Botox or Laser- Which is Better?

Question:  My Mom  reads your blog and  has been talking about getting Botox  or the “lunchtime laser.”  I want to get  her a treatment for Christmas but don’t know which one to choose.  I can afford  only one  and I want  her to see the biggest results.

Answer:  What a great question and you’re a great daughter! Both  Botox and  Intense Pulsed Light  laser  ( also known as the lunchtime laser) will make a major  difference in her appearance.  The choice depends on the condition of her skin.  If she has spent many  happy hours in the sun, its likely that she has lots of freckles and dark patches.  An Intense Pulsed Light treatment  will literally vaporize this aging pigmentation and leave her skin younger and refreshed.  The results are permanent but brown spots will return if she goes out without sun protection.  If she was not a beach bunny and  her skin  has   lines along the cheeks, forehead and  and around the eyes, Botox will erase them– for about 3-4 months.   Because lasers leave the skin extra sensitive for a few days,  you can also give her a stocking  filled with a gentle cleanser ( eg Cetaphil), sunscreen ( Neutrogena for Sensitive Skin)  and soothing water spray ( eg Dermalogica UltraCalming Spray).

The Right Tool  at the Right Time

Which anti-aging tool to use  and when to use it  was the fundamental question   behind the No-Nonsense Beauty Blog.   Initially, I planned to start with  Retin A  to reve up the circulation and skin growth, add Botox to reduce lines and polish things up by removing  large freckles and age spots with a laser.  But  as it turned out,  lasers work best on darkest spots, so I started the anti-aging journey  by removing them with a   traditional laser and then continuing with  my  plan. 

But in the past  few years since I started, there have been so  many new options  that  my new plan has become  an exploration  of new forms of Retin A, new lasers and new machines that  deal  both singly and in combination with a slew of aging issues.  At a recent dermatology  conference at Mount Sinai, the experts  came up with an effective anti-aging game plan  that started with   gentle lasers like Intense Pulsed Light  to brighten and Botox to smooth the skin.

I’d love to hear which treatment you chose.  Happy holidays!

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An Apple A Day Keeps Wrinkles Away

The NHANES study which looked at the links between nutrition and health  included a section that  reviewed  diet and skin aging.   One finding  showed  people whose diets were higher in fiber had fewer lines and wrinkles.  Nice to know, but the question is why?  One theory is that fiber helps control blood sugar levels.  Its those spikes in sugar that set off a series of events that ultimately damage collagen and impede growth of new strong healthy collagen.  And its collagen of course that is so important in keep the skin smooth and  freee of lines and wrinkles.

Current guidelines reccommend  20-30 grams of daily fiber from fruits, vegetables and whole grains.  ( And this figure is 2-3X  the 10 grams a day that  most Americans consume a day).  However,  many   high fiber grains are  also very high in carbohydrates–  which then triggers aging high blood sugars.  The good news is that  each serving of   fruits and vegetables  delivers 2-3 grams of  fiber.  And if you follow the 4-5 daily servings of fruits and veggies, plus 2-3 servings of whole grains and you’ve more than met  great nutritional requirements– without raising blood sugar.

Check out the chart to help you plan fiber healthy menus.  This chart gave me new respect for  apples.  It has a generous payload of fiber and is super high in vitamin C–  the vitamin most closely  linked to  smooth youthful skin.  A daily apple is a true beauty food.

Fiber Rich Foods

* 1 apple —————-3.2 grams

* 1 cup bran ————18grams

* 3/4 cup cantaloupe -1.4 grams

* 1 raw carrot———–3.7 grms

* 2 stalks celery———2.0 grams

3/4 cup corn kernals—4.2 grams

3/4 cup cabbage——–2.1 grams

1/2 cup lentils———–4.0 grams

1 pear———————2.8 grams

1/2 cup strawberries—2.6 grams

1 slice  wheat bread—- 2.2 grams

1 zucchini—————-3.o grams

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Getting Back The Pretty

At the recent Mount Sinai derm conference Dr Marmur explored the beauty imperative of what  makes a man or woman attrctive.  For men its fairly simple — a strong jaw ( think Superman) and broad shoulders immediatey convey appealing masculinity.  For women, its more complicated.

Dr Marmur identifed the five features of femininity that are deemed appealing– full lips, big eyes, small nose, arched eyebrows, and smooth rounded forehead.  (Think Byonce, a young Liz Taylor  and Bratz dolls).  What  blew me away was that as we grow older we lose those signs of pretty femininity.  The forehead becomes lined  and bone loss at the temples  makes the eyes look smaller.  It doesn’t stop there.  Collagen contracts in the nose  making the tip to droop down and look longer.  As gravity drags the face down, the jaw becomes wider, making the face  look more masculine.  So in addition to age spots, lines and grey hair, the loss of the pretty makes us look older than we feel.  But this  is not all bad news.  Dr Marmur uses these five  femininity signsposts to guide her approach to anti-aging plans  for her patients.  “For example, to restore feminine balance, I use Botox or Dysport to lift eyebrows and smooth out forehead lines.  I add fillers to the temples to make the eyes look larger and  the chin look more delicate”  All of these are actually very small changes, but make a distinct difference in a woman’s appearance.

Dr Marmur and other doctors demonstrated these techniques  at the live patients demonstration and it was fascinating to watch them work.  I had just thought of fillers and Botox as a way to erase wrinkles and fill in lines.  But its much more complex than that and  watching these masters work, it became clear  that its important to have a doctor who really understands facial anatomy– and to know where to place “tox”  and fillers to get  back the pretty.

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The Link Between Health and Beauty

During the holidays, I went to an event hosted by The Three Tomtoes (thethreetomatoes.com), a great  site that is aimed  at women  “who aren’t kids”.  As I  looked around, I could see  the room was filled with attractive women.  Not so long ago women over  50 were described as “aging”  Today 50 plus women are dynamic, vital and sexy.  But this was not just a room of Botox Babes.  There was  something more, much more.

When I mentioned  to my physician husband how healthy and attractive the women looked at the party, Neil was  not surprised. “Women today look better because they are healthier.  They eat healthier, smoke less, exercise more and if health probems arise, we have new tools.”

Health care advances have changed the landscape of middle age.  For example, common medications for heart  problems preserve the circulatory system.  When the body gets enough oxygen  and nutrition, it can repair itself.  For the skin, this means  more collagen, better skin tone and fewer wrinkles.  Before the days of drugs like beta-blockers and ACE inhibitors, heart and blood pressure problems caused  a characteristic  ashen pallor, slack skin and a diminished lifestyle.  Today these once devestating heart  problems are far less frequent due to changes in lifestyle and health care.

I also thought back to my childhood when the mother  of my best friend Peggy developed lupus.  I was only eight yet I could see how she changed from a lively women to a pale, gaunt shadow of herself.  By comparison a co-worker with lupus has remained an chic and energetic women with a full calendar of work, friends and travel.  The difference?  Advances in treatment  have changed lupus from  relentlessly progressive disease into a chronic but usually mangeable  condition.

Its wonderful to know that the changes that I see in my tribe  are more than cosmetic.

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New Year, New Retin A

I finally got  my new Retin A this week and I’m lovin it.  To recap my Retin A adventures, I  had been using .04% Retin A  micro with wonderful results.  Its the lowest dose of  one of the gentlest forms  of tretinoin and I got good results  without too much discomfort. After about 10 months, I noticed that  I no longer could see  that characteristic yourthful glow you get with Retin A  and  realized  it was time to move up to the next level.  Dr Marmur gave me a prescription for.1%  Retin A– the  turbo powered one, not the micro-sphere stuff.  And here is where I went rogue.  In my local CVS, brand name Retin A was about $200.  I decided to order a generic version from Canada for $40.  I was so proud of all the money I saved.

When my bargain Retin A arrived, I was a  concerned that  it was yellow, not white, but I had faith in the label.  Concerned that  it would be too irritating, I used   a dab every other day for a week.  Nothing happened.  Then I used it every night.  Nothing.  I used two dabs.  Nothing.  I used it for a  month and while I didn’t get irritated, I didn’t see the lovely “pinking”   that I developed with  Retin A  Micro.   I even tried it under my eye.  Nothing.  I did everything but spread it on toast and eat it.  I don’t know what is in this yellow goo, but its not an effective Retin-A.

For my holiday present, I bought myself  .1% Retin A micro.  At $269 at my pharmacy, it was a commitment.  It turned out to be the right choice.  Within a week, I’ve got a little glow again.  I’m still using it every other day without flaking and redness.  My skin feels tight after washing — a signal to keep taking things easy– but I’m back in a good Retin A routinue. 

I’ve used  so many anti-aging tools, I’m running out of body parts.  Its going to get difficult   see  what procedure or product is  responsible  for changes.   That’s why I am so excited that a good friend  has volunteered to join me on this anti-aging exploration.  First  treatment, IPL for the brown spots on her hands.  I used  lasers and we can see  what a different approach can do.   Have a wonderful New Year!

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Trading Up My Retin A

I’ve noticed that my skin had become very comfortable with  my .o4% Retin A Micro– maybe too comfortable.  It didn’t sting when I applied it right after washing my face, and I didn’t  see as much of the the rosy glow. After seven months of almost daily use, it  was time to graduate to a stronger version.  Dr Marmur gave  me a script for .1% Retin-A cream.  This is considerably stronger not only in concentration but in formulation as well.  It is also considerably cheaper.

Since Retin-A is now off- patent and there are generic versions, the prices  are lower, even in a US pharmacy.  A standard tube of branded Retin A is $129 at my local  Duane Reade. At my online Canadian pharmacy, I have two choices:

1.  Generic Retin A, which is labeled Tretinion,  is about $43 for about 40 grams ( about 1.5  oz) and made in Canada.

2. Branded  Retin A, is about the same  price for  a few grams  more is $45 and  made in Barbados.  The name on the tube  is not  Retin A,  but something like Epidure. Its very common  for a product made in a different country to have a comepletely different name, but I don’t love it. 

The procedure is simple.  I need to fax the prescription to the pharmacy and give them my credit card number ( they don’t take American Express).  I should have my new anti-ager within two weeks.  I  am using CanadaDrugs.com which was great to work with when I ordered Tri-luma.  However in that case  I had to mail the prescription to them and the total process took more than a month. 

The savings on my new Retin A prescription are impressive.  Retin A Micro is about $300/tube.  Generic Retin A from Canada is about $43– more than 70% cheaper.  This is less than some  anti-aging  treatment products on drug store shelves!  I’m a little nervous both about using generic forms and using products made outside the US.  I would love to hear about others experience with generic Retin A.  Are these generics  less effective?  More irritating? 

If   I can  get these Retin A savings, I will still have enough  leftover for an end of the summer micro-dermabrasion.

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Stubborn Dark Circles

I have been using two eye care products for about a month and neither has made a visible difference. In the morning I applied a roller with caffeine and at night I used a cream with AHA’s.   My shadows are still there and the slight bagging under the eyes  actually seems a bit worse. So when a dramatic looking package at Sephora  caught my attention, I was hooked.  Called Hylexin,  the box had a photo of  a young woman  with a football players black smudge under  her eye.  The box copy said that this product was for’serious dark circles’ (hence the name) and not for dark circles  that  ’pop up in the morning and are gone by breakfast ’ . 

Directions on the box said  to do a patch test on my arm.  I opened the tube and was rocked back by a heavy fragrance.  I hesitated a moment, took a breath and applied a small amount on my  arm.  Very quickly the spot  felt warm and a bit itchy.  I opened the brochure to read more about Hylexin, but instead of information about the product, it was an flyer for other products from the manufacturer.  Apparently the company was very proud of an item  called ” Boob Job in a Box” .  I don’t know about you, but I have a problem  taking  skin care advice from a company that  sells “Boob Job in a Box”.  Between the  heavy perfume, itchy patch test  and the Boob Job thing, I decided that I did not want to put this product anywhere near my eyes.  I packed it  up, found my sales slip  and plan to take it back today for a refund.

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Allergies and Aging

We all know that spring allergies can make us sneeze and itch– but did  you know spring allergies can make you look older?  Seasonal allergies produce daily inflammation that trigger dark circles under the eyes.  Blood vessels swell and leak fluid that pool under the eyes.  The result?  Eyes become puffy and swollen.  A bad allergy season  can lead to permanent  bags  and wrinkles under the eyes. 

With seasonal allergies, the  best offense is a strong defense.  When you see the trees and flowers blooming, start taking a daily non -sedating anti histamine like Zyrtec  or Claritin. Your body needs  several weeks  to build up allergy- fighting levels of medication for the months of pollen heavy air  that are coming.

Make you own home  an allergen-free zone.  To keep pollen from building up inside, close windows and turn on the A/C.  If you wake up with swollen eyes and congestion, try to eliminate stuff that attracts  pollen and dust — thick rugs, heavy drapes and the well-named dust ruffle.  (Actually it should  be called  a ‘dust magnet’).  In the morning use a saline nasal spray to prevent build-up of fluid that will quickly lead to puffy eye bags.  When  you come home after work or school, leave shoes outside to avoid tracking in dirt and pollen.  Two hours before bedtime, turn on a HEPA style air filter to clean the environment  that you will be breathing all night long.

This might sound like  alot of work  but its so worth it. Many women who seem to age faster  just  have uncontrolled seasonal  allergies.

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This Is Not Your Mothers’ Retin A

I went to  a wedding recently and caught up with old friends who  I had not seen in about a year.  They all told me how  great I looked– rested,  healthy and radiant were  words that  they tossed at me.  But when I shared with them that  that my “glow”   was due to Retin A  they shuddered and   declared  they would not use it.  

 Although most dermatologists  believe that Retin A  is the foundation of anti-aging  skin care, so  many women are resistant to using it.  I think  that  they may  have  used the original formulation which was terribly irritating.  When it was first  introduced, I ran out and bought a tube  and it felt like I was using paint remover on my skin.  Today  the newer formulations are  light years  milder  and yet more effective.  If you used Retin A in the past and didn’t  like it,  you owe it to your skin to try it again.   Just remember to include  a mild cleanser and a daily sunscreen in  your Retin A   skin care routine

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It’s True! Stress can Make You Look Older

I know that stress is linked to  increased risk of heart disease, high blood perssure and even diabetes.  But can it cause wrinkles?  Pale skin color?  Saggy skin? I’m a science geek ( I went to Bronx High School of  Science)  and I need  a solid explanation that such a cause and effect does exist.

And here it is. Stress which can  range from  a traffic  jam  to a bad break-up, triggers a firestorm of  hormones in the body.  The worst of these  bad boys is cortisol   which causes problems everywhere it shows up.  Cortisol not only damages existing collagen,  it  shuts down  growth  of healthy new collagen and elastin.   The result? An increase in lines, wrinkles and flabby skin.  And wait, there’s more.  Cortisol slows down circulation which makes   your skin look pale and dull.

Short periods of stress  such as a  long line at Starbucks or a bad haircut are frustating, but not the type of stress that adds age to your years.  It’s the chronic stress like  job loss, a sub prime mortgage or a painful divorce  that  can visably age you in a matter of months.  There are many situations in life we can’t control, but we can change how our body reponds to them.

Turns out that interrupting  the cycle of stress “fools”  the body into relaxing.  This breaks  the flood of cortisol and allows  the body chemistry to stabilize.  This is the theory behind stress management.  Yoga, exercise and meditation are time honored  suggestions  for  shutting off cortisol production– but anything  you do which  you enjoy will have the same beneficial  effect.   Painting,  collecting things like coins,  meeting up with friends,  or reading a juicy novel,  will short circuit  the aging stress hormones.   I could never get the hang of breathing exercises or meditation, but I love cooking.    I love to plan, shop for and then cook big meals for friends and family.  Time passes happily as  I wander through  aisles of vegetables and take them  home to be chopped, sauted and served. I can feel  the problems of the day fade away as I work  in my kitchen.  And now I know its not only dinner, its an anti-wrinkle strategy.

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