Archive for December, 2010

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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When I started exploring anti-aging options I really wasn’t aware that my neck looked, well looked old.  After I  used   tools  like  Retin A and IPL, I could see a big difference between the texture and color between my neck and face– as if  I was wearing a heavy foundation.  On the neck there was that bumpy “chicken skin”, thick horizontal lines and lots of fine lines.  I’ve been using Retin A and sunscreen on my neck but apparently its nowhere near as effective for the neck.  Not good news.  

There is a short list of anti-aging tools for the neck.  Top of the list is the full facelift ( Check out recent pix of Madonna.  Some experts believe that she   has had a facelift because  her neck  is as  smooth and tight as a women half her age.)  Botox  can relax the vertical cords while fillers can deal with the horizontal lines.  But  I’m not   ready to do these things  now.  Truthfully I cringe at the thought of injecting stuff  into my neck. 

  I had decided to rely on Hermes scarves and a great personality and ignore  my neck issues.  But when Dr Prasad said Pelleve can benefit  my neck, I was in.  Painless, effective and no needles– my favorite kind of treatment.    Here is  the neck  three weeks after Pelleve photo.   The skin looks less bumpy and less lined.  As on the face there is a subtle refinement of skin quality.  Its  not tight and perfect like Madonna’s, but  I like what I see.  I’m wearing scarves  now because its freezing, not because I have to.

FYI:  We did not work  on loose skin just under the chin  and that looks pretty much the same.   I’m planning on another Pelleve treatment to deal with that area.  I’m brown bagging lunch in earnest to put aside cash for the treatment. Does anyone have  interesting sandwhich ideas?

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Here are the pix I took before  and three weeks after my Pelleve procedure. To my eye there is a visible difference in contours of the face.   The smile  lines are not as deep   and  my jaw line a little tighter.   I don’t look in my twenties or  even in my thirties– but to my eye I just look more like the person I remember. 

I really like these subtle changes  much more than the  more drastic changes of a full face CO2 laser.  While that bad boy can erase decades of  lines, wrinkles and age spots, I find  the post -laser face looks waxy with a  pale  shiny appearance.  Its the  strange face you see on some of the women on The Real Housewives of You  Name the City.


Because Pelleve does not affect the surface of the skin,  you do not need to change your skin care routinue.  I was able to do  the  Retin A and my regular  sunscreen  routine the  next day.   While  its safe, painless and provides quick results, Pelleve  has one drawback– its expensive.  A full face treatment is $1800, a specific area is $900 and  usually 2-3 treatments are needed.  But I believe that its something worth saving for.  For example, brown bagging   lunch saves at least $10/day.  In three months that’s $650.  Cut back on one dinner out a week ( @$30/meal) and you save another $360. 

                                                                                                                AFTER PELLEVE

In six months, you’ll  have the cash  for two regional treatments– and probably  saved enough calories to drop a few holiday pounds. 

One final thought.  Most of the comments  and questions I get are from women in their twenties and  thirties who are concerned about  preventing aging.   I’m not that comfortable  recommending  high octane  anti-aging tools at such a  young age– I mean    you need to save a little something for menopause. By contrast,  it turns out that Pelleve’s subtle changes are  an excellent option  for thirtysomethings.  A  neighbor who is in her late thirties and pregnant with her third child,  is looking forward  to her post pregnancy Pelleve treatment.  It makes a perfect ‘push present’.

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These photographs were taken  at the time of my first treatment with Dr Prasad. ( Before on the left and after on the right)  I was a little disappinted that the changes that I saw in the  mirror were not completely captured in these pix.  I saw “girlish” contours that had  been missing for  many years.  Pelleve changes are in millimeters while surgical facelifts alter centimeters of facial contours.  Personally I much prefer the subtle changes  of  less invasive procedures, rather than the unaturally tight and altered appearance of a full face lift.

According to Dr Prasad, Pelleve  helps to restore volume and reduces  crow’s feet around the eyes and smokers lines around the mouth.  I don’t have the latter two problems,  but  by adding volume to the understructure of my lower face, it lifted the shape and reduced  sagging.   Most doctors  recommend 2-4 Pelleve treatments given a month apart.  You can expect these improvements to last  up to 2 years. 

One more fact.  Pelleve is also one of the few anti-aging tools that can be used safely by women of color.  Lasers, IPL and even some forms of Retin A can all lead to  irregular and splotchy dark patches on the skin.  Sub-ablative radio frequency ( the technical name for Pelleve)  because it does not affect the surface of the face, can be confidently and effectively used by women with darker complexions.

The benefits  of Pelleve are supposed to increase in the next few weeks after the procedure.  On Monday I will post before and three week after  photos.  I’ll be really interested to hear if you see the differences I perceive or  if I am just delusional.

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Dealing with the Sags and Bags

I have been on Retin A for over a year, fried off   facial hair and blasted away age spots with lasers and IPL. The surface looks great, but now I am ready to take on the bagging and sagging on my face.  The gold standard for lifting and tightening  is the full facelight  and/ or the CO2 laser– two steps I am nowhere near ready for.

I researched other options, and when I heard about Pelleve, I wondered if it was the anti-aging  tool I was looking for.  Pelleve is FDA approved for ” skin tightening for mild to moderate lines and wrinkles” ( FDA’s words,not mine).  It uses radio frequency to gently heat the lower layers of the skin to tighten existing collagen as well as encourage new collagen growth.  Lasers also tighten the skin, but leave you looking like a burn victim for 2-4 weeks during the healing process.  And I’m a slow healer.  Like most of us I don’t have  two days for downtime, much less than two weeks.  In addition ( and there is no way to sound cool about this) lasers hurt and I am a coward.

Pelleve operates in the lower layers of the skin and spares the surface, so  there is no change in color or texture.  So no downtime.  And when I heard  that Pelleve is  painless, I was in.  Like every  anti-aging procedure, its important to find  an expert in the technique, and through colleagues in the beauty field I  got an appointment with Dr  Amiya Prasad, who has offices both in Manhattan and Long Island. An occular and cosmetic surgeon, Dr Prasad (www.drprasad.com)   is one of the top experts on Pelleve.  While he believes that  nothing can match the benefits of a full facelift, he recognizes that most women today  do not want to invest the time ( and money) for a full lift.  He has found that Pelleve treatments give a patient enough of a change to make them happy.  In my  conference with him, I was especially impressed that he did not  try to oversell the benefits of  any anti-aging treatment. 

Before he began, Dr Prasad took a series of before and after photos, including a Reveal photo that showed the areas of sun damage.  Dr Prasad, who is the author of  ‘The Fine Art of Looking Younger” showed me where the IPL had eliminated some problems.  Then Dr Prasad’s RN technician went to work.  First she applied a layer of ultrasouund gel and began moving the wand across acorss my face.  I had told her that I was interested in dealing with the aging  along my chin and my  neck.  She focused on one area  at a time, making 15-20 passes in each series.  The wand grew warmer, but never uncomfortable.  The entire procedure took one hour.

I couldn’t wait to see the results.  My skin felt a little  tight and I looked a bit rosy. When I looked in the mirror, I saw something I hadn’t seen in years– the girl I remembered. 

Coming up on Friday– My Pelleve Before and  After Photos

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I have to confess that I  felt pretty smug about following the NHANES  anti-aging data and started to meet  the recommended 5-7 daily servings of fruits and vegetables.  Given that the study linked high levels of vitamin C to  fewer wrinkles I was convinced I was on the right track. My sense of accomplishment was rattled  when I read that vegetarians  can have  higher levels of pesticides in their body because  they eat more  produce.  Not what I wanted to hear.   The article suggested that vegans and vegetarians eat organic foods, grown without pesticides to  get the health benefits of increased intake of fruits  and veggies without risk of additional chemicals.

Sounds reasonable but organic foods are significantly more expensive  than traditionaly grown  fruits and vegetables.  In my local market organic carrots are $2.29/lb while regular carrots are just 90cents/lb.  Organic  yams are $1.49/lb while their comon cousins are 99 cents/lb.  Similarly onions are $1.99/lb, while regular onions are $1.29. On average, organic fruits and vegetables are at least 30%  higher.  Its  bad enough for one person, but for a family of four, it can become real money.

I was stumped until I found a shopping guide from  The Environmental Working Group.  They identified “The Dirty Dozen” — the 12  types of produce highest in pesticides and the cleanest 12 with the lowest levels.  Makes sense.   This list  decodes which  organic foods  are a smart idea — and those instances where its not necessary.  In other words, spend the extra money  where there  is a potential helth benefit  and save cash  where organics don’t offer an extra value.

The Dirty Dozen

* Peaches

* Apples

*Sweet Bell Peppers

* Celery

* Necterines



* Grapes ( imported)




Clean and Lean

* Onions

* Avocodo

* Frozen corn


* Mango

*Frozen peas

* Asparagus

* Kiwi


* Cabbage


* Eggplant

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 Last week I went to the annual Mount Sinai Advances in Dermatology Conference in NYC.  Begun over a decade ago as a local meeting, doctors now come from all over the world to hear  state of the art developments from the best and brightest in dermatology.  It is the creation of  Park Avenue dermatologist Albert Lefkovits– who by the way  has taken care of my daughters since they were teenagers.  He is such a good derm that I actually got flowers from a co-worker to thank me for recommending him.

By the end of the three day  meeting, I finally understood the difference between Sculptra, Radiesse, and Juvaderm, learned about the new sunscreen guidelines, and heard about  ways to deal with adult acne that  improves both breakouts  and skin aging.  Awesome!

I even found out about two new FDA approved  therapies  that hadn’t even been on my radar.  The first, Photodynamic Therapy, the skin is  pretreated with medication and then exposed to red and blue lights of varying wavelengths.  It is used for aging, acne  and brown age spots.  It sounds great, but I wonder if anyone  has  used it.  I’d love to hear about your experiences.

The second new anti-aging techique goes by the  tongue-numbing name of Sub-Ablative Radio Frequency.  It is a laser that does not affect the surface of the skin, but makes improvements in the lower architecture.  I was so impressed with the results, I made an appointment to get  it done. I’ve always been hesitant to use lasers since the skin looks raw and red for at least a week.  When I  lasered the freckles on my face, a three year old pointed a finger at me and  said ” Clownie?  When I lasered the  brown spots on my hand, a  women asked if they were bed bug bits.    With this new laser, all the effects are below the skin’s surface, so you look better, not redder.

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