So what 5 things to do?

1.  SUNSCREEN.  Not going to go on and on about this one.   You know it is good.  SPF 15 or 30.  Daily.  I don’t care if you aren’t outside a lot.  If you live in the Bay Area, you get tons of sun.  Sun is one of the most damaging, aging things you can do to your skin.  It will make you look old and wrinkly.  Block it.

2. DON”T SMOKE.  I won’t go on and on about this one either.  Smoking damages your skin.  It has toxins, it reduces blood flow, it causes little lines around your mouth.  The effect of it won’t show for years, but when it does it hits like a brick wall.  You can never fully reverse the damage smoking does.  So don’t do it.  It will make you look old and wrinkly.

3.  EXFOLIATE.  Cleaning your skin well is a must.  It will keep your skin healthier, remove all those bad things in the environment, reduce your pore size, and help your products work better by penetrating more.  You can use a chemical exfoliant (like my lovely glycolic acid pads!) or a mechanical one (like the clarisonic). 

4.  ANTIOXIDANTS.  These are products which help repair the damage to your skin.  Think of them as little doctors running around your skin fixing the injured cells.  Don’t buy over the counter products.  They are not the same strength and tend to cost as much.  Buy from a MD.

5.  VITAMIN A products, like Retin A and retinol.  This is still the gold standard for reversing damage in the skin.  I have tons of information on the subject.  If you don’t tolerate full strength Retin A, retinol is a good alternative.  Don’t do over the counter products- they don’t have the same strength medical grade products do.  Also, if you are within six months of trying to have a baby, you need to stop these products.  They are NOT safe during pregnancy and breast feeding.   

Dr. Zein Obagi started the line in Southern California years ago.  As this article in Plastic Surgery Practice states “For 25 years … he has written and rewritten the book on healthy skin.”  He does not judge skin based solely on the Fitzpatrick System (looking at white to black skin, and judging it on how it responds to UV light). 

He instead wants to base classification of skin based on a more “clinical classification” looking at five things:

• color
• thickness
• oiliness
• laxity
• fragility

He describes life stages of the skin: 

• Under age 10.  Properly clean and hydrate your skin.  Apply sunscreen.  He recommends antioxidants to prevent early damage from free radicals (**I am not sure how I feel about this.  I don’t know any research has been done on safety of antioxidants in young children.  Remember whatever you put on the skin can be absorbed through the skin. But I think it is an interesting concept and makes sense.)
• Age 10, the skin needs to be cleansed properly. If there are issues with sebum production (ie acne), you need to cleanse with a specific cleanser for oily skin and do a nonirritating scrub to prevent whitehead formation.  He recommends an astringent to decrease the sebum deep in the pores.  If needed, he also recommends hormone balancing.  The best you can do with acne scarring is to PREVENT it.
• After age 25:  He calls this the “inactive phase.”  Most cells making collagen and elastin become lazy.  This leads to aging.  So we should stimulate these cells.  The most effective agent to do this is Vitamin A- Retin A and retinol.  I agree with this statement.  Retin A products are well studied, their positive effects on the skin are well known, and it has been the workhorse of skin care for 20+ years.  I carry both Retin A and retinol in my office.  ***These products are NOT safe during pregnancy or breast feeding.  So if you are starting to think of babymaking, stop these 6 months before you start trying for your baby.

Other interesting pearls…

97% of the public gets skin care products from department stores and not physician offices.  This number surprised me.  The cost is usually similar (and for my personal line, my products are sometimes less).  Don’t pay for advertising and packaging.  Get a medical grade product.

Guidelines and safety in our industry:  He had an entire page dedicated to “unqualified doctors doing procedures.  We have board certified doctors who have worked hard in their training and worked hard to get the best results.  And we have a lot of other doctors who are not as well trained, who are doing it just for the money.  The dilemma is very big.  I think the future is not in creating more devices.  It is to create guidelines, to create standards. … I think the consumers really need to do their homework and go to board certified specialists and ask for a second opinion on a procedure.”  I agree. 

• Spend $350 and
• join or are a member to their “inner circle program”
• For purchases made between Dec 1-14. 

Stock up! If you purchase the Nuderm line, you would qualify.  Need elastiderm? Retin A? Clear? A travel Nuderm? If you are thinking of a blue peel, you start by prepping your skin with the NuDerm line. 

Go to www.obagi.com/ic for more information.

In my quest for good effective products at a reasonable price, this one from my Dr. Lauren Greenberg skin care line is good for antioxidants and to decrease redness.

This specially made product has three important ingredients:

Green tea.

Easy description of green tea :  Antioxidants.  What does it do? Aids in improving fine lines, wrinkles and pore size. It is nti inflammatory which calms and cools the skin and decreases redness.
Medical stuff:90% polyphenol isolates. This is the active ingredient in green tea –contains egcg (epigallocatechin 3 gallate). Antioxidants counteract the effects of free radicals so they cant cause harm.”analysis of published studies demonstrates that green tea polyphenols have anti inflammatoryand anticarcinogenic properties.”. Archives of Dermatology 2000; 136; 989-994.

Resveratrol, an ultra-powerful antioxidant therapy. 

Resveratrol, an antioxidant polyphenol from red wine, has been the subject of intense interest in recent years due to a range of unique anti-aging properties. These include cardiovascular benefits, possible benefits on Alzheimer’s, phytohormonal actions, anticancer properties, antimicrobial effects, and sirtuin activation(which is believed to be involved in the caloric restriction-longevity effect). Here we report a resveratrol-based skin care formulation, with 17 times greater antioxidant activity than idebenone. The role of resveratrol in prevention of photoaging is reviewed. Journal of Cosmetic Dermatology, 2008 March.

Caffeine USP to deliver enhanced antioxidant benefits.

Caffeine enhances the antioxidant properties of the green tea and acts like a topical vasoconstrictor which reduces redness.  And the combination of Green Tea Polyphenols and caffeine has been clinically demonstrated to promote positive apoptosis stimulating new cell growth.

• This product will improve the texture and tone of the skin while providing long term protection and treatment.
• Maximizes protection from Free-Radical damage.
• Reduces the appearance of fine lines, wrinkles and pore size.
• Moisture enhanced with Hyaluronic Acid.
• Visibly reduces the signs of redness and inflammation; ideal for Rosacea, sensitive skin and post-procedure.
• Contains 90%  Polyphenol Isolates – the active ingredient in green tea containing the most antioxidant benefits including the compound EGCG (epigallocatechin 3-gallate,) which is the major preventative component.
• One bottle is equivalent to approximately 500 cups of green tea!
• Use once or twice daily after cleanse & tone.
• Paraben-Free 

And best of all, it is a good price. 

What’s in it?

Retinol. 

Green Tea.

Caffeine.

Hyaluronic acid

This Retinol based formulation helps achieve more radiant looking skin while delivering the skin enhancing benefits of Green Tea Polyphenols and caffeine in a moisturizing base. 

• Anti-aging patients and those concerned about photodamage.
• Acne Patients – the increased exfoliation unclogs pores and helps fade acne scars

Some science articles:

Int J Cosmet Sci. 2011 Feb;33(1):62-9

Dermal elastic fibres are extracellular matrix protein complexes produced by fibroblasts and involved in skin elasticity. Elastin fibres decrease with age as a result of reduced synthesis and increased degradation, resulting in skin sagging and reduced skin elasticity. In this study, we show that retinol (ROL), known to enhance dermal collagen production, is also enhancing elastin fibre formation. ROL induced elastin gene expression and elastin fibre formation in cultured human dermal fibroblasts. Topical treatment of cultured human skin explants with a low dose (0.04%) of ROL increased mRNA and protein levels of tropoelastin and of fibrillin-1, an elastin accessory protein, as documented by QPCR and immunohistochemistry staining. Luna staining confirmed the increased elastin fibre network in the ROL-treated skin explants, as compared with untreated controls. These data demonstrate that ROL exerts its anti-ageing benefits not only via enhanced epidermal proliferation and increased collagen production, but also through an increase in elastin production and assembly.

Heaters blasting, dry air, wind, cold.  It is enough to make your skin look like one of those old dried out apple dolls.  Not a great look. 

What can you do? Hydration is good.  Sunscreen is good. (Did you know windburn is really a sunburn?). And this is the only time of year I find I need a moisturizer.

Products? I think many moisturizers are expensive and don’t do much, so I worked with a company to create a good, well priced moisturizer.  When you buy an over the counter product at a department store, you are paying a lot for the marketing and packaging.  Over the counter products can’t have the same concentration of active ingredients as doctors offices can.  So after all this, the product we came up with- Replenish.

• Liposomal Vitmamins A, C, E, CoQ 10, and Green Tea Extract
• Oil free
• Fortified
• Ideal of anti againg, dry, and mature skin.

And the best part? Reasonable price.  ($30 for for 46 grams).

GLYCOLIC ACID PADS.

These 10% glycolic treatment pads are convenient and easy-to-use.  They come in a canister with 60 pads.  You just take a pad and wipe your face (and neck! don’t forget the neck!).  This is not a red, itchy scratchy skin inducing kind of thing.  These pads gently exfoliate, moisturize and assist in the removal of oil and residue on the skin.

What is glycolic acid?   Glycolic acid is in the group called alpha hydroxy acids (AHAs) It is found in sugar cane (yum!) and has the smallest molecular size of the AHAs. Therefore it is believed they penetrate the skin more easily than the others. 

Why do we care? Glycolic acid helps to gently exfoliate the dead skin cell layer which manifests fine lines and uneven skin tones.  When dead cells on the skin’s most outer layer are removed, new fresher skin is revealed.  With continued use the appearance of fine lines seem to fade with clearer more supple skin its place.  It also helps your other products go deeper and be more effective.

Why do people say glycolic acid is a moisturizer? Isn’t it an acid?  Traditional moisturizers act as a surface conditioner, so they offer temporary benefit.  Glycolic acid acts as a gentle exfoliant and high potency moisturizer by bringing water molecules from the environment into the skin and by pulling water from the lower levels of the skin to the dry upper layers. 

• They are ideal to tone and prepare the skin
• Contain witch hazel for additional toning.
• Contain liposomal vitamins A,C,E, Co-Q10 and Green Tea Extract.  Why? To nourish the skin while providing antioxidant protection from free radical damage.
• Formulated with ultra-pure crystalline, non-buffered glycolic acid at a pH of 4 to provide maximum efficacy. 

I love it! Not expensive.  Come on in and get some…

Dum ta dum dum……………

The winner has been drawn and notified. (Sorry. Can’t write who it is due to privacy stuff.) $1000 of product and services. Wow!! Happy New Year!

I will be doing another talk and promotion on Saturday January 22 for the Palo Alto Mother’s Group. Details to follow.

Sign up to be a fan of me on Facebook to get updated on the latest specials and promos.

Hope your holidays continue to be merry and bright!!!

The poor, often forgotten and neglected, neck.  It is not just a pretty thing to adorn with necklaces and keep your head on.  The neck is an important place to protect if you want to hide your signs of aging.  And it is a difficult place to treat.  Often people come in saying “I don’t want a facelift.  I just want a necklift.”  Your face ages in units, and the neck is attached to the unit of the lower face. 

There is no easy fix. 

So what can you do?

First, basic skincare is still good:

• Sunscreen
• Products – antioxidants, RetinA

Second, you can try to resurface the skin

• Most lasers are NOT safe on the neck.  Can lead to pigmentation and scar.
• I use a chemical peel, the blue peel, which I usually combine with the face and chest to create a smooth, even color and contour.  Again, the neck is connected to other parts. You want them to all look in sync in color and texture.

Third, other noninvasive means.

Fourth, surgery.

• If your issue is fat, and you are under the age of 40, then chin liposuction is a likely good option to crispen your neck and jawline.
• If your issue is fat and you are over the age of 40 or have poor skin tone, then you get into a grey area.  Liposuction can remove the fat, but your skin may not retract.  If it doesn’t retract, then it will hang there.
• Bigger surgeries.  There are surgeries which are just necklifts, but they look funky.  As your neck is part of the lower face unit (cheek, jowls, jawline), the real answer is a facelift.  There are many misunderstandings and spins on facelifts: mini facelifts, necklifts, skin only lifts, lifestyle lifts, suture lifts, barbed suture lifts, lower facelifts, etc.  My belief is that a facelift is a facelift.  A true facelift should be a two layer fix: the SMAS and the skin (skin only is destined to fail, as skin stretches, and you can’t put much tension on skin without getting bad scars).  It will address the cheek, nasolabial fold (parenthesis around your mouth), your jowls and jawline, and your neck.

Bottom line with all of this? Give your neck some love.  It will pay off in the future.

• sensitive skin,
• lots of past sun damage (think growing up in the 80s, fair skin, lots of California sun, and maybe SPF 6 if any sunscreen at all), and
• I can’t tolerate some of the stronger products.

I wanted something that will

• exfoliate my skin (avoid whiteheads and acne, and help the products drive deeper to work better).
• reverse my damage, and I can’t tolerate most of the RetinA products- I get too red and scaly, so then I stop using them (they aren’t too helpful when on your shelf in your bathroom)…
• decrease the irritation and redness in my skin.

So I started working with a company, testing products and…

WALAH.

Four basic products:

RESURFACE: glycolic acid exfoliating pads. These pads gently exfoliate, moisturize,  and assist in the removal of oils and residue on the skin.  They are convenient and simple to use treatment pads with witch hazel to deliver skin toning and astringent benefits.

REPLENISH: moisturizer.  This moisture enriched facial cream contains Vitamins A, C, E, Green Tea and Coenzyme Q-10 to assists in minimizing free radical induce skin damage.

REPAIR: Triple antioxidant powerhouse made of Green tea polyphenolisolates, reservatrol, and caffeine USP.  Minimizes redness and harmful effects caused by free radicals.

REVERSE: Retinol product, mixed with Green Tea and caffeine to minimize irritation caused by the retinol.  Retin0l can help achieve smoother firmer and evenly toned skin.

If you have fair to medium skin, are on the more sensitive side, this may be the line for you.  I have been able to tolerate it well.  If you are buying creams at a department store, don’t waste your money.  Medical grade products are only available through doctors and give you more bang for your buck.  And the products are bundled, so you save $ when you buy together…. Do I hear perfect stocking stuffer?