Category Archives: chemical peel

Should you jump on the wagon with microdermabrasion or a chemical peel?

Every single human on the planet will need to speed up skin cell turnover with exfoliation after the age of about 28. Done. It is a fact. If you are not exfoliating then you are probably wondering where your luster went, why you are broken out, and why your skin tone is so darn patchy. It’s ok. Never too late to start. There are many many ways to exfoliate and demolish that dead flaky skin that is hindering your god given glow. Let us delve a little deeper into the utterly fascinating world of skin cell turnover:

Skin cell turnover is the sad little march of new skin cells to the top of the epidermis where they ultimately meet their demise and slough off. This march of doom can take anywhere from 14 days (in our infancy) to months and months (in old age). The typical span being about 30-40 days for us 30-50 something’s. The trick to luminous, tight and youthful looking skin is to decrease the time that new skin cells spend marching to their death and hanging out on our faces.

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Microdermabrasion is great little way to get the blood flowing to the surface of the skin and get some fairly hard core exfoliation going for you. Ease your feet into the deep pool of anti-aging addictions by trying this little gem of a treatment first. I love microdermabrasion for any one that has healthy but dull skin or very light and superficial acne scarring. If you have redness, irritation, rosacea, broken capillaries, or a great disdain for following a treatment protocol of every 3-4 weeks for at least six treatments, then this is not a good option for you. Retin A users beware, while I don’t recommend microdermabrasion for you (remember that whole lipid barrier discussion on the sonic cleansing post), you must at least go off of your Retin A 3-4 days before a treatment.

Chemical peels are for folks that want to amp up their beauty routine. Chemical peels, unlike microdermabrasion, can really be customized as far as the depth of the peel and ingredients used to address the concern (wrinkling, irregular color etc.). Superficial, medium depth and deep chemical peels are available with a variety of additives that sucker punch anything from melasma (pregnancy mask) to acne and those, near to the heart, fine lines and wrinkles. Please see this post on glycolic acid peels if you want a little more information on peeling.

Your Dangerous Love Affair: The Sonic Cleansing Brush.

How could this miracle cleansing tool that leaves you with baby soft skin be back biting you?! How completely satisfying is it to get in the hot steamy shower with your sonic cleansing brush and step out with the smoothest skin of your life? There is no denying the outright allure of that little device. Some companies recommend using the brush to cleanse your delicate little face two times a day, and many of my clients are at least avid once a day users. But there is an ugly and dark side to the sonic addiction. I have clients that come to me with red irritated skin, acne flair ups and cystic pimples. After investigating for culprits, the one common factor is that they all are having a dangerous love affair with their cleansing brush! Here is why my clients are forbidden from using any cleansing brush more than 1-2 times a week:

You know me; there will be an anatomy lesson to be sure!

The top layer of skin, (aka Stratum Corneum) is made up of fats, cholesterol, water and protein. It retains moisture for you and protects you from bacteria, elements, and shriveling up like a prune. We call it the lipid barrier.

Once that lipid barrier breaks down, you start losing moisture (trans epidermal water loss aka. TEWL), your skin gets inflamed and red, bacteria can fight its way into the skin, and you may develop a rash or acne flair up. This is EXACTLY what happens when many people use their sonic brush every single day.

The beloved sonic brush is day after day breaking down that lipid barrier and causing water loss. While I have noticed that there are some skin types that can tolerate the brush (thick and very oily skin types), most can only afford to use the brush once or twice a week.

So, my friends, I encourage you to break up with your sonic brush. Bring it out only once or twice a week at most, and be sure to replace the lipid barrier with great emollient (replaces lipids) moisturizer.

I've had it with you!

I have had it with you!

So what do I tell my suffering folks that have already messed up their lipid barrier with overzealous sonic cleansing?

1. Stop using the tawdry sonic brush altogether for at least 2 weeks

2. Stop using all actives (retinoids, glycolics etc.)…on a side note if you are using tretinoin (renova, retin a) please throw away the sonic brush it will eat your face off.

2. Use a gentle creamy cleanser that is free of my most hated ingredient SLS (sodium laureth sulfate)

3. For two weeks switch your moisturizer to an emollient cream that will replace the lipid barrier such as Oxygenetix moisturizer (my personal go to) or CeraVe over the counter

4. Lactic acid has been shown to help barrier function and increase fatty acids so use a gentle lactic acid toner or serum like PCA’s Nutrient Toner once daily.

Don’t hide behind the mask. Melasma do’s and don’ts.

It’s known as the “mask of pregnancy”,  but it very well could be called the “mask of contraception” or the “mask of hormonal outrage”.  Melasma is dark pigmented patches of skin that plague the faces of a good quarter or more of my clients.  It’s a rare day that passes when I don’t have a gal in my chair lamenting her lost even skin tone. Melasma is one of the medical community’s annoying oddities that no one can quite figure out.   This small detail makes it a bit of a challenge to wipe off the face of the planet…..or at least off of your face. We do know that it is hormone related and that sun exposure makes it much worse.  Dark pigment in the skin is produced by overactive melanocytes (small cells that create pigment in our skin).   One of the first things my clients want to do is laser their faces off in hopes of destroying the malicious pigment.  Lasers may not always be the best option.  The trick to lifting the mask is removing the top layers of pigmented skin (microdermabrasion, retinoids, and/ or chemical peels) and suppressing the melanocyte that is producing the brown spots with tyrosinase inhibitors (hydroquinone, kojic acid).  Here are my top do’s and don’ts when fighting melasma:

  1. Don’t spend hundreds of dollars on skin care and treatments and then slather on sub par sunscreen, or worse forget it entirely.
  2. Do think of sunscreen as your first line of defense.  Sunscreen keeps the skin from sustaining as much “injury” from the sun.  (Melasma is made worse by stimulation of melanocytes, which are the cells that produce pigment!) follow me?  Apply your sunscreen every 2 hours when out in the sun.  I’m obsessed with Colorscience’s powdered sunscreen.
  3. Don’t hang out in the sauna or hot tub.  Studies show that heat can cause the melanocytes to rear their ugly heads and start to pump out extra pigment.
  4. Do get religious about your skin care routine.  Consistency is key when applying skin lightening products so don’t go to bed without dousing yourself in the creams your skin care professional recommends.
  5. Do add in the gold standards for treating pigment: tretinoin + hydroquinone + vitamin c.  You can alternatively look for non prescription products that have retinols, kojic acid, alpha hydroxy acids.  It’s going to take 3-6 months to see a big change either way.
  6. Don’t jump right in to photofacials or IPL.  Studies show that melasma can be made worse following these treatments.  In my personal practice, photofacials tend to offer minimal benefits and carry too much risk for melasma.
  7. Do  try the safer medium depth chemical peels that are on the market today.  My personal favorite is the VI Peel.  It will make you peel like a snake and even out your skin by lifting off surface pigment.  You’ll still need your skin care products but peeling makes the process move along much faster.

    before/after Vi Peel

 

What is in a Smashing Skin Care Routine?

Skin care.  Sounds easy enough.  Slather on lotions, creams, serums and sunscreens in hopes of slowing down the heavy hand of age, and hope for the best.  Hope for the best? Hope is not exactly who I want in the ring as I fight off father time.  I want heavy hitters and appropriate ingredients that will help me maintain my dewy fresh skin and make my foes a little jealous!  Enter the routine:

Cleanse-  Your cleanser needs to be chosen based on your skin quality: Are you Oily, Dry, Sensitive, or combination.  Dry skin tends to do well with creamy cleansers.  Oily and problem skin does well with low PH washes and lactic acid.  Sensitive skin does best with very mild cleansers with calming ingredients.

Exfoliate- Only the finest of exfoliants should come in contact with your precious face.  Steer clear of coarse grainy exfoliators such as St. Ives.  These particles nick the skin and cause irritation and redness. Choose exfoliants that are gentle and only use them up to 3 times weekly.  Also build in retinoids at night and/ or glycolic acid as daily chemical exfoliators (to be used after toning).  The best approach is to allow your dermatologist, nurse, or esthetician assist you in choosing exfoliation appropriate to your skin type and quality.

Tone- this step restores the PH balance of the skin and  prepares your skin for the absorption of other ingredients.

Treat- Remember “clear before creamy!” The order of application is very important! Serums, gels, creamy serums, lotions, then creams for best penetration!

Moisturize- acts as a barrier.  petroleum is not the most popular kid in class, but this heavy-duty moisturizer is a must for dry skin.  Water based formulas that are non-comedegenic are best for oily skin.  Sensitive skin formulas should contain chamomile, bisabolol, or green tea and clay.

Protect- look for a sunscreen that is at least SPF 30 and Zinc or Titanium based, and don’t skimp!  Sunscreen is the single most important product in your arsenal.  Every single day, you must put on sunscreen no matter if you plan to be outside or not. My clients hide from me if they have a tan or sun burn because I threaten bodily harm:)

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My Skin:  Oily, sensitive, acne prone.

My Routine:  I am a skin care junkie, but no matter what I rotate in or out of my routine this is what I end up going back to.

Day: Obagi- Rosaclear Gentle Cleanser, Obagi- Toner, PCA Rejuvenation Serum, Obai C-serum 10% (only around my eyes) followed by IS Youth Eye Serum, Obagi Rosaclear Calming Hydrator, PCA Perfecting Proctection SPF 30.

Night: Obagi- Rosaclear Gentle Cleanser, Obagi- Toner, tretinoin 0.25%, Obagi Rosaclear Calming Hydrator

Weekly: PCA gentle exfoliant 3 times weekly

Monthly: Facial with extractions

Yearly: VI Peel 2-3 times a year

Day 2 of my 3rd VI Peel of the year. ~

Those squirly fine lines don’t stand a chance!

You can Botox that gorgeous face till the cows come home, but you won’t see those static lines going away anytime soon.  Static lines are the squirly little fine lines that are visible when you aren’t using your muscles to make a facial expression.  They typically show up in your 30s but can grace you with their presence as early as your twenties.   There is no reason to wave that white flag when you start seeing these feisty lines of fury.  Enter the big guns.  With the invention of tretinoin, chemical peels, and fractionated resurfacing, those babies don’t stand a chance!  When deciding which strong arm to bring into the rink against fine lines, you have to keep your schedule in mind.  Not every resurfacing method is created equal when it comes to beauty down time.  Tretinoin is a cream that resurfaces slowly over time.  You may have some minor flaking, but no real down time.  Chemical peels take about 3-5 to run their course of shedding.  You will have anywhere from light flaking to peeling like a snake depending on your peel choice.  Then finally there is the laser peel with fractionated resurfacing.  Enter the Pixel.  The Pixel resurfaces the skin by lasering tiny channels into the skin leaving a majority of the skin untouched and healthy.  Beauty down time is only about 3-4 days, and you get the benefits of stopping those fine lines, dark spots, and loose skin in only 2-3 treatments.

Glycolic Acid for celebrity perfect skin….ahem minus the photoshop wizard.

Glycolic acid has the very desirable talent of “softening” fine lines (that is esthetician and nurse speak for:  Don’t even think it’s going to eradicate ALL of those wrinkles).  Sun damage and the faux mustache known as “melasma” is also nipped in the bud.  This is done over a series of treatments, and  I typically will recommend anywhere from 6-8 peels, spaced around 3-4 weeks apart with 40-60% glycolic acid.   Chemical peeling of any type dissolves the desmosomes (sticky glue) that hold the skin cells together.  These peels also strip lipids that make up the acid mantel that protects us from bacterial invasions and dry skin, so you must replace what you take away.  Following a peel,  a rich anti-inflammatory moisturizer should be part of your recovery with a healthy fat dollop of sunscreen.  Stay off the actives that you have bought and use religiously because you are a very well-educated DermaDarling follower for 7-10 days  (vitamin c, AHAs, retinol, and hydroquinone) .  The peels range in price from $120- 250 each depending on your city. I would highly recommend getting a package of 6 to save some cash, since you know you are going to have to have more than one.   Glycolic acid should be a considered addition to your bag of tricks for smooth gorgeous skin.  Celebrities rumored to be fans of Glycolic acid: Cher, Janice Dickenson, Naomi Campbell.

You are not a candidate for a glycolic peel if:

You have sensitive skin

You want instant results

You want no social “downtime”

You want nothing less than a blooming miracle

You are standing in front of the counter at the nail salon asking about their LivingSocial glycolic acid discount

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I will be teaching an advanced chemical peel course at the Elaine Sterling Institute the first week in November.  For more information on how you can advance your esthetic career please call ESI at 1-877-233-5246