Managing Pigment in Ethnic Skin Types

We all deal with pigmentation issues at some point in our lives.
No getting around it, my friends. And it's NO FUN for ANY of us!

Today we are focusing on pigmentation in Ethnic skin types.
I have been writing and rewriting this Blog for a few weeks because this is a serious issue that effects millions of people.
I wanted to make sure I got this right for you.

Now, DON'T stop reading right here because you don't have ethnic skin and you think this Blog won't apply to you. It applies to all of us! (Thanks Ancestry websites for telling me just how much Native American heritage I have!)

There is oodles of great info coming up regarding pigmentation in ANY skin type.
Beyond that, here's why you should keep reading....

The face of America is evolving.

Courtesy National Geographic

The U.S. truly is a Melting Pot and these statistics from the US Census Bureau prove it!

"U.S. minorities now represent more than half of America's population under the age of 1, a historic demographic milestone with profound political, economic and social implications."

"Non Hispanic Whites are projected to no longer make up a majority of the population by 2042."
Just to give you some perspective, Non Hispanic Whites made up 85% of the population in 1960.

I'm super proud to see stats like this that prove how inclusive, accepting and progressive this young nation of ours, founded mostly of immigrants, has become in such a short time. Take a second and appreciate how amazing that is.
Okay, back to task at hand.

SO, WHAT ARE THE CLINICAL IMPLICATIONS OF MANAGING PIGMENTATION IN THE CHANGING FACE OF AMERICA?

Patients with ethnic heritage (African American, Spanish, Middle Eastern, Asian, Native American) inherently produce more melanin than Caucasians.
And while ethnic skin types have many benefits...managing pigmentation in ethnic skin presents a very specific and unique challenge.

Many of the tools in my expansive and cutting edge toolbox include Lasers, IPL, and other light based treatments. These treatments are awesome but can be problematic (or flat out contra indicated) for darker skin types. Thusly, limiting our options.

Here's why:
The mechanism of most of these modalities of treatment typically relies on a controlled injury to the skin to create a wound healing response, or they target pigmentation (which is hard to do when a laser cannot tell the difference between a freckle vs the natural pigment in the skin.)

For ethnic skin, many times, when skin or tissue is injured-the response of the body is to create MORE pigmentation. "HYPERPIGMENTATION"!

There is also a condition called Post Inflammatory Pigmentation (PIH). This is a direct response of trauma to the skin (lasers, peels, injuries, acne etc.).


One of the main concerns I hear daily from patients with ethnic skin types, is how to correct or manage pigmentation issues.

The short answer: YOU'RE DOING IT WRONG.  (But that doesn't give you much help, does it?)

The longer answer involves educating you, my readers, and my patients about the types of pigmentation, their causes and giving you the knowledge to become an advocate for yourself and your skin.

If you are ready...then get comfortable, grab yourself a cup of tea or glass of wine and settle in for a few minutes. I will condense this as much as I can but commit to reading for the next 10 minutes. You will thank yourself.

First, let's discuss the causes of pigmentation.

Melasma
This is a genetic predisposition and hormonally induced specific type of pigmentation. It presents differently than your run-of the-mill UV damage. Instead of scattered freckles-you will see patches/blocks of pigments that usually show up bilaterally on the face (temples, cheeks, jawline or upper lip).
See my Blog about Melasma for more detailed info.
We are getting away from calling this a "cosmetic issue" as it has been found to be a dysfunction of the skin.

Though this is a hormonal induced condition, it never presents in isolation. There are compounding factors in play.
Usually, pregnancy, birth control, hormone replacement therapy or UV exposure are the instigators.
FYI- certain Over the Counter supplements like Cohosh and St. Johns Wort have been found to mimic estrogen and make Melasma worse!!

The trick is to FIND YOUR TRIGGER!


Melanocytes (those pigment producing cells) are, in fact, immune cells. They respond when trauma or inflammation is present in the skin.

Certain traumas like cuts, scratches, acne, ingrown hairs, eczema or other dermatological conditions can lead to hyperpigmentation.

Acne Induced PIH

Some clinical causes include: lasers, IPL, microdermabrasion and chemical peels.

Certain medications- ranging from oral antibiotics to medications to treat heart disease and cancer-can create hyperpigmentation in the skin.

UV exposure. Don't make me say it again!!!
Even if you have darker skin, your skin can still over produce melanin when traumatized with UV radiation.

MANAGING YOUR PIGMENTATION
I'm not going to get into whether you are a candidate for laser treatment. This is very specific to your skin type and condition. You must be personally assessed by your Skin Care Professional to determine if this is right for you.

Lets talk about what you can do at home.

HYDROQUINONE (HQ)  4%-6% (prescription strength) has long been considered the Gold Standard for Melasma, pigmentation and PIH.
However, HQ is becoming more and more controversial due to long term effects like potential cytotoxity and contact dermatitis.

The other major issue with HQ is the potential for Exogenous Ochrinosis.

That's a lot of big words! Speak to me in plain English, you say? Here you go.

HQ IS A DRUG and you MUST take drug holidays.
The current thinking is you can only use this topical for 8 weeks (MAX 12 weeks) and then take 16 weeks off.
Otherwise, you may induce Ochrinosis which is a condition that results from an overuse of HQ.
The hyperpigmentation takes on a blue/black appearance and this...ugh...is irreversible.

I don't know about you...but I have too much going on between kids, work, house, pets, doctors/ortho appts etc to remember how to keep the HQ dosage straight. Was it 6 weeks on/8 weeks off? 8 weeks on/10 weeks off?
Who cares. I'll just use it all the time. Every day. For years. After all, MORE is BETTER, right?
It's easy to get lazy...AND I GET LAZY, TOO!  AND I'M THE PROFESSIONAL, Y'ALL!!!!

There's an easier way, folks.

1- Avoid UV radiation. And remember, this occurs insidiously and from an early age. Even incidental exposure can create irrevocable damage. Have you considered the ambient heat factor?
Living in Texas (as the saying goes, Texas has 2 seasons: Summer and August!) can cause major pigment issues. Dangit, enough already!

2-Wear SPF EVERY DAY! At least once in the AM. If you are going to be outdoors for any extended period of time, Reapply every 1-2 hours.

However, all you need is an SPF 30-45. Once the number of the SPF is increased higher than that...well, you really aren't getting more protection.
In fact, to get to those higher SPF #'s manufacturers must introduce more chemicals. More chemicals=more pro-inflammatory ingredients.
I like Elta MD SPF 46. It contains Niacinimide which inhibits melanin transfer.

3- Antioxidants are proven to augment the efficacy of SPF. Use a good one every morning. My fave is SkinMedica's C+E Complex or their TNS Essential Serum.

4-Use a good pigment inhibitor. There are lots of different ones on the market if you are looking for a non HQ option. Alternatives include:
Arbutin
Azelaic Acid
Kojic Acid
Licorice Extract
etc...

My fave right now is Lytera by SkinMedica.

It is a non-hydroquinone brightener that works on all skin types without a prescription.
This product has been scientifically proven to address all 4 stages of hyperpigmentation in the skin..
-Activation
-Production
-Transfer
-Migration

No breaks or drug holidays needed. I'm kind of obsessed with this product. Like, seriously obsessed.
Even though I don't have Melasma, I use this product twice per day. I have never gotten so many compliments on my "radiant, glowing skin" as did after 2 weeks on Lytera.

5-Retinol.
Retinoids (Vitamin A) have been clinically proven to down-regulate tyrosinase.
Tyrosinase refers to the enzyme in your body that controls and regulates melanin (pigment) production.
So, if you have overactive pigment production-i.e. Melasma, UV damage, PIH...Then Retinoids helps slow down and "police" that over production!!
I did a write up on the importance of Vitamin A ("The Best Thing You Aren't Using"). Read it.


Okayyyy. So, you feel like you just got spit out of a F5 tornado of information, right?

I know. It's a lot to take in.

But I want you familiar with this terminology and what these products do.
Education is the key to helping you manage your pigmentation.

Don't go blow your hard earned cash on some department store product that upcharges you to pay for their Prime Time commercial featuring a spotted Robin's egg that miraculously clears up within their 30 second time allotment. You won't get the results you are looking for.

There s a very specific and scientific regime to control and combat pigmentation issues, even in the most diverse skin types.

I'll break it down real simple for you.
Your basic skincare will look something like this:

AM:
Cleanse
Topical Antioxidant
Lytera
Elta SPF 46

PM:
Cleanse
Anti-Aging Serum
Lytera
Retinol Complex

This is the bare Nuts-N-Bolts of a skin care regime to aid in managing pigmentation (AND AGING!! It's a two-fer!!!).
Every case is specific. I'm here to educate you and make sure you walk into your doctor or skin care professional's office armed with as much knowledge as I can force down your gullet.

**Last Note***
Keep your eyeballs peeled for my write up on an Over The Counter Supplement called HelioCare (available at Walgreens, CVS etc).
It claims to reduce the absorption and negate the effects of UV by up to 400% when taken daily.

I have done a lot of research on this and I cannot find a single negative.
I have been using it myself for the last year. I had my daughters take it when we went to Mexico.
I was already convinced based on my personal experience.

Then, I went to a Plastic Surgical Skin Care Conference in San Francisco a few weeks ago and this product was brought up repeatedly in my lectures.
Not only for prevention of sun burns, but also in management of pigmentation/melasma in ethnic skin types.
I have begun my own personal study to test this theory and will let you know my findings in a few weeks.

Until then,
Buy the ticket, take the ride.

Michelle and Nancy
THE SKIN GURUS

How old you are is YOUR business, how old you LOOK is ours.
skin-gurus.com

Off topic...But On Point

I am back from hiatus and ready to blog!

So, over the last few weeks I have been gathering data and collecting my thoughts..should I tell y'all about the importance of retinols, or Managing Pigmentation in Ethnic Skin types, or the role Hormones play in skin throughout a lifespan (These Blogs are coming soon!!) ...but..

Something else kept coming to the forefront of my brain.

And it's not really related to skincare in the clinical sense, but more the 'WHY'  I got into this field in the first place.

Humanity lost one of its most treasured gifts last week.

So, I'm putting those Blogs on the back burner for a moment to pay a little tribute to Maya Angelou.

Ssshhhhh. Just keep reading. TRUST ME. It's not going where you think it's going.

I have always been inspired and captivated by this woman. As I started pinning and posting my favorite quotes from her and reading other peoples tributes... it started to dawn on me....just how many times in my life I have repeated her words in my head. Especially during rough times.

There are dozens of others of sayings that I put in a special little folder on my iPhone dedicated to inspirational quotes *nerd alert*
I've repeated them so often that I know them by heart and rarely think much anymore about the author. So, when I started reading all these posts, pins and tweets of Ms. Angelou's amazing insightful and graceful words...I realized how big of an influence she was to me.

I began to question whether I could ever be as influential as Maya Angelou.
I mean C'mon. I work in Plastic Surgical Skin Care. I'm a blonde from Texas! Can I make that kind of impact on the world?

I thought about this and started to remember why I was drawn to this field in the first place.
Then, I answered my own question. Yes, I can. And Yes, I do. One person at a time.

We all have baggage. Myself included. (Lawdyyyyy! Don't get me started! I don't have 'issues', I have SUBSRICPTIONS!)

Isn't funny how someone can say one thoughtless, cruel or careless remark in some crucial, pivotal moment in your life...and that seems to stick with you over the years, fuel insecurity and direct the course of your internal monologue for weeks or decades?
Especially for young women and men who have been teased about their appearance or body-shamed during those formative years, this can shape self and body image for a lifetime.

I was made fun of for my 'bologna-lips', my bad home perm, my chub... not to mention my snort-laugh and my innate clumsiness (which I never grew out of ;)

We all have issues and insecurities. If you tell me you don't, I call BS on that.

I have the absolute best job in the world. I get to make people feel better about themselves every. single. day.
I won't ever win a Pulitzer or Nobel or an Oscar (though some days I think I give Meryl Streep a real run for her money! And, I can legitimately tell you that I have a Best Actress Oscar winner as a patient. But that's the closest I will ever get to a golden statue.*sigh* all those hours wasted practicing my acceptance speeches in my bathroom mirror with a hairbrush-microphone ...C'est la vie.)
God knows, I don't do this job for money or lavish lifestyle.

I do it for you!

You, my lovely patients and online followers, let me into your life every single day. You open up to me about your fears and insecurities. You tell me about your loves, your aspirations, your families and your past. You put your faith and trust in me to guide in the right direction (and use lasers on your face! Talk about TRUST!)

What I love most about my profession is watching the transformation happen.
Because it's not just a physical.

Patients come to each appointment with a little more bounce in their step. And as their confidence grows, the narrative of their life starts to change.

For instance, that person, who, the first day I met her at our consult, had tears in her eyes. Her husband just left her. Now she is a 40 year old single mother of 3 and feeling low and beating herself up.
Or the nervous guy who had a hard time telling me why he came to see me. It took me 20 minutes to drag it out of him. Turns out, he wouldn't date or even be seen at the pool/lake or go to the gym due to his Gynecomastia.
It takes real courage to open up to a stranger like me about these personal insecurities. People probably tell me more about themselves than even their best friend in the world knows about them.
I don't take that lightly.

My greatest professional and personal (outside of my kids and loved ones) satisfaction comes on a daily basis when patients hug me and tell me how great they feel.
All of the sudden, their world is changing. They are happier. They have the confidence to take chances they otherwise would not have taken. I get to be your biggest cheerleader, high five and hug you and jump up and down and celebrate in your accomplishments!

Like a proud mama bird, my gratification comes by watching you take flight.
And when you leave my office, I look in the mirror and give myself some Shooter McGavin finger guns. Because, DAMN! I'm good at this!

Nancy and I also volunteer for the Phoenix Society for Burn Survivors annual World Burn Congress as part of the Image Enhancement Team for traumatic burn injury survivors.

If you know anyone who has suffered a traumatic burn injury, I highly recommend this organization.
They are a phenomenal support system.

As part of the Image Enhancement Team, we teach people how to camouflage scars, draw on lips and brows etc to help those who have suffered traumatic burn injuries re-enter society and cope with not only physical limitation but also the emotional trauma associated with disfigurement from traumatic burn injuries. It's not just changing faces, it's changing lives.

 

This is a wonderful profession and we are privileged to have y'alls continued trust and support.
This is our dedication and calling.
We promise to keep bringing you Blogs you find informative, useful and (hopefully) a little funny and sassy.

I leave you with this last quote because....well...Dammit. YES!

And now..back to your regularly scheduled programming.

Michelle and Nancy
The Skin Gurus

How old you are is your business, how old you look is ours!

What your kids need to know!

What your kids need to know about Skin Cancer
Easy talking points to eliminate the eyeball rolls

    As mothers, we try our best to provide our children with the knowledge that they need to keep them safe throughout life. Don’t talk to strangers, look both ways before crossing the street and Stop! Drop! And Roll!

  But, how much does your teen know about Skin Cancer and sun safety?

 We have decided to assemble some common myths and talking points that you can discuss with your child.  

 TEEN MYTH- Skin Cancer only happens to old people.

FACT- Among young American adults aged 25-29, melanoma is the most commonly diagnosed cancer, and the No. 1 cause of cancer death among 15-20 year olds.

 

TEEN MYTH- You don’t have to wear sunblock if you have a naturally tan or olive skin.

FACT- All skin types, regardless of race, should be using sunblock. Naturally darker skin types have a lower incidence of skin cancer, but when melanoma is discovered on darker skin, it is at a more advanced stage than on lighter skin.

 

TEEN MYTH- Tan skin looks healthy and prettier than pale skin.

FACT-
Tanned skin is actually an indicator that the skin is injured or damaged, so there is no safe tan. If you desire the appearance of a tan, there are much safer alternatives. For instance, Tan Towels self tanner is easy to use, not orange-y and not smelly. Fake-Bake away!!

TEEN MYTH- You only have to wear sunblock on sunny summer days.

FACT- UVA rays penetrate through clouds and windows, and are reflected off concrete, asphalt, snow and grass.
These rays are present from sun up to sun down, all year-round.
Sunblock should be worn every day, regardless of season or how sunny it is.

TEEN MYTH- Tanning beds are a safer alternative to sun exposure.

FACT- Tanning beds can expose an individual to four times the amount of UVA (aging rays) and two times the amount of UVB (burning rays) as a similar period of sun exposure. 
People are unable to feel the UVA rays on their skin, but they contribute the most to skin aging and skin cancer.

 

KNOW WHAT TO LOOK FOR:

 

    

    A – Asymmetry: Most early melanomas are asymmetrical

     B – Borders:  The borders are uneven

     C – Color:  Varied shades of brown, tan or black are often the first signs

     D – Diameter:  Early melanomas tend to grow larger than common moles.

     E – Evolving:  Change in any parameter: color, size, shape or feel

Educate those kiddos! NO matter how disinterested they seem, it's our job as parents!
Be the example!
They will thank you in 20 or so years! Then you can say "Sure, no big thing. Day in the life of a mom." and roll your own eyeballs back at them :)

Sincerely,
The Breakfast Club
Michelle and Nancy
The Skin Gurus
skin-gurus.com

 

 

Do you know what MONTH it is?

That's right.

It is officially May

May is Skin Cancer Awareness Month!

Allow me to take you on a little walk and transport you to another time....

A Time of DISCO

 

 

 

Soul GLO............

 

 

 

And... generally unfortunate decisions.

 

 

Yes, Welcome to the 70's. An era when we all lived on the edge! Child Car Seats? We didn't need no stinking car seats! Hell, my folks use to let me stand up on the seat of the car, without a seat belt (hence the scar under my chin from my jaw meeting the dashboard when my mama hit the brakes too hard once), as they cruised around town in our family Ford Pinto! (Remember those cars? They were riddled with design flaws and the slightest rear impact would turn them into a fiery death trap!)

 

HOW DID WE MAKE IT OUT OF THE 70'S ALIVE?  

 

Ahhhh yes. Also the era that the (in)famous "California girl next door" look began to take a foothold across the nation. That trend extended to the 80's. Think Farrah Fawcett, Cheryl Tiegs and Christie Brinkley.

 

We all wanted to be those girls. Tan and blonde and carefree!

 

Well, let me tell you a little story. It's about a red headed, blue eyed, pasty-white girl from the rough and tumble streets from Dayton Ohio. She wanted to look like those girls on the magazine covers. 

 

She saved for months and then bought herself a lifetime supply of baby oil and a couple of bottles of Sun-In. She decided that 'THIS" would be her summer of her "Cali-Girl" transformation.  

 

That girl had moxie. The odds were stacked against her. But she had to go for it. She dumped an entire bottle of Sun-In on her head, doused herself in baby oil, grabbed a tin foil reflecting blanket and headed to the community pool.

 

Long story long, that girl ended up that summer with bright orange Ronald McDonald hair and multiple blistering sunburns that, more than once, almost landed her in the hospital from sun poisoning. She never got that tan she dreamt of. It wasn't in the cards for her no matter how hard she tried. Only months of lobster-y red skin, swollen feet, endless peeling and miserable pain. She was destined to be the girl at the local pool under a tree, in a tee shirt and a wide brimmed hat for the rest of her life. Watching as all those tan blondies in bikinis won the hearts of every 6th grade boy at my school. *sigh*

 

But that girl little girl from an Ohio steel town had a dream to dance. The deck was stacked against her and her blistered skin. How did she overcome the those odds? By believing in herself! She literally had to become a 'MANIAC'! She had to strip down to nothing but her pasty white birthday suit and sit in a chair on a stage with her back arched...and she pulled a chain to nowhere and doused herself with water!!! She believed in herself! She believed so hard SHE SPUN! And she SPUN AGAIN! And she spun herself into that exclusive Dance School and into our hearts!

 

****Disclaimer: Everything BUT that last paragraph is 100% true. The last part is from the movie Flash Dance. But.... in my head, that's how my story SHOULD have ended.

 

 

This is how it ACTUALLY ended.

 



 

OKAYYYY... So the point of this lengthy anecdote is that we have all made sun mistakes. Thankfully, we all know better by now. And as a wise person (Maya Angelou) once said, "When you know better, you do better."

 

So let's start by undoing some of the sun damage from decades past and prevent UV damage for decades to come.

 

WEAR YOUR SUNBLOCK!

I cannot emphasize this enough. You need to be wearing an SPF 30-45. Every. Single. Day.

Anything over that number won't really give you more UV protection. Only dump more chemicals in your skin. 

If you will be out for prolonged periods of time-reapply your sunblock every 1-2 hours. Go read my Blog on the TRUTH ABOUT SPF. It's not as boring as it sounds. I promise.

My favorite SPF is Elta MD. It's affordable and offers more physical protection than OTC sunblocks.

 

 

 

 

 



 

USE A GOOD TOPICAL ANTIOXIDANT EVERY MORNING.

Antioxidants help neutralize free radicals (those scavenger cells that cause accelerated photo aging) and help repair your skin's cellular DNA.  

I love SKINMEDICA'S TNS ESSENTIAL SERUM AND SKINCEUTICAL'S PHLORETIN CF.

AVOID TANNING BEDS!
Duh! Do NOT make me come over there and smack you on your head.

SEE YOUR DERMATOLOGIST ANNUALLY (more frequently if you have personal or family history of skin cancer) FOR MOLE CHECKS!

LEARN THE  'A, B, C, D AND E's' of Skin Cancer Detection.
If you have a suspicious mole or lesion, get into your Derm and get it checked out. Like, NOW.

From Sun Safety Alliance Photos

The ABCDE rule is a quick and helpful guide for detecting the usual signs of skin cancer. It is vital to monitor your skin and contact your doctor about any spots that match the following descriptions:

A- Asymmetry: Normal moles or freckles are completely symmetrical. If you were to draw a line through a normal spot, you would have two symmetrical halves. In cases of skin cancer, spots will not look the same on both sides.

B- Border: A mole or spot with blurry and/or jagged edges.

C- Color: A mole that is more than one hue is suspicious and needs to be evaluated by a doctor. Normal spots are usually one color. This can include lightening or darkening of the mole.

D- Diameter: If it is larger than a pencil eraser (about 1/4 inch or 6mm), it needs to be examined by a doctor. This is includes areas that do not have any other abnormalities (color, border, asymmetry).

E- Elevation: Elevation means the mole is raised above the surface and has an uneven surface.


These are just the very basics here, folks.
See your Doctor or Skin Care Professional for a customized treatment plan and skin care regime.
Love yourself. Love your skin! And pass this on!
Don't let Skin Cancer affect you or someone you love!


HOW OLD YOU ARE IS YOUR BUSINESS, HOW OLD YOU LOOK IS OURS!

Never settle for a good time, when a GREAT time is there to be had!

Michelle and Nancy
THE SKIN GURUS
 http://skin-gurus.com

 

 

 

 

 

 

 



HAIR LOSS and THINNING HAIR?

'WAIT? HAIR LOSS? Don't you call yourself a 'SKIN GURU'? Not a 'HAIR GURU?".

Yes, I know, this is a little 'off topic'.
And Yes, I am a 'SKIN GURU'. And no, I'm not a hair guru. But I have a little sumpin' sumpin' you may be interested in if hair loss is a concern for you or someone you know.

This topic comes up so frequently that I thought I would share some valuable info with you (picture me rolling up my imaginary sleeves with a sly, sideways smile..as I prepare to make your day!).

Women come in all the time to address their cosmetic concerns.
Some women will come in to talk about Melasma after childbirth and at some point in the convo say "BTW, why did my hair start falling out after I had the baby???"

Or, women will come in to address their anti aging concerns (wrinkles, age spots etc) and say something along the lines of  "AND! If all this wasn't bad enough!! Now my hair is thinning! I HATE MENOPAUSE!"

I also have male patients who, once they feel comfortable with me, will quietly ask if there is anything I can recommend for hair loss.
(I even made friends with a cabbie when I was visiting NYC. When he found out what I do for a living- the one and only question he asked me about was.... his Male Pattern Baldness!)

It can be very traumatic!
I started a medication a few years ago that is particularly notorious for inducing hair loss.

Every day I saw more and more hair in the shower drain. Finally, one day, I had a meltdown. In the corner of the running shower. Fetal position. Rocking back and forth. Like Meryl Streep in that scene from the movie Silkwood! (For you 'youngins'...YouTube it. Then, you will understand the gravity of that moment!)

I have had patients try pre-natal vitamins, Rogaine and even hair transplants to help restore lost and thinning hair.
Sometimes, a lot of the time, actually-most times, with less than stellar results.

BUT I may have a much simpler solution for you!

There is an OTC (Over The Counter) called 'VIVISCAL Extra Strength' that is sold at drug stores like CVS and Walgreens.
*The first time I went to look for it, I couldn't find it with the supplements. I asked the pharmacist and he couldn't find it either. As I was walking out, I made a U Turn at the shampoo aisle and there it was..sitting amongst the medicated shampoos. Just  FYI. You won't find this supplement with the actual supplements.

This product retails for about $50 for a month supply.

I started recommending this to patients about a year ago based on what I heard from people who had actually used it.

The ingredients are a little vague and consist of:  

AminoMar C™ Marine Complex

 Horsetail Extract

 Vitamin C

I can't seem to locate any information regarding these first two ingredients but I have seen some studies out there that indicate this product is effective.

It is made by a company called LIFES2GOOD that markets health and beauty products. They have been in business since 1997 and have a BBB rating of A+ with no complaints (last time I checked).

DOES IT WORK?
Well, I can't give you definitive proof.

However, I have told dozens of patients about this supplement and every single one has been very pleased. It, also, has really good online reviews. I rarely see such consistent reviews from consumers.

I have actually had patients come back 3 months later and show me the new growth they have. So, I have seen first hand that SOMETHING is DEFINATELY happening.

SIDE EFFECTS?

There are a few reported side effects of headaches and sleep disruption.
Always consult your physician before beginning a new supplement regime. 

I think the word is getting out about this product because I have had a few patients that could not find it locally. It was sold out and they ended up having to order online.


SO, there you have it!!!

HOW OLD YOU ARE IS YOUR BUSINESS, HOW OLD YOU LOOK IS OURS.

"That rug REALLY tied the room together!"

Michelle and Nancy
THE SKIN GURUS

Skin Care 101-How to layer your products

There are so many products out there!

It's overwhelming and hard to know exactly WHAT you need.
Even once you figure out what you need...are you using it correctly? If not, you may not be getting the most bang for your dinero.

This Blog will address what each product does and how to properly layer your skincare products for maximum efficacy.

Your regime should look something like this: (and I promise, once you get the hang of it, it will only take you 5-7 minutes)

AM:

1-Cleanse (Exfoliate)
2-Tone
3-Antioxidant/Anti Aging Serum
4-*AM Specialized Treatment
5-Moisturize
6-Eye Cream
7-SPF

PM:

1-Cleanse
2-Tone
3-Anti Aging Serum
4-*PM Specialized Treatment
5-Moisturize
6-Eye Cream

Let's talk about each of these individually.

CLEANSE

The dirt on the skin is made up of dust, pollution, sweat, oil and cosmetic residue.
These things stick to and are suspended within the thin oily protective layer of the skin (the acid mantle) on the surface.

It is important to cleanse at night (no matter how dog tired you are after a long day) to help remove the buildup of this debris that you accumulate throughout the day.

However, if, very occasionally, you've had one too many margaritas and forget to wash your face before you "fall asleep"- I will let that slide every so often. Hey, who hasn't been there?

You have to cleanse in the morning too!

There are many credible studies by organizations with lots of capital letter (NIH etc) that show our brains and bodies purge toxins while we sleep. If you don't cleanse in the AM then you can reabsorb these toxins which can lead to breakouts and, overall, less healthy looking and glowing skin.

If you use a scrub or exfoliating cleanser- use it in the AM to give your skin a healthy glow and help pores look smaller.

I recommend using a pump cleanser- not a bar soap. If you have dry or mature skin then use a creamier cleanser. If you have oily or acne prone skin then use a foaming or gel cleanser. If you have combo skin, there's nothing wrong with Cetaphil, Aveeno or Neutrogena.

TONE

Toners usually contain alcohol and water plus additional ingredients that modify them for specific skin types. The purpose of toners are to restore the skin's pH balance, help constrict pores and leave the skin looking taut.

I have a love/dislike relationship with toners. I think if you are a toner gal, GO FOR IT! I have no problem with them at all. I use a toner occasionally I feel like I need a refresher or have already cleansed a couple times in a day.

However, my skin care regimen needs to be as few steps as possible (Don't let my 4 tiered spice rack of products by my bathroom sink fool you.) Some mornings, I just don't have the timmmeeeee.

It's really up to you on this one. Just stay away from those harsh astringents (yeh, remember that crisp, burning sensation from that SeaBreeze  we used in 7th grade. That'll clear out the nostrils!)

ANTIOXIDANT/ANTI AGING

THIS IS WHERE TO SPEND YOUR MONEY WHEN TALKING ABOUT SKINCARE.
Everyone should be using a good antioxidant in the morning. This helps repair cellular damage that has occurred in the skin and helps neutralize free radicals we are exposed to throughout the day.

If you are under 30 then you can check out SkinCeuticals Phlorertin CF. This is a GREAT stand alone antioxidant. Although, my personal favorite is Vitamin C+E Complex by SkinMedica. I find it much easier to dispense and use than the Phloretin.

If you are over 30, you need an antioxidant AND an anti aging Serum. Check out SkinMedica TNS Essential Serum. My all time fave. I've never seen anything work like this product.

*AM SPECIALIZED TREATMENT

This would be products that fall into the category of addressing certain conditions. For instance, skin brighteners like Skin Medica's Lytera (love, love it) or any prescribed cream or acne treatment etc.

MOISTURIZER

Yes, you need one. Even if you think you are 'oily' or acne prone.

The water content of the skin (epidermis and dermis) is 80%. In the very top layer  of the epidermis, the one that the world sees, we only have a water content of only 10 to 30%.

You need a moisturizer to help retain water and keep it from evaporating on the surface of the skin. This will leave your skin looking smoother and more supple.

If you are oily or acneic, then you are likely using an acne treatment and those are notoriously drying. Use an oil free moisturizer. There are lots of oil free options available over the counter. SkinMedica makes a nice one called Ultra Sheer Moisturizer.

Dry or mature skin will need something that is a little heavier. Again, there are plenty to choose from OTC. SkinMedica makes a great one called Dermal Repair and SkinCeuticals has one called A.G.E. Interrupter. It's a little heavier but has a really nice elegant feel to it. Perfect for women over 50.

EYE CREAM

Eye creams specifically address that delicate tissue around the eyes. Different creams address different concerns. For dark circles, I LOVE AuriDerm Vitamin K cream. It's not really moisturizing but is the best topical I have found for dark circles.

The nation wide best selling eye cream is TNS Eye Repair by SkinMedica. It contains the same growth factors as the TNS Serum to help restore collagen and elasticity. It also has high concentrations of vitamins C and E and hyaluronic acids that improve the appearance of fine lines and wrinkles.

SPF

You need a daily SPF between 30-45. EVERY. SINGLE. DAY. Even if you don't think you will be getting sun exposure. Even a little daily sun exposure accumulates over time and can have damaging effects.
My favorite is the Elta MD line. It's affordably priced, has more physical protection than OTC sunblocks and it looks completely transparent on the skin.

These same things all apply to you night time regime...with the following exceptions.

PM Step #3. If you are under 30 and only using an antioxidant...You can use it once or twice per day. If you are only using it once- do it in the AM. If you are using it twice per day then it falls under Step #3.
If you are using the TNS Essential Serum then this already contains all your antioxidants and you should def be using your anti aging serum twice per day where I have indicated above.

PM Step #4. This is where you would apply your Lytera, your Retinols etc. If you have more than one product that falls in this category, a good rule of thumb is to apply them from thinnest to thickest viscosity. For instance, Lytera feels thinner than Retin A when you rub it between your fingers, so apply in that order for maximum absorbency. Make sense?

There ya go!

HOW OLD YOU ARE IS YOUR BUSINESS, HOW OLD YOU LOOK IS OURS.

Andie: So what do you want to drink?
Duckie: Oh, you know, beer, scotch, juice box....whatever.

Oh, that Duckie!

Love,
Michelle, Nancy and Laurie
THE SKIN GURUS




 

The skinny on the Cursed CELLULITE!!

I am writing this Blog because I can't get through a week without a minimum of 20 questions about cellulite and how to get rid of it. Especially with summer fast approaching!

If I had a cure for cellulite and stretch marks then I would be insanely wealthy and retire comfortably at the ripe old age of fortysomethingsomething *cough*cough*.

Until then, let me tell you a little bit about this condition and why I'm not vacationing with Richard Branson on our own side-by-side personal islands right now.

Everywhere you look there are creams, injections, supplements, office treatments, commercials, SPAM and brochures promising to 'cure' cellulite.
As the saying goes...
"There's a sucker born every minute!"
Well, you won't be that sucker! Not on my watch, sista! (and/or bruthas!)

Allow me to bore you with a little Physiology 101.

In order to understand why some treatments will or won't work we need to understand what we are dealing with.

Cellulite is an alteration in the skin that presents as a sort of  "orange peel" or 'dimpling' on the surface of the skin that can vary in degrees of severity. Cellulite doesn't discriminate. You can be Jillian Michaels and still have it!

Cellulite typically appears on the thighs, buttocks and sometimes lower abdomen and upper arms of otherwise healthy women.

Yes, I said WOMEN!
About 85% of women have cellulite vs only about 10% of men. Guys have thicker skin which makes it harder for fat to push its way to the surface. THEY HAVE IT SOOOO EASY! Buncha jerks!

Lets talk about the different kinds of fat. There is one kind of fat that you can pinch an inch or two on your tummy or love handles. That is the fat that is typically treated with Liposuction or alternative noninvasive methods like CoolSculpting.  That's not what we are talking about here on this Blog.

Cellulite....picture this...
Just beneath the surface of the skin, in the Dermis, we have a little network of fibrous bands (these are called Septae. Think of them like a honeycomb) that connect our skin to it's underlying tissue. When fat cells become trapped between these bands and start to protrude and bulge upwards ... Viola! Cellulite!

Because these fat cells are trapped in the skin instead of underneath it, liposuction rarely fixes the appearance of cellulite. And in some cases, lipo can make the appearance of cellulite even worse. It's true. Google it ;)

This 'honeycomb' is the genetic makeup of the skin for most every living female on the planet. I can't change the way your skin is made up. Therefore, almost any results you see from treatments or OTC creams/supplements for cellulite is temporary.

Now, I'm going to be brutally, horrifyingly honest.
I HAVE CELLULITE! *SHRIEK!*CLUTCH YOUR PEARLS*

Over the last decade (and then some...) I have tried tons of things.

I tried Mesotherapy (which involved hundreds of microinjections using a solution primarily containing phosphatidycholine. (Talk about painful swelling and bruising! And I saw NO results!)

I have tried VelaSmooth/VelaShape (Painful, expensive, time consuming and only provided temporary results).

I have tried an invasive yet-un-named clinical trial using a cannula and radio frequency. (Results=nada. Unless you count the crazy swelling. That made my cellulite look a little better. Or maybe I was just too distracted by the purple/blackish bruising I HAD FOR WEEKS..Needless to say that little procedure hasn't quite hit the market quite yet)

I have tried body wraps (great if you do it right before an event or beach vacay. But results don't last).

There is also endermologie. I haven't done this but I can't imagine it's really worth it. Not many places even offer it anymore.

Here's the deal. VelaShape, Endermologie etc. etc. all use a massage technique to release those trapped fat cells. You will see a temporary improvement but because *we cannot change the biological make up of your skin...Once you stop treatments you will see the cellulite come back. How quickly it returns has lots of variables. Genetics, lifestyle yada yada yada.

So, is it worth it you to spend a few grand and a few hours per week for short term results? Well, that's something that you have to decide.

I promise you this, though. When and if something comes down the pike that actually works, I will be the first to have it. And I will shout it from the mountaintops like Maria from the Sound of Music!

So, in the meantime, here's a cool little trick of the trade. It will save you a few grand and give you some nice results in a pinch.

Using the same philosophy that massage helps improve the appearance of cellulite..get yourself one of those handheld massagers, the plastic or wooden ones that look like molecules.

You can use this a few different ways. Whatever you find the easiest way to be consistent. BUT, if you are shooting for a specific date or event-start about 3-4 weeks before you need to look your best.

A) You can use it in the shower. For instance, when you are all lathered up and conditioning your hair, use the massager on each upper thigh, booty, arms, wherever and massage away for about 5 minutes on each area.

B) You can use this with a nice body firming cream. I use it at night while I'm laying in bed (not sexy but I know if it's on my nightstand, I will do it) for about 5-10 minutes on each leg.
A body cream containing caffeine works great as it is a diuretic and helps flush those fat cells. I will warn you, one or two patients used a caffeine body cream at night and had trouble sleeping (anything applied topically bypasses the GI tract and absorbs directly into the bloodstream. If you are sensitive to caffeine then either use it in the AM or just find a nice firming cream without this ingredient.)

Also - Eat healthy! Drink Your Water! Work Out! Take care of yourself! It matters!
Then use all that money I just saved you on something SPECTACULAR for yourself! (I know you've been eyeballing that pair of shoes!)

That's all I got!

HOW OLD YOU ARE IS YOUR BUSINESS, HOW OLD YOU LOOK IS OURS.

Peace, Love and Sweet Dreams of Benedict Cumberbatch
(Those cheekbones, those lips, those mischievous eyes and that impish grin.. *swoon*)

Sorry, he carries me away...

Michelle, Nancy and Laurie
THE SKIN GURUS