Q&A logoQuestion:   How much SPF do I need to use  in the summer?  My favorite  foundation has  a 15SPF which I know is pretty low.  If I  also use a moisturizer with a 15SPF  will  that bring my protection to a 30 SPF?

Answer:  You’re righ,t a 15 SPF  is pretty low, but adding  another product with a 15 SPF will not give you a 30SPF.  Its not fair but the math on sunscren products  are not cumulative.  Your final SPF  will only be the  highest SPF you are using.  In this case, the final SPF  will still be 15.  If you use a moisturizer with a 30SPF  you final SPF will  be able  to face  the sun with a  very respectable 30 SPF.

Please  keep in mind that  the SPF numbers  are just an indication of how long you can stay in the sun without burning.   A 30 SPF means that you can stay in the sun  for 30 minutes without sundamage.  However these calculations were done in the laboratory and  made on the assumption that   at least  two teaspoons of sunblock  is  used on the face and  1-2 tablespoons are used on the body. I decided to put these  standards to the test and the results were both funny and troubling.  Clearly  few if anyone actually  use  the prescribed amount of sunblock  and   we often fail to reapply  during the day.  This means that   the SPF which we  have to  face the sun is much lower than  we think.  For that reason I recommend using at least an SF30 and in the summer aim for a 50 SPF.  During the day I dust on a mineral sunscreen powder like Brush On Block by Susan Posnick.  I can apply it over foundation  to  boost  sun protection.

One final thought.  If you have sensitive skin, rosacea, psoriasis you might find  chemical sunscreens too irritating.   Look for broad spectrum physical sunscreens that get their  sun block powers from minerals like  zinc oxide or titanium dioxide.


layer cakeI just spent   four days at three different   beauty conferences.   There were probably over 100 vendors with  lines of at least twenty products each.  So  many products, only one small face.   At many of the counters,   I was urged to use  4-5 products at a time, each one promising   different benefits.  

But the skin is not like a layer cake with each new layer adding  more and better flavors.   The reason  that  the body is covered with skin is to protect the internal structures  like the  heart, muscles and  brain.  It is designed  to keep stuff out, including  dirt, bacteria, mold, insects and toxic chemicals.  Indeed  when the integrity of the skin is broken from a cut or burn, we all know its important to clean the wound  and cover it to prevent infection.  Its very difficult for most ingredients  to pass thru the upper layers of the skin and  arrive at the growing, lower  levels.  Applying  any product, be it  a  lotion, serum or moisturizer, makes it  much much more difficult for the next product  to  pass through the skin layers to get to the area where is can actuallydeliver results.   

So What’s Girl Have  To Do to Look Good?   

Different ingredients offer different benefits. For example  antioxidants  protect  skin  structures from UV damage while hyaluronic acid  is an uber moisturizer that draws and hold  water in the skin.  To get  as  many benefits as possible you have two options:

1. Combination  products

Rather than using a serum with antioxidants, a moisturizer with hyaluronic acid and a sunscreen with zinc oxide,  look for a product that contains all three.  Mixing the molecules  together in one  product  gives all ingredients equal access to your skin.  Even better, it’s  a great  way of stretching your  beauty budget.

2.   Alternate Skin Care

I’m often asked how  to use Retin A, a moisturizer, a sunblock, and an antioxidant serum.    Short answer, not all at the same time.   For example, at night you can use Retin A and a moisturizer on Tuesdays, Thursdays, Saturday and Sunday.  On Monday, Wednesday and Friday nights  use the antioxidant serum topped by the moisturizer, and skip the Retin A.  This alterrnative application will allow  even sensitive skin to use a  full strength Retin A .  In the morning use a moisturizer with sunscreen under  your make-up.   To make things even easier  you can use  a BB or CC  cream which offers a  combination of hydration,   antiaging ingredients, sun protection  AND foundation.  You can get  the benefits of four products at the price of a  single  item.  Cool.

Fashion Flash logoThis week Mirabai  of Moving Free with Mirabai is hosting Fashion Flash. The spring weather is making  me want to get out and move again and I’m inspired by Mirabai’s exercise DVD’s shot  on the beach or in the mountains of Colorado.  She makes it look so  easy  and fun that  I actually went out and bought a new pair of running shoes. 

The Cheap Date Guide to Style  

Like most of us, I started my fashion journey  around age 13 when I was allowed for the first time to go shopping with a friend, rather than Mom.  And for most of these years, I wanted not so much to stand  out as  to  be appropriate.  I’ve pretty much achieved my goal and now  feel confident that I will be neither  over or underdressed for  all occasions.  I look  fine,  but not especially  interesting.  I’ve been wanting to crank up my style a bit, but not so much  that   Seth Cohen of Advanceed Style would  pick me out of a crowd.  When I found a copy of   The Cheap Date Guide to Style  by Kira Jolliffe  and Bay Garnett, I felt I found  a source of fashion tips to CHEAP DATEtake me where I wanted to go.

The authors are the founders of a uber hip UK  mag called Cheap Date.  The book  is done in a magazine style   of call-outs, photos  and boxes that  make you smile and nod– “oh that’s how its done”.  Cheap Date  gets its fashion inspiration from  a diverse  group of icons including Kate Moss, CHanel, Zac Posen, Jeanne Moreau  and Keith Richards.I love the lists in Cheap Date  and I think my favorite is the list of five dresses every woman should own:

* relaxed jersey

*flowery vintage

*classic black

*wrap around

* djellaba

With sandels in summer and boots plus an over coat in winter, you’re ready for anything.

Other super easy tips for adding a bit of style include scrunching up  your sleeves, adding a monogram somewhere, and tipping on a beret .   Adding a pair of Ray Bans  pulls it all together. Now this is fashion advice I can actually follow.

QandA3Question:  I’ve had acne since I was a teenager, but now  I’m  37  and its still a problem.  I wanted my doctor to give me Retin A, but she insisted that Differin would work better.  Its not covered by my heath plan and I can buy  Retin A online for a lot less.  Any advice?

Answer: Its sad but true  that acne can remain a problem long past high school.   Differin ( adapalene)  is actually the newest form of Retin A  ( aka  tretinoin).   This new kid on the block  has several advantages than its older cousins.  It is less irritating than traditional  Retin A, yet can be more effective  preventing   blocked-pores.  It also acts both to reduce inflammation and helps the skin shed old dead skin cells.  But what makes adapalene   an anti-acne rock star is its ability to get along well with  other acne fighters.  Both benzoyl peroxide which kills acne causing bacteria and clindamycin  which reduces  inflammation,   reduce effectiveness of  Retin A.  By contrast,  Differin ( adapalene)  works beautifully with other acne medications.  You can layer all three at night and  then use the benzoyl peroxide and clindamycin during the day.  To round out dynamic acne care, wash your face with an oil free cleanser like Neutrogena  Oil-Free Acne Wash   and  be sure to use an oil-free  physical sunscreen  such as  SkinCeuticals Physical Fusion UV Defense  SPF50 during the day.  Keep in mind that  Differin like the original Retin A  increases skin sensitivity. 

This triple threat program is the current  gold standard for acne care and you should see  big improvements in 2-3 months. If  things  don’t get better, you probably have some form of hormonal acne  and will need hormonal therapy.   I agree that its outrageous that most  healthcare plans refuse to cover any form  of tretinoin  much past adolesence.  Retin A is now available in less expensive generic form while newer Differin is  still under patant. Despite the increase in costs,  I think your doctor  made a good call.

Fashion Flash logoThis week  Staness of  Menopause Makeover is hosting Fashion Flash.  This upbeat and  supportive site offers valuable and reassuring wellness advice for the changes that come with “The Change”.   While those days are behind me, I love Menopause Makeover for its delicious  AND healthy recipes.  Her turkey chili  is my go-to dish that I bring to Superbowl parties.  I have to admit that I’m not a big fan of fish, but her fish recipes  which  also feature   nutrient packed  vegetables  are so tasty it makes it easy to get in those two weekly  servings  of  Omega 3’s.   It  makes life  very pleasant when a dish of Panko Coated Tilapea, Louisiana Cafishfish with corn and okra and and  Asian Tuna Kebobs are as healthy as they are  enjoyable.    Too many recipes in magazines seem to be created  just to fill up pages.  By contrast  the recippes in   Menopause Makeover have been carefully  tested and tasted  before they  are published.  Nice.

scan0302The New Menopause Resource Center

Menopause and its little cousin peri-menopause, create a tsunami of physical and emotional issues that can last more than a decade.   To provide comprehensive health support, woman’s health expert and  cardiologist Dr Nieca Goldberg is developing a new comprehensive  Menopause Program at the  NYU Langone Center for Women’s Health.  The goal will be to provide  unique support for the symptoms, health care and treatment options.  To make sure that the services truely meet  our needs, Dr Goldberg,  who is the Director of the NYU Langone Center for Women’s Health ,   has organized  a pair  focus groups in Manhattan on April 25 and April30th.  If you are between the ages of 44-59, come to a dinner to explore  how menopause and peri-menopause affects  you with symptoms that include  irritability, anxiety, hot flashes and sleep problems– and  what services you would want  to see in an effective program.   For more information contact Staci Weininger at Staci.weininger@nyumc.org.

QandA3Question: My chest does not match my face. It’s  discolored with brown, white  and red patches.  I’ve tried moisturizers with vitamin C, skin brighteners with Kojic acid and even broke down and bought  hydroquinone to lighten the skin.  Nothing worked.  Do you have any suggestions?

Answer: I have received  several very similar questions and I  finally  have a good answer.  The Woman’s Dermatology Society arranged for me to  interview  Dr Tina Alster,  the internationally  acknowledged expert in laser dermatology to discuss the best way to deal  with  a discolored  chest or decollete.    According  to Dr Alster, the technical term  for the problem is poiklioderma.  Caused by unprotected sun exposure, its a mash-up of  hyperpigmentation ( brown spots),  hypopigmentation ( white areas), swollen blood vessels ( reddened skin tones), and damaged collagen ( wrinkles).  The UV rays  can lead to this permanent bronzing.While a standard vacation  suntan usually fades by the time you have unpacked,  thus type of hyperpigmentation stays darkened throughout the year. 

If the discolorations are fairly  mild (  often seen under age 30), they may respond to  a series of  office based glycolic peels.  This is not the milder 10% peels that you can buy at the cosmetics counter.  These are the 50- 70% peels that are available in a doctor’s office.  They are adminstered by a  nurse and physician.  This  strong  glycolic  solution is  dabbed on the  chest and allowed to reamin for 5-10  minute. Then a neutralizer is applied to restore normal PH to the skin.

Lasers to the Rescue

   More  pronounced poiklioderma mottling responds beautifully  to a series of Fraxel or IPL laser treatments. Because  chest bronzing is made  up of four different problems, Dr Alster uses the Fraxel Dual in two different wavelengths to treat both white and dark patches as well  as encourage new collagen growth.  To  deal with the redness, Dr Alster may also use  pulsed dye laser or  IPL.     Fraxel will leave the skin bright red and a little sore for 48 hours.  Use a mild cleanser like Cetaphil and moisturizer  like CeraVe   to reduce discomfort and  peeling.   If the skin seems  super dry   you can dab on  a light  layer of Aquaphor.  If the sorenss persists for more than 2  days,   Alster may recommend a mild steroid cream to reduce inflammation.  Whatever therapy is used,  it must be accompanied by an iron bound committment to use a 50SPF sunscreen such as SkinCeuticals Physical Defense SPF50  for both the  chest  and neck.    Freckles and dark spots  have a powerful memory  and unprotected sun exposure will trigger their return.


Fashion Week is a big deal in New York City and photos of the runway fashions  fill magazines, newspapers and locals  news shows.  I love the theater  of the shows but I could never translate  what  I saw into what I wear.  That is   until I met Susan Swimmer, Fashion Features Editor  at More magazine.  At a recent  National Osteoporosis Luncheon, Ms Swimmer decoded fashion trends into dozens of  wearable style tips.  In a follow-up interview, I asked her to translate the latest designer inspirations into  great over 40 fashion choices. 

1.  Black and White

Fashion experts   always encourage us  to wear more color.  As one of the millions of women who live in black pants, how cool is it that black and white combo’s are now  at the top of every fashionistas must have list.  A black and white dress, a black dress and white coat  or a black and white gingham raincoat put you on a firm  fashion footing.  Ms Swimmer cautions aginst adding a pop of color like red shoes  or a turquoise necklace.  This year true chic is black and white and nothing else.STRIPES

2. Stripes

Striped mariner tees have been popular for a few years but now stripes have migrated onto jackets, pants, dresses, shoes, scarves and bracelets.  Vertical stripes are best, Swimmer counsels, and the thinner the stipe the better

3. Color Blocking

If you’re old enough to remember the Saint  Laurant Mondrian prints, you’re probably wondering if these strong chunks of color  will work for you.  According to Swimmer, the short answer is yes. A swarth of color  that runs down the side or front of the body   automatically narrows your waist. Now that’s what  I’m talking about.



4. Peplum

Finally a fashion trend that lets you eat dessert.   The peplum top is an incredibly forgiving silhouette that narrows a waist  and erases a few inches  off the belly.  You can find them  in  tops ( some with with sleeves!),  jackets, dresses, and  vests. I’ve seen  them in leather, silk, knits and I love them all.   I hope peplums stay a fashion favorite  for a long, long time.  

Banana Republic

Banana Republic

5. Kitten Heels

More good news!  Three inch heels are hard for feet  at every age.  But as time passes,  we lose padding on the soles of  our feet.  Shoe styles that were once uncomfortable now become agony.  With the return of kitten heels, I will enjoy dressing up again.

6. Graphic Prints

Joe Fresh

Joe Fresh

The explosion of prints on the racks this spring are not just an expression of style.  According to Ms Swimmer, new technology has allowed  manufacturers to produce gorgeous designs in a wide  range of fabrics and  prices.    Graphic prints- strong, geometric  patterns and shapes- are especially popular.  If you want  to take baby steps, a graphic print scarf will  be an instant link to  runway style.  Feeling a  little bolder?  I fell in love with this graphic print raincoat from Joe Fresh.  Its so cool I am actually looking forward to rainy spring days.

One Final Tip.  Many styles, especially for summer, are sleeveless.  If you don’t want to share your arms with the world , Susan Swimmer offers another great solution.  Just  pull a “Michelle”  and cover up with a small cardigan– an quick answer for an all too  familiar   problem.

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