses vibrating metal paddles to exfoliate the skin. Eliot F. Battle Jr., MD, assistant clinical professor of dermatology at Howard University, prefers it for his African-American patients because the paddles are gentler than crystals—important for dark skin, which is vulnerable to spots when it becomes irritated or traumatized. More and more microdermabrasion techniques are also marrying exfoliation with topical treatments. The Vibraderm treatment can be followed up with a solution of antioxidants, glycolic acid, collagen, or bleaching agents. The SilkPeel or DermaSweep machines remove dead cells while delivering either hydroquinone to lighten dark spots, salicylic acid to heal acne, or hyaluronic acid to hydrate dry patches.

Results: One light chemical peel or microdermabrasion treatment will leave the skin temporarily brighter; a series of at least four is necessary to get results that can last several months, like a smoothing of rough patches and more even pigmentation.

Medium or deep chemical peels should be done only in a doctor's office. Because these peels reach all the way to the dermis, collagen production is stimulated with one treatment. Fine lines are effaced, and skin may even be slightly tighter.

medical: As a reminder, always consult your doctor for medical advice and treatment before starting any program.

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Your Skin's New Best Friend, Retinoids

  

  

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Your Skin's New Best Friend

Five reasons you probably don't use a retinoid (and why you should consider it)

By Jenny Bailly
O, The Oprah Magazine  |  From the July 2009 issue of O, The Oprah Magazine

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Photo: © 2009 Jupiterimages Corporation

1. You have no idea what a retinoid is. The term describes vitamin A derivatives that unclog pores, boost collagen to reduce fine lines, and speed cell turnover to even out discoloration and smooth the skin—sometimes in as little as four weeks. The first retinoid—tretinoin—was FDA approved (under the brand name Retin-A) almost 40 years ago as a prescription acne treatment. Dermatologists soon noticed that patients on Retin-A experienced not just clearer but softer, brighter, less-lined skin. Today there are three prescription-strength retinoids: tretinoin (brands include Atralin, Avita, Retin-A, Retin-A Micro, Renova), tazarotene (Avage, Tazorac), and adapalene (Differin). Many dermatologists find tazarotene stronger (and potentially more irritating) than tretinoin; adapalene is the gentlest but may be less effective.

2. You don't want to go to the dermatologist. While prescription formulas yield the most impressive results, an over-the-counter retinoid, called retinol, can also improve lines and discoloration. Because retinol is gradually converted into retinoic acid (the active ingredient in the prescription creams) it is less potent. Count on 12 weeks before seeing results.

3. You think a retinoid will make your skin sun-sensitive. "This is one of the biggest retinoid myths," says Doris Day, MD, clinical assistant professor of dermatology at New York University Medical Center (and a Tazorac user herself). "The ingredient itself is sensitive to sunlight, which is why you should apply it before bed at night." A retinoid shouldn't make your skin any more vulnerable to UV rays than it would be after buffing away dead skin with a face scrub. Summer is actually a good time to start a retinoid: Humidity makes your skin less likely to dry out as it adjusts. Of course, apply sunscreen (SPF 30, at least) as diligently as you always do.

4. You're afraid your skin will look worse before it gets better. Retinoids can cause dryness, redness, and flaking—but if you ease in, you can avoid a rough transition. For the first two weeks, apply a retinoid every third night, says Leslie Baumann, MD, director of the Cosmetic Medicine and Research Institute at the University of Miami (who uses Atralin). If your skin isn't irritated, ramp up to every other night for two weeks. Not dry or flaky? Go for it every night. A few other irritation-mitigating guidelines: Wait 15 minutes after washing your face before you apply a retinoid, and use one pea-size dab to cover your whole face. After a few minutes, apply a basic moisturizer to prevent dryness.

5. You think you can't afford it. Insurance coverage of a prescription retinoid, like Retin-A, varies by plan, and a 20-gram tube will cost about $75. But generic tretinoin costs about $40—not bad for a product guaranteed (by decades of science) to work. (For now, only tretinoin is available in a generic version.) Some drugstore retinol products are even less expensive. Look for ones with 0.1 percent retinol packaged in aluminum tubes (to protect the formula from air and light); we like RoC Retinol Correxion Deep WrinkleNight Cream ($22).

Caveat Emptor

• Don't use a retinoid if you are pregnant or breastfeeding.
• Benzoyl peroxide and alpha hydroxy acids may deactivate retinoids, so don't layer them.
• Waxing can cause excess redness on retinoid-treated skin; don't use a retinoid for several days before a treatment.
• A small percentage of people with ultrasensitive skin can never tolerate a retinoid; if you're one of them, use a gentle physical exfoliator twice a week to soften your skin, and be extra-conscientious about sunscreen to prevent collagen loss in the first place.

Discover 15 more treatments to cure any skin ailment

Kitchen cures for the skin

  

  

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September 2009’s Featured Article:

Take a peek in your refrigerator and evaluate its contents. Chances are, you have a variety of healthy foods that can be incorporated into the skin care services that you offer your clients. Now is the perfect time to rediscover the multi-purpose benefits of common everyday foods that have great potential to nourish our bodies and our skin.
You may have noticed that your clients are more ecoconscious than ever before and are expressing interest in incorporating natural options into their beauty routine. Position your spa and the treatments you offer as ecofriendly by adding natural ingredients found in your kitchen, at your local grocery store or the farmer’s market. Fruits, vegetables, dairy products and natural oils and fats have been used in skin care, hygiene and anti-aging for thousands of years, dating back to the Egyptians. Educate your clients about how you are using these familiar ingredients in their treatments and maybe even share a few remedies they can try at home in between appointments.
Before you decide to empty the contents of your kitchen, pack a bag (make sure it is not plastic) and we will take you on a tour through your local market while highlighting all the best skin care recipes for various skin types.

Renowned for its antibacterial properties, honey is considered to be one of the best natural acne fighting ingredients.

Normal/combination

Since normal/combination skin types generally do not have specific problems to address, anti-aging treatments and gentle exfoliation to increase circulation work best.
• Strawberries can be used to condition and tone any skin type. They help lighten pigmentation problems and keep skin smooth and supple.
Tip: Mash strawberries and use as an astringent or face cleansing mask.
• Cocoa. The antioxidant powers of the distinctive bean promote healthy skin. Research shows that when cocoa is applied topically it helps to reduce skin irritation and combat cellular damage.
Tip: For a soothing mask, mix cocoa powder with a little water or buttermilk—an excellent source of lactic acid that stimulates the cocoa’s antioxidant function and softens skin.

Oily/acne prone

Oily and acne prone skin is frequently irritated by harsh cleansers, acids and anti-acne products. Give your client’s skin a break with gentle remedies that treat acne and keep oil at bay.
• Carrots. The carrot is probably best known for containing vitamin A, which has proved to be as effective in dealing with acne as some compounds such as retinoids.
Tip: Carrots make an excellent skin mask for acne and blemishes.
Apply raw, grated carrots to the face. Add lemon juice if you like. To make a cooked carrot mask, boil three large carrots and mash them or blend in a food processor. Add five tablespoons of honey or yogurt (optional). Apply gently, in an upward motion. Leave on for 15 to 20 minutes. Rinse with warm water.
• Honey. Renowned for its antibacterial properties, honey is considered to be one of the best natural acne fighting ingredients. Why? Because honey actually kills the bacteria that cause acne.
Tip 1: Massage a small amount of slightly heated honey into the skin.
Tip 2: Dab honey on individual pimples to help clear up blemishes.
• Egg whites. Although egg whites alone have no real long-term benefits, they are great for shrinking pores and treating blackheads and whiteheads.
Tip: Egg whites are best applied with a flat brush on clean skin. After the mask has dried, your client will look like a prune—but this lets you know that it is working. The mask can be quickly removed with a wet washcloth.

Dry

Sun damage is usually the culprit behind dry and cracked skin. Other factors include diet, environment and insufficient water intake. (Note that acne is usually the result of dry skin.) Create a facial that not only moisturizes, but helps the skin retain the treatment’s benefits.
• Avocados. Packed with monounsaturated fats and vitamins B and E, avocados are excellent for moisturizing and rejuvenating dry skin. They are also rich in vitamin C, which can stimulate collagen and reduce visible signs of aging.
Tip: Mash one tablespoon of ripe avocado, add half a teaspoon of honey and mix. Stir in a small amount of almond meal until creamy. Apply to clean skin, leave on for 15 to 20 minutes and wash off with lukewarm water. Finish with a rinse of vinegar pH balancer.
• Bananas. High in potassium and possessing the same benefits as the avocado, the banana is often a preferred treatment for dry skin. The long lasting moisturizing effects give the skin a healthy glow. The treatment can also be penetrated into the skin with the use of galvanic or ultra-sound machines.
Tip: Mash the banana and add two teaspoons of yogurt. Mix until creamy and apply immediately to the skin. Leave on for 10 to 15 minutes. Remove with a spatula and then rinse.

Olive oil can be used on the face daily. With continued use, olive oil can also reduce hyperpigmentation.

For all skin types

• Olive oil. The Egyptians, Greeks, Phoenicians and Romans all took full advantage of the benefits of topical oil application. Today, when we observe the beautiful skin of Med­iterranean women, many identify olive oil as the main ingredient behind their complexion. Sofia Loren is an olive oil devotee, having used it as part of her skin care regimen for most of her life.
Olive oil comes in several grades—extra virgin is the least processed. The cell size of olive oil is smaller than the blood cell, and extra-virgin olive oil has all of the antioxidants the body needs in direct proportion to the body’s requirements.
Tip: Olive oil can be used on the face daily. With continued use, olive oil can also reduce hyper­pigmentation.
• Green tea. The plentiful antioxidants in green tea help fight free radical damage. When applied topically, tea reduces the appearance of lines and wrinkles and can even help prevent skin cancer and signs of aging resulting from sun damage.
Tip: Brew strong tea (one or two tea bags for each cup of water), let cool and apply to the client’s face after cleansing.
• Salt and sugar. When used as natural exfoliating particles, sugar and salt help loosen lifeless epidermal cells that need to be physically removed. The glycolic acid in sugar and its rough texture makes it ideal for exfoliation to give skin a healthy glow.
Tip: For a cost effective scrub, mix a teaspoon of sugar or salt with any cleanser and apply in small, circular motions.

For a cost effective scrub mix a teaspoon of sugar or salt with any cleanser and apply in small, circular motions.

Super foods for the skin

It is true that we are what we eat. While the topical application of fruits, veggies and natural oils will help improve the skin’s appearance, ingesting these same foods is important as well. Remind your clients that a great complexion can be achieved from a healthy diet and taking the right supplements and vitamins. It is also important to drink enough water to keep the skin hydrated. Doctors recommend consuming at least 10 to 12 glasses of water each day to avoid dehydration—which affects cellular metabolism—and to help flush out the toxins in the body, which results in clear skin.

Using these kitchen remedies in your treatments helps you stand out as an innovative and eco-friendly professional in your field.

Experts recommend a diet high in fiber and low in fat. Countless scientific studies have shown that antioxidants and foods rich in omega 3 fatty acids help clear skin and slow the aging process. Antioxidants decrease cell destruction by neutralizing free radicals that can cause damage, and omega 3 fatty acids help reduce skin inflammation and improve circulation. Some super foods that are widely touted for their benefits to the skin include salmon, sardines, nuts, seeds (pumpkin and sunflower), flaxseed and olive oils, blueberries, pomegranate, broccoli, oats, spinach, dark chocolate, wheatgrass, red wine, green or black tea and tomatoes.
Using these kitchen remedies in your treatments helps you stand out as an innovative and ecofriendly professional in your field. Consumers are overwhelmed with the saturated skin care industry and therefore welcome a fresh and natural change. Using these ingredients is good for the skin, better for the environment and easy to add to your existing treatments. Not only can you save money by using low-cost ingredients (when bought in season), but your clients can learn at home treatments to enjoy between appointments to save both money and their skin! They will likely be back and may even send a few referrals your way!

Note: Always remember to ask clients about any food allergies that they may have prior to treatment application.

Maria Comfort is a licensed celebrity esthetician and owner of Touch Total Look, Face & Body Spa in Woodland Hills, CA. She is also an educator for Bella Spa & Salon Distributors, the spa division of Ultimate Beauty Companies, whose efforts are focused entirely on servicing, educating and growing the business of spa industry professionals. Visit www.BellaSSD.com.

The Search for the Ideal Sun Protection

  

  

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May 2010’s Featured Article:

Without question, sunscreen is the most important aspect of any skin care regimen. It is imperative to maintaining treatment results and the prevention of skin cancer. Unfortunately, misleading and often incorrect consumer-directed information has led many patients to believe that these crucial products are actually harmful. It is imperative that all skin care professionals feel comfortable speaking about the importance of SPF and are prepared to dispel some of the myths regarding these invaluable products. Also, by developing a deeper understanding of how sun protection products work to safeguard the skin, the clinician is able to identify the most effective sunscreens on the market.

Ultraviolet (UV) radiation

To understand sunscreens, one must first understand the ultraviolet light they are designed to screen out. UV light is electromagnetic energy ranging from 200 to 400 nanometers (nm). It is critical to realize that one does not have to be outdoors to be exposed. Human beings are constantly in contact with UV radiation, as it is emitted from multiple sources including the sun, tanning beds, black lights, germicidal lamps, halogen lights and fluorescent and incandescent lights. The almost unavoidable exposure to UV radiation makes daily sunscreen application essential for healthy skin. UV rays have been officially categorized as a known carcinogen, and as we learn more regarding the risks of overexposure, groups such as the Indoor Tanning Association (ITA) are finally being held accountable for their actions. In January 2010, the Federal Trade Commission charged the ITA with making false claims regarding the health benefits of tanning.
UV rays are divided into three types: UVA, UVB and UVC. UVC radiation ranges from 200-280nm. Fortunately, UVC is almost completely absorbed by the atmospheric ozone and exposure is minimal. Although light sources such as germicidal lamps and certain types of tanning booths utilize UVC rays, specific topical protection for UVC is not believed to be necessary.
UVB rays span from 280-320nm, and are thought to be responsible for the majority of the sun’s negative effects on the skin. Although the inflammation and erythema produced by a sunburn is the most obvious change, it is what is happening within the skin that is the most worrisome. UVB radiation is responsible for a cascade of events inside the epidermal cells, including increasing levels of damaging free radicals and reactive oxygen species (ROS). In addition, UVB causes a reduction of the skin’s endogenous, or natural, antioxidant levels, making it even more vulnerable to DNA damage and mutation. The UV-induced DNA mutation is the number one cause of skin cancers. UVB rays can be remembered as the rays responsible for burning.
UVA radiation ranges from 320 to 400 nm, and makes up the majority of the rays that reach the Earth’s surface. UVA rays are believed to be the primary cause of premature visible aging. The deeper, dermal penetration of UVA leads to the breakdown of structural components such as collagen and elastin. UVA radiation is able to penetrate glass and most clothing, and its strength remains constant throughout the day, which makes daily sunscreen use imperative, even if one remains indoors. Like UVB rays, UVA rays increase cellular oxidation and decrease the body’s natural defense mechanisms. Although UVA is thought to play a less significant role in carcinogenesis compared to UVB, it is still responsible for approximately 20 percent of the sun’s cancer-causing effects.

UV protection

There are thousands of sun-shielding products currently available in the U.S., and their level of usefulness varies widely when it comes to their UVA and UVB screening abilities. The clinician should be able to identify which products offer the best protective benefits in order to preserve the health and appearance of their patients’ skin.
Sunscreen agents are classified as physical or chemical. A physical sunscreen is an inorganic product that sits on the surface and reflects or scatters UV radiation before it induces cellular damage. In the past, although physical sun protection was effective, it was often associated with thicker product consistency and a white appearance on the skin. Proper formulation and smaller particle sizes can alleviate these concerns, leading to a lighter and more appealing product feel. In contrast, a chemical sunscreen is an organic substance that penetrates the corneocytes and absorbs UV rays before they affect the skin. Many people avoid chemical sunscreens out of concern for sensitivities. In actuality, reactions typically occur in response to a product’s base rather than its active ingredients. Therefore, even patients with sensitive skin should be able to find an effective sunscreen.
Numerous ingredients are FDA-approved to either reflect or absorb UV radiation. Each of these ingredients is able to counteract specific wavelengths, and a blend is typically needed for ideal protection. The following are some of the most commonly used active sunscreen agents in the United States.

Sun protection terms defined

Many of the words that are used to describe sunscreen products can be confusing to both the patient and the clinician. Understanding these commonly used terms can greatly assist skin professionals in choosing and recommending protective products.
The term “SPF” is the abbreviation for a product’s Sun Protection Factor. It only indicates a product’s ability to screen the sun’s burning rays, or UVBs. Consumers typically do not understand what SPF is and often believe that a product’s effectiveness is solely determined by the SPF number. It is important to educate patients and explain that the level of protection is not proportionate with the SPF rating. In fact, an SPF of 15 provides protection from 93 percent of UVB rays, SPF 30 protects from 97 percent of UVB rays and an SPF of 60 protects from 98 percent of UVB radiation. Many dermatologists believe that an SPF higher than 30 is of little value. In most circumstances, products with an extremely high SPF are thicker and heavier, and because they provide minimal added protection, they are often unnecessary. In addition, people often incorrectly believe that re-application is not warranted when using a high SPF product. In reality, nearly all sunscreen products break down and must be re-applied every two hours. Personally, I would prefer my patients wear an SPF 15 product daily rather than an SPF 70 only when they are outside.
The term “broad-spectrum” indicates a product’s ability to protect against both UVA and UVB radiation. At this time, the U.S. has not implemented a rating system for UVA protection. The only way to ensure that a sunscreen absorbs UVA rays is to read the ingredient label on the back of the bottle. At least one of the following must be on an ingredient list in order to achieve true broad-spectrum, UVA/UVB protection: avobenzone, ecamsule titanium dioxide or zinc oxide.
Water and sweat-proof claims are false and irresponsible, as there are no such products, and these terms are misleading to the patient. Products can however be water or sweat-resistant, meaning that they are able to maintain their protective effects in water for a certain amount of time. A water-resistant product remains active for up to 40 minutes of submersion, and a very water-resistant product maintains results for up to 80 minutes. Regardless of a product’s claims, all sunscreens should be reapplied after swimming, sweating, toweling off or vigorous outdoor activity.

Sunblock 101

The only way to ensure a sunscreen absorbs UVA rays is to read the ingredient label on the back of the bottle.

Dispelling sunscreen myths and misconceptions

While the Internet can be an excellent source of information, it is also often full of erroneous data. Recently, a consumer-focused website falsely claimed that many of the available sunscreens on the market do not provide adequate protection. Such reports create confusion and actually discourage many patients from using any type of SPF products. The statements made in the report have been discredited and criticized by dermatologists and the Skin Cancer Foundation.
The frequent misleading claims regarding the biological need for sun exposure for vitamin D production can also be confusing for the patient. Although it is true that vitamin D is essential to overall health, research has shown that the sun is not only a dangerous source of vitamin D, it is also unreliable. The recommended dose of vitamin D for an adult is 1,000-2,000 IU per day. Adequate amounts should be obtained through milk and fish consumption, vitamin supplementation and sun exposure from normal daily activities while wearing sunscreen.
A study conducted by the University of California, Riverside, triggered multiple incorrect and confusing media reports claiming that sunscreens actually caused cancer. While the study itself was valid, its findings were completely taken out of context in the report. The research showed that when exposed to UV rays for prolonged periods of time, sunscreen ingredients can break down and stimulate cellular oxidation, or free radical damage. While this seems worrisome, these effects can be completely avoided through proper reapplication. In most circumstances, a sun protection product should be re-applied every two hours, regardless of SPF number, active ingredients or water-resistance. Further, the use of sunscreens formulated with added antioxidants or antioxidant products in conjunction with SPF can also eliminate this concern. Look for ingredients such as caffeine, silymarin, L-ascorbic acid, tocopherol (vitamin E), resveratrol and glutathione for superior protection against sun-induced free radical damage.

The ongoing search

Locating products with optimal UV-protective blends, potent antioxidants and a cosmetically elegant feel may seem like a daunting task, but once you have found them, your patients will thank you for years to come. Developing knowledge of the sun-shielding ingredients and their unique UV-protective capabilities will aid you in this search. As professionals, we must also research what our patients are reading online and hearing from other media outlets and be prepared to dispel any myths. Educating patients on the truth about sunscreen and offering exceptional products promotes overall health and beautiful skin.

Jennifer Linder, M.D., is a board-certified dermatologist, a fellowship-trained Mohs surgeon and one of the foremost U.S. experts in the use of the cosmetic filler Sculptra. A biomedical engineer and chemist, Dr. Linder holds a clinical faculty position in the department of dermatology at the University of California, San Francisco. Dr. Linder is the chief scientist for PCA Skin.

Injectables

  

  

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		This month’s Featured Article: What the esthetician needs to know By Linda Rae and Sherry Taylor The demand to restore a youthful appearance to the face has been an obsession of many since ancient times, but never more so than in today's society. Up until a few years ago, the ultimate in facial rejuvenation was plastic surgery, but today there are many more options available to those who do not wish to go under the knife. In addition, today's economic stress has created a demand for less expensive ways to achieve facial rejuvenation without the cost or the downtime of surgery. According to a recent survey by the American Academy of Facial Plastic and Reconstructive Surgery, approximately 80 percent of board-certified facial plastic surgeons reported an increase in non-invasive cosmetic procedures within the past year among consumers looking to delay the effects of aging. There are so many possibilities for facial rejuvenation that often the available products and names are confusing. While injectables do not replace cosmetic surgeries, especially when it comes to severe loss of elasticity (sagging) or deep folds, they can drastically improve the appearance of an aging face or even slow down the process. There are two broad categories of injectables. They are botulinum toxin paralyzing agents and fillers. It is extremely important that estheticians become not only familiar with what they do, but what they cannot do as well. Botulinum toxins Botox® and Dysport®: When you look at yourself in a mirror with a straight face, any wrinkles or folds you see are referred to as "static." When you smile, frown or grimace, the additional wrinkles that appear are called "dynamic." Botulinum toxins help "dynamic" wrinkles and folds. It does this by immobilizing and relaxing the areas injected, working to paralyze the muscles so they cannot contract. When muscles cannot contract, the skin over the muscles also becomes relaxed, smooth and youthful in appearance. Results are not immediate. In general, it may take up to a week to start seeing improvement. Dysport is very similar to Botox since they both contain the same main ingredient, made from the same neurotoxin, botulinum toxin A. According to plastic surgeon Roberto Palma, M.D., of Sunrise Intracoastal Plastic Surgery Center, Ft. Lauderdale, FL, Dysport seems to have a faster onset. Botox starts working within 24 to 48 hours, reaching maximum effect within 9 to 12 days. Dysport starts working within 24 hours, reaching maximum effect within 5 to 7 days. There is no difference in longevity, which is approximately three to five months. Although Botox and Dysport are only FDA-approved for frown lines between the brows, physicians use them "off label" in other areas. Off label means that the physician may inject into areas not yet FDA-approved. The FDA does, however, require patients to be informed of any "off label" use. According to Murray Smith, M.D., of Las Olas Derma­tology, Ft. Lauderdale, FL, resistance to treatment and formation of antibodies to Botox and other FDA-approved botulinum toxins are extremely rare. Very low doses are used. Side effects are infrequent and usually resolve spontaneously in a week or so. Dr. Palma states that "paralyzing the wrong muscles can lead to very visible abnormalities such as droopy upper eyelids, eyebrow deformity and asymmetries (different on each side). If the entire forehead is treated, the eyebrows can fall, making the patient look tired and sleepy. The patient may lose normal facial expression. I do not believe in injecting lips with these products," Dr. Palma continues, "because of the high risk of causing smile abnormalities and asymmetries." Fillers While botulinum toxins help "dynamic" wrinkles, fillers help the "static" wrinkles by filling in the grooves, folds and hollows. The products do this by bulking or raising them up, which then smoothes the skin, giving the face a more youthful appearance. Fillers lift sunken and depressed areas, fill in wrinkles, fine lines, creases, hollows in cheeks and under the eyes, as well as enhance lip fullness. "The longevity of fillers varies with the product, the sites injected and the skill and experience of the injector," says Dr. Palmer. While it may seem like there are already many options available, many more filler products are currently awaiting FDA approval. Do not be surprised to see several changes before the end of 2011. According to Dr. Palmer, "There is no such thing as one product being better than another. They all have different indications and the well-trained, experienced injector usually will use most of them depending on the specific needs of each individual patient and the areas to be corrected." Selection of filler is an important part of the process, as different fillers work best on deeper wrinkles, whereas others are needed for fine lines and creases. Hyaluronic acid Hyaluronic fillers have the best safety profile of all the fillers currently on the market. Since hyaluronic acid is naturally present in all living beings and a component of connective tissue, chemically identical in all species, no skin testing is required. Dr. Palma feels that only these synthetic fillers are safe to use on the lips. When talking about the longevity of the products, he states that "in the nasolabial creases, the average is six to nine months and in the lips I have seen up to one-and-a-half years in my patients." Juvederm® XC, Perlane®-L and Restylane®-L are all second-generation hyaluronic-based dermal fillers that work just like the original formulas (Juvederm, Perlane and Restylane) but they contain a small percentage of lidocaine, which numbs the treated area so that the injections become more comfortable for the patient. Hyaluronic fillers can easily be removed by dissolving with an enzyme if the patient is unhappy with the results. Radiesse Radiesse® is considered a volumizer filler. It is composed of CaHa (calcium hydroxylapatite) similar to tooth material. Radiesse instantly restores volume to the face and also keeps working to stimulate the production of the body's own collagen. This results in increased volume that may last a year or more. It is used in the correction of facial folds and moderate to severe wrinkles and is often used to lift the cheeks. Sculptra Sculptra®, poly-L-lactic acid, works by stimulating the patient's own collagen until the area is volumized. The procedure consists of a one-time treatment regimen of up to four injection sessions that are scheduled about three weeks apart. Full results may not be seen for several months. It can last for years and is suitable for larger areas such as mid-cheek hollows, states Dr. Palma who refers to Sculptra as a volumizer, rather than a filler. Unlike hyaluronic fillers, both Radiesse and Sculptra must wear off and cannot be removed. Artefill Artefill® PMMA (polymethylmethacrylate) microspheres, with bovine collagen as the carrier, is relatively new to the U.S. market. Since it is non-absorbable by the body, it is considered a permanent filler. Because the bovine collagen is not identical to human collagen, skin testing is mandatory per the FDA. A four-week waiting period, before the first injection, is required. If the testing is positive, the product cannot be used. Complications, although rare, include hard, red, swollen bumps, which must be surgically removed. "Longer is not necessarily better as some side effects are known to be associated with longer-lasting products," adds Dr. Smith. Collagen Collagen fillers have been used for more than 20 years and are meant to replace the lost collagen in the dermis. There are two types of collagen-based injectable fillers: purified bovine (cow) collagen (Zyderm® and Zyplast®), which requires allergy testing; and human-derived collagen (CosmoPlast® and Cosmoderm®), which does not require allergy testing. Both of these collagen fillers last from three to six months. Autologous fat/fat grafting Fat is usually extracted from the abdomen or thighs. The fat is then processed through a centrifuge and injected into the areas of the face where volume is needed. It is long lasting, even sometimes permanent. It may take more than one series to get the desired result. This procedure requires greater surgical expertise by the physician and a few days of down time. Selphyl System The Selphyl® System, referred to as the "vampire facelift," is a new filler that uses the patient's own blood, which is injected into skin depressions, wrinkles and creases. Upon injection, the platelets release growth factors that trigger the cells to multiply, which increases volume to create a more youthful appearance. Results are immediate but do not reach its optimum capacity for 3 weeks and can last 12 to 18 months. Esthetician's role Often the role of educating the patient about injectables falls to the esthetician. According to Loretta Ciraldo, M.D., a leading South Florida dermatologist, "It is so often the esthetician who is the first person truly consulting with the potential filler patient. If someone complains of any problem relating to volume loss (nasolabial creases, marionette lines, tear troughs) fillers are often a wonderful modality to consider." Estheticians should not advise clients as to what type of fillers are appropriate. This is the medical practitioner's responsibility. The esthetician's goal is one of education, referral and support. According to Dr. Ciraldo, "It is best not to do other procedures on the day of a filler treatment. I like to stress to my filler patients that if they are going through filler treatment, they want to be sure to maintain their entire face in the most effective way." Recommend treatments and home care to keep your client's skin in the best possible shape to enhance their new look. Schedule a series of peels, microdermabrasion or other types of exfoliation. Send them home with collagen-boosting and hydrating products as part of their daily regimen. While there are no proven modalities to actually enhance or prolong Botox or fillers, keeping the skin in optimum shape will certainly enhance your client's youthful appearance. Sherry Taylor currently serves as paramedical skin care instructor at Florida College of Natural Health, Fort Lauderdale, FL. She has previously served as director of esthetician training and development for a national chain of medical spas, and is also the owner of a successful skin care and image consulting business. Linda Rae is the owner of Linda Rae Skin Care and the creator of a results-oriented pre/post facial plastic surgery program. She was formerly an international educator for a major skin care line. They may be reached at info@TaylorRae.net. About Let us know your thoughts about this article... Rating:   Five Stars Four Stars Three Stars Two Stars One Stars No Stars Your e-mail address:   Comments: Questions for the author: Verification code:   Enter code:

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Moisturizing your skin, Chemistry 101

  

  

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Skin Care Moisturizers

By: Eric S. Abrutyn, TPC2 Advisors Ltd., Inc.

Posted: November 30, 2010, from the December 2010 issue of Cosmetics & Toiletries.

Moisturizers are an important category of personal care products,¹ and such formulas are designed to add moisture to the skin. Developing a good moisturizer requires carefully balancing the ingredients in a formula so that, upon application, the product maintains proper water content in the skin, i.e., 10–30%, to maintain its plasticity and barrier integrity. Insufficient water content can lead to the thickening or thinning of skin; fissure development, which produces chapped, rough and cracked skin; and the loss of pleasing skin aesthetics. Therefore, choosing the right moisturizer requires knowledge of its chemical, physical and performance properties and how to best utilize it against the targeted performance claims and consumer expectations. In addition, it requires knowledge of the skin to which it will be applied.

In general, skin conditioning needs can be classified based on skin health: normal, varying degrees of dry, oily, sensitive, dermatologically damaged and mature. There are other ways to classify skin types, most notably by the well-known and modified Fitzpatrick systems, all of which are more centered on the physiological health of skin and effects of sun exposure. Skin discomfort is unacceptable to consumers, thus moisturizers containing emollients and humectants are used to help alleviate the symptoms of skin discomfort. Since moisturizing lotions provide temporary relief of these symptoms, they are applied to the skin as a constant routine for skin management, to help to provide a healthy skin feeling. Following is an abbreviated explanation of the performance criteria of moisturizers, humectants and emollients.

Approaches to Moisture

Moisturizers: Moisturizer is a generic term used to signify an ingredient that adds moisture to the skin; to refer to humectants, which maintain skin hydration; and to describe emollients that soften skin.^2–4 Unfortunately, these terms are used interchangeably but each of these materials provides different performance benefits to skin and is quantified by different clinical methods. Moisturizer typically describes the function of a finished product and tends to include polar materials that are hygroscopic and able to hold water in place. The skin’s natural moisturizing factor (NMF) also plays an important role in moisturizing the stratum corneum (SC).⁵ The average NMF composition consists of approximately: 40% amino acid; 12% PCA; 12% lactate salt; 7% urea; 1.5% glucosamine/creatinine; 0.5% citrate salts; 18.5% Na, K, Ca or Mg phosphate; chlorine; and 8.5% sugars, organic acids and peptides. Thus, moisturizing ingredients are chosen based on their ability to substitute, replenish or maintain skin’s natural moisturizing components.

Classic moisturizers: Classic ingredients used as moisturizers include petrolatum as an occlusive barrier to hold moisture in the epidermis and SC; dimethicone (250–5000 cps) to modulate moisture in the skin; lanolin and its derivatives; vegetable butters/oils and their derivatives, e.g. shea butter, avocado oil, olive oil, etc.; high molecular weight linear fatty acid esters such as arachidyl propionate and cetyl palmitate; potassium lactate, alkyl methyl siloxanes, e.g. C_30-45 alkyl dimethicone; and film-forming polymers.

Humectants: Humectants are ingredients that have hygroscopic properties and can thus modulate moisture and retard moisture loss from skin.^{3, 6} They typically are associated with skin moisturization and can be divided into two classes of chemistry—inorganic, e.g. calcium chloride, etc., and organic, including polyols, organic salts and amino acids. Popular humectants include glycerin, urea, pyrrolidone carboxylic acid (PCA) and others (see Commonly Used Humectants). They provide good water-binding capacity with good skin substantivity.

Formulating with humectants: One noted polyol combination mixes various polyols with glycerin in a ratio of glycerin/sorbitol/propylene glycol/water at 12/9/10/59 (40/20/40 glycerin/sorbitol/propylene glycol) to provide good skin hydration along with good skin aesthetics to aqueous-based hydrating moisturizers. Also, diglycerol and triglycerol are good additions to glycerin to slow the absorption of water from the skin and provide a better equilibrium of moisture externally and internally to skin, equating to better moisture modulation. They also tend to be recognized as contributing less tackiness to a cosmetic formula.

Finally, polysaccharides are also a class of humectants that can provide good skin hydrating properties, and in some cases, they impart the added benefit of desquamation of flaky skin. Hyaluronic acid, i.e. glycosaminoglycan, and chitosan, the deacetylation of chitin, are two popular ingredients. Hyaluronic acid is ubiquitous with the intercellular matrix of connective tissue.

Emollients: Emollient is a complex and misused term.⁷ It is most often associated with substances that have the ability to plasticize, soften and smooth the skin, usually by filling void spaces on the skin surface and replacing lost lipids in the SC. This term was originally used to describe skin plasticization based on NMF to slow transepidermal water loss (TEWL) based on the theory that moisture retention can keep the SC flexible; therefore, water loss prevention maintains softer and smoother skin. Emollients can also provide protection and lubrication on the skin surface to minimize chafing and enhance skin’s aesthetic smoothness and softness.

Emollient properties are described analytically by interfacial tension/spreading coefficients, coefficient of friction, solubility and polarity characteristics of the molecule. Interesting concepts such as those based on cascading emolliency,⁸ surface tension, polarity and solubility have been used to develop synergistic blends of emollient ingredients with differing skin aesthetics, spreading characteristics and a solubility similar to the SC.

Formulating with emollients: The chemistry of emollients is diverse and covers most fields of chemistry. The most popular emollients are based on hydrocarbons and their derivatives; mineral oil, fatty acid esters, vegetable oils, synthetic triglycerides and polymers (see Figure 1 and Commonly Used Emollients). Formulators should note the viscosity of a mineral oil, which is based on complex mixtures of varying carbon chain length-hydrocarbons purified to varying degrees, is a key determinant to the average molecular weight of the hydrocarbon mixture.

Detox with Infrared, from Les Nouvelles Esthetique

  

  

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This month’s Featured Archive Article:

Cleansing the body is so vitally important for health, wellness and mental clarity, it cannot be overstressed. If we acquired the diets people followed in the 1800s, which consisted of fresh meat with no hormones or antibiotics, pesticide free vegetables and fruits, raw foods with no preservatives or chemicals, no plastics, no pollution in the air, no hydrogenated junk foods and no artificial anything, we would most definitely be a healthier society with lower cancer and disease rates. Yes, people may have died from illnesses that had no cure at the time, but they were probably not nearly as toxic as we are today.

Oxygen and improved blood flow nourish and cleanse the body, as well as enhance the metabolism.

Research conducted on umbilical cords found that hundreds of toxic chemicals are present in newborn babies. Today it is becoming increasingly difficult to stay toxic free—there is only so much you can do to keep your body clean without going insane.

Toxins—move on out!

Infrared heat is one of my favorite applications and I use it on clients for numerous treatments. This method of detoxification has been used in Europe, Asia and South America for many years—it seems as though Americans are always the last to know. What have we been waiting for? Stimulating circulation in sluggish areas of the body with infrared treatments moves waste and toxins out, lessening the appearance of cellulite.
Infrared heat blankets and saunas are a great addition to spas and wellness centers for weight loss, pain relief, detoxification and total body relaxation. As a matter of a fact, the Food and Drug Administration approved the use of infrared light therapy for pain relief and muscle aches in 1998. The reason that it is so productive for detoxification is the same reason that it functions so well for pain relief and circulation—oxygen and improved blood flow nourish and cleanse the body, as well as enhance the metabolism. In fact, a Seattle-based neurologist conducted a study to find out just how significant the difference is between conventional and infrared saunas. Lab test results showed that the sweat of people using a regular sauna was 95 to 97 percent water while the infrared produced 80 to 85 percent, with the nonwater portion being cholesterol, fat-soluble toxins, toxic heavy metals, sulfuric acid, sodium, ammonia and uric acid.

Deep cleansing

There are various infrared treatment options out there. Some spas offer the "sit down" style of infrared saunas where it is a little difficult to relax because of the hard surface and lack of position friendliness. With the horizontal thermal sudation method you can lie down, relax, close your eyes and drift off. Other treatments can be performed while you are in the horizontal cozy heat heaven device—facials, facial massage, reflexology, etc., which translates into an improved profit center and a multi-faceted treatment option without the need for wet rooms or showers.
I have the client lie on the treatment table in a room filled with candles, where I play soothing music and place essential oils on their towels. While the heat may vary from treatment to treatment, I do like creating a calming ambience for all. I conduct a 25 minute session with the temperature set to 46 to 48 degrees C (about 115 F) for relaxation prior to a massage or facial. It puts them in a warm sedation, relaxing the muscles and creating a light sweat. Usually I give a 10 minute facial massage during the session and charge $40 for the upgrade—the client almost always wants to receive a more intense detox session in the future.
The detox treatment is a little longer lasting at 40 minutes. It delves deep into the toxin release—I often see beige or dark colored sweat left behind on the plastic. I charge $70 and wrap the client in the blanket for a longer period of time at 48 to 50 degrees C, depending on the client's tolerance. I give an aromatherapy facial massage, make sure the fan is blowing gently on their face and offer a cool towel for the forehead, which makes them feel calm but energized.

Detox and stress release

The Sudatonic treatment (thermal sudation) is an intense detox method that consists of various steps. It is the preferred type of infrared treatment at my day spa. The process involves a body composition test, a weigh in and the application of proprietary blends of creams and essential oils. These formulations help break down cellulite, fat and toxins by forcing the action of sweating to use the fat as energy. I charge $125 for a single treatment and a prepaid discount for a series of treatments.
After each treatment the client is weighed again and gets another body composition reading. I always see a reduction. With repeated treatments a client can obtain desirable results both physically and mentally. The detox and cleansing are intense and the effects are amazing. There are many benefits other than the skin's softer texture: pain relief, reduced cellulite (the movement of toxins and excess water, circulation and blood flow gets energy to the sluggish areas), arthritic joint relief, headache relief, stress relief, cleansing of the circulatory system and a healthy glow. I have clients who are addicted to the feeling of endorphins flowing throughout their body all day long. The nice feature about this system is that it can easily be stowed away under a massage or facial table, which is ideal for those with limited space.

Essential for weight loss

I explain to my clients that if they are trying to lose weight, the body needs to rid itself of excess toxins. The two go hand in hand. Many experts on the subject will state that detoxification is a pre-requisite to weight loss. Although almost everyone is a candidate for the treatment, a health history and consent form is advisable for any and all contraindications. There are treatment guidelines as well.

There are many benefits other than the skin's softer texture: pain relief, reduced cellulite, arthritic joint relief, headache relief, stress relief, cleansing of the circulatory system and a healthy glow.

In closing, using infrared technology can be very satisfying for the client and extremely profitable. Consumers are more and more health conscious and the baby boomer market wants "feel good, look good" treatments. It is satisfying to the therapist to offer infrared because of the health benefits. The latest in infrared technology can boost sales while providing a remarkable means to healthy detoxification, which in itself leads to improved health and wellbeing.

Donna Dodier has a background in skin care/esthetics in New England and in Florida. She has been involved in dental health and wellness and is a frequent guest on Health Talk Radio. Dodier has 20 years of experience researching holistic medicine and believes in anti-aging from the inside out and the outside in through skin care, esthetics and nutrition. Contact her at keywestluv@hotmail.com, quasarbeauty@hotmail.com or 561.886.8427.