Posts Tagged ‘age spots’

older and younger womenWhen I started  No-Nonsense Beauty Blog I expected  that most of the people who would be  would  be like me and over 40– way over 40.  I was  pretty surprised  when site analytics  showed that over 30%  of  No-Nonsense visitors were in their 20’s and 50% were under 40.  In fact   the majority of comments and questions  were sent in from smart resourceful  thirtysomething women. Its human  nature to  avoid issues  until they on top of us, but these bright young women are asking all the right questions  years before they  actually have to face them in the mirror. 

Different Answers for Different  Aging

Like everything else  in the body, skin changes naturally over time and its not surprising that anti-aging skin care differs over time.  Under  age 30 our skin is rich in estrogen and natural hydration.  The challenge is not to mess it up.   To prevent aging, women often use overly rich cleansers and night creams which  can provoke the reappearance  of teenage style acne.   Called acne cosmetica, its the trigger in over half of   adult acne problems.  Not only  are breakouts   just not necessary, acne scars  tend to become lines and wrinkles as  we get older.

Rather than drowning still  youthful skin in   heavy anti-aging products ,  good skin care starts with gentle  but through cleansing,  and regular exfolitation with microdermabrasion brush.  At night  use an oil free   glycolic acid or lactic acid lotion.  These ingredients  are like a baby step Retin A.  They shed dead dry skin, hydrate the surface and encourage  collagen and elastin growth. 

Its during the day that  thirtysomethings can take major  steps  to prevent aging. Up to age 60,  between 80-90% of skin aging is due to UV damage– but  using  effective sun protection  will short circuit environmental aging. 

After age 40, the good times and bad leave their mark on your  face. Sun filled vacation days  reappear years later as dark patches, red spots  and crows feet around the eyes. Work and family stress show-up as deepening  lines on  the  forehead  and along the sides of the mouth and chin. That’s the bad news.  The good news?  All of the signs of living can be reversed. But before buying a buffet of creams and serums with  a boatload of anti-aging claims, think about what you skin actually needs.    Before you  swipe your credit card at a store  or make an appointment at a doctor, identify what your skin issues.  Brown spots  and splotches?   IPL, Clear and Brilliant  and Fraxel lasers are different ytpes of lasers that quickly zap discolorations.  Lines around the eyes?  Botox will erase them in moments. Dull pale skin color and fine lines? Retin A will deal with both by reving up  circulation and  boosting   healthy collagen.  And when you’ve done with all the heavy lifting repairs, be sure to protect your investment  with a 30-50SPF sunscreen  to prevent new  UV damage.


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Q&A2Question: I am a 45 year old South Asian women. I now live near Chicago  and the weather is  usually  grey and very cold.  My cousin says I still need to use a sunscreen and I think its unnecesary  at this time of year.  Who is right?

Answer: Umm, I tend to stay out of family arguments, but  in this case I have to say your cousin is right.  The UV rays are  hitting our skin all year  round.  While  your melanin rich complexion  provides protection from sun aging and skin cancers,  even weak UV rays  can  provoke  unwanted patches of darker pigmentation known as hyperpigmentation or melasma.    Brown spots and splotches  are an increasing problem  for  skin  of color.  Rather than spend a good part of your beauty dollar on  products that promise to  brighten and even out the skin tones,  prevent hyperpigmentation by investing   in a sunscreen with at least a 30SPF.  In summer a 50SPF is  even better.

Virtually every dermatologist  I  speak to makes sun protection for everyone  their main focus– and they dream of the day when its as automatic  as brushing  your teeth.  Because its so essential for skin health and beauty, its key is choosing the right sunscreen for your skin.  If you have dry skin, a good sunscreen can   boost  hydration.  However if you have oily  or acne prone skin,   the wrong sunscreen can increase  skin problems.  For  best results,  look for  oil free forumulation that provide physical sun protection with zinc oxide or titanium dioxide.  The chemical sunscreens like avobenzone and Mexoryl are effective  but can be irritating– and this irritation can provoke moremelasma and hyperpigmentation  in women of color.  Not what you are looking for.

Use the sunscreen every day  on your face, neck and hands.    There has been  alot of discussion about how much  goo you should put on.  I’ve tried out the   often quoted recommendation of one tablespoon  per face and the results were both funny and disturbing.    To keep up sun protection during the day, use a mineral based powder  like Brush on Block ( $30, free shipping)or Colorerscience ( $50, free shipping).

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While I cover many anti-aging tools, I get so  many questions about Retin A,  I decided to do  a post  covering  the Five Top Questions.  This actually increased the number of questions  that I posted a free, four page  PDF  guide to Retin A.    Retin A Road Rules covers  the basic issues such as  how it works and  who should use it.  The  guide continues with  a step by step program  for  incororating  Retin A into a daily skin care.  For example  to avoid  irritation and flaking you need to wait at least 20 minutes between the time you wash your face and when you apply Retin A before bedtime.  Road Rules also includes a complete  review of the six different types of Retin A , including the pros and cons of each and  how to choose the right one for your type of skin.

Right now you can download the free guide by liking my Facebook Page.  At the start of 2013, I will replace  Retin A Road Rules with  The No-Nonsense Guide to Dark Spots and Splotches.  It  will  look at the causes of different types of hyperpigmentation, and explain  how to even  out skin tone.  The free four page PDF will explore different options including  lasers, IPL, hydroquinone,  Kojic Acid and licorice root.  And it will look at which popular  skin lighteners are  a waste of money  as well as those that can cause more discoloration and scarring.  

Questions  about hyperpigmentation are second only to interest in Retin A.  When I started my anti-aging  journey my first step was a date with a laser to remove larger age spots and freckles.  I’ve used IPL to erase small freckles and   Triluma to lighten under eye circles.  Next week I will be trying out a new type of low level  laser called Clear and Brilliant.  This  device   can be used on the body and is wonderful for dealing with hypigmentation  and sun damage on the chest.  It was featured on Dr Oz, but the show did not reveal before and after results.  I’ll be posting  photos of the entire process — the  good, the bad and hopefully the beautiful.

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When I started my anti-aging  explorations, I really wasn’t thinking about my neck.  It was  just there to hold up my  head and someplace to hang a great necklace.  As I could see changes  on my face from Retin A, I could see a clear difference in the skin quality between my cheeks and my neck.  Dr Marmur, my uber dermatologist, told me that I could use Retin A on my neck, but it would take at least a year to show genuine results.  She also reminded me to use sunscreen on my neck, something I had NEVER done.   It just didn’t occur to me. 

After several months on Retin A without  the big results I saw on my face, we decided to remove  the big freckles and age spots with   lasers and cauterization.  When she finished, my neck looked like it had been attacked by a flock of  vampire bats.   I wore scarves for several months, even when the weather was warm and sunny.  When they healed I was meticulous about  using sunscreenon my newly clear neck skin.  I have continued  using Retin A and while the changes  are not as dramatic as on the face, I can see improvements.  The chicken skin bumps are smaller, the color a bit better and  the general texture is smoother. 

The  easy to do treatments for the neck are limited. Botox can relax the vertical lines that are  are more prominent as the years go by.  Fillers can be used on the horizontal lines that  deepen over time.  IPL  and microdermabrasion are not options for the neck and  most real changes would need to be done surgically.  Procedures to pull and titghten neck skin, the so-called “Madonna Lift”, is the current operation of choice.  If  you look at recent pix of  the performer’s  neck, it has the smooth taut lines of  a women in her twenties.  It’s a beautiful example of cosmetic surgery gone right, but its not on my to-do list.  I make my living with my brains, not beauty– and instead of going to a cosmetic surgeon, for now  I’m just going to opt  for Dr Hermes.

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Answer:  I love new beauty ideas that are based on good science and BB creams are just such a concept.  BB stands for ‘blemish balm”  where blemish is defined as a skin defect ( eg dark spots and splotches and acne scars), not  just  traditional breakouts.

The original BB creams were developed by a Korean dermatologist to help his patients care for laser treated skin.  After having both IPL and frying off my freckles with a YAG laser, I had difficulty finding  appropriate  moisturizers and sun protection products.  The treatments made my skin especially vulnerable to sun damage, yet traditional chemical sunscreens were irritating while  zinc based formulations left my  skin with a weird white sticky film. 

BB creams are a genuinely clever idea.  They are a zinc based high SPF moisturizer/sun block combo that have a flattering tint.  The result?  On the skin it looks  like a traditional, flattering foundation rather than  mime  make-up.  Most of them are enriched with anti-aging ingredients  like anti-oxidants and peptides that also promote healing.

BB creams from Dior, Mac, GArnier and Estee Lauder are promoted not so much for post- laser sensitive skin but as a skin brightener to erase dark spots and splotches.  By coating the skin each day with a high 40-50 SPF, the existing melanin in the skin will be breaking down and new melanin will be prevented.  The results should be a fresher, clearer complexion.

There is good theory here but does it really work?  General skin lightening aka brightness or luminosity, is a hard thing to measure and even harder to capture in a home photograph.  To see if  BB creams can actually make a difference, I am going to take a  Visia imaging scan that can actually see the melanin deposits in the skin.(  I’ve posted this type of photo  before and there results are  pretty startling.)  Then I will use a BB cream for a month and then do another Visia photo.  If the BB cream actually changes the melanin content of the skin, we’ll all see it.

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Question:  I have heard so  many horror stories about IPL, but you had great results.  Can you tell me what machine was used and at what settings?

Answer:  I had IPL with Dr Ellen Marmur of Mount Sinai School of Medicine, so I  asked  her to answer this question.  Dr Marmur used the Luminis IPL with two handpieces– the 560nm and the 590nm.   “Both  of them focus on red spots, blood vessels and brown freckles”  she explained.  “The treatment settings vary from patient to patient based on skin color and the amount of the target to be removed.  For example, I use  lower settings for freckles to avoid over-heating the skin.’    Dr Marmur also warned against getting IPL when tanned ”   You need to avoid the sun for at least wo weeks prior to IPL treament ” she warned.

IPL Road Rules

IPL or Intense Pulsed Light is a form of light that is related to laser technology, but  far less invasive.  It operates in the top layers of the skin and can remove unwanted hair, small red lines and spots as well as freckles,brown spots,  and dark patches.    It is practically painless, and leaves the skin a bit red rather than burned and oozy like true lasers.

But there are reports of problems with IPL.  Because the light focuses on pigments in melanin,  women  with darker complexions are most at risk of developing irregular pigmentation.  Even  dark olive complexions  should  proceed cautiously with IPL. 

Choosing  the right setting, device and timing of applications is a learned skill.  I met Dr Marmur though a smart, well-connected  friend  and I have found this type of one to one reccomendation is a great  way to getting  someone  you can trust.  I would also check out  a doctors credentials  to be certain that they have the training they need  to  give you healthy,  beautiful results. For more info on IPL you can also check out an earlier post IPL- Five Top Questions.

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This week’s question  shows how far  skin care products  have come in the last ten years.  Both cell growth factors and Retin A  are significant anti-aging tools.  Cell growth factors wake up old tired fibroblasts in the skin and get them to provide  more collagen.  Retin A also  increases healthy young collagen in the skin but we don’t exactly know  why.  In addition the retinoids stimulat circulation   producing a youthful healthy glow to the skin.  Finally retionoids  exfoliate the skin  that has three, count ’em three great benefits–  it removes dull dry tired skin, it stimulates the growth of  new fresh  skin and it slowly lightens discolorations and flat age spots. Nice.

But both retinoid and cell growth factors products are a few  issues.  Retinoids  can be very irritating and  some women  just can’t use them.  For women of color, retin A  may actually cause increased  pigmentation because of the irritation.  Cell growth factors are far more gentle and do not increased sensitivity to the sun like Retin A and alpha hydroxy acids. In cold wintery weather it can be very hard to use Retin A everyday and cell growth factors will   help the skin withstand cold windy weather.  However  they are unregulated. Unlike retinoids which have to list their concentration, there is little way of knowing how much  growth factor is actually  in a  that pricy tube or jar.  It could be a full effective dose or  just a drop  so that  it can be included on the list of ingredients on the label.

To bottomline it,  I don’t think its an either/or situation.  I think there is a role for both retinoids and cell growth factors  in a  successful  anti-aging plan.  There is good science behind  Rejuve MD with cell growth factors  and I use it rotation with Retin A Micro and a vitamin C serum  from Skinceuticals.   I tend to reach for my cell growth factors when  I don’t want to wait for 30 minutes to apply a night treatment before going to  bed.  Both  Retin A and vitamin C can sting  if applied to freshly washed skin and treatment products with cell growth factors are soothing rather than irritating.    One final thought. Some experts recommend using both at at the same time.  I’m not a big fan of layering because I’m concerned about absorption .  I use them on different nights and love the results.

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