Author Archives: SkinSense
Part I
Hormones and acne:
Puberty is often associated with acne break-outs and at SkinSense we regularly counsel teenagers about skin hygiene and sensible dietary choices as we clean their skins. But many male and female clients develop acne later in life after navigating puberty and pregnancy without any problems. This can be due to excessive stress and in women it frequently signals approaching menopause, as estrogen levels drop allowing more free testosterone to take control.
Tip: Spironolactone (Aldactone) is an effective oral androgen blocker that helps to control this kind of late onset acne. (For women only.) Ask your doctor for details.
The formation of an acne lesion occurs when the skin is oily and begins to shed excessively, clogging the pores and supplying a food source for Propionibacterium (p. acnes). This creates inflammation and an immune response.
Identify the type:
Comedonal, Inflammatory and Cystic acne are the main categories used to define this condition. For the first two, a mix of topicals including salicylic, lactic and glycolic acids, with tea tree and camphor for spot treatment is very effective. Sometimes oral antibiotics are necessary to treat inflammatory acne but don’t stay on these for too long and always take a good probiotic at the same time. The redness and scarring is easily treated with an over the counter or prescription retinoid. Build slowly – one or two nightly applications a week – to avoid irritation and always wear a sunscreen during the day.
With both Comedonal and inflammatory acne regular cleaning and rebalancing facials are really helpful to bring the breakouts under control. At SkinSense, we often use a Mandelic Acid peel and an enzyme treatment that incorporates Niacinamide and Pumpkin extract to get rid of scarring. Oxygen facials are also great for a deep clean, killing bacteria, calming and revitalizing the skin.
Cystic acne is a more serious type of acne with deeper inflammation and a higher risk of scarring. It needs to be tackled quickly. If after three months oral anti-biotics don’t do the trick then Accutane is often recommended. Aczone is a topical medication that is non-irritating, reduces inflammation and can be used along with Accutane. Accutane does have some potential risks for certain individuals so make sure your dermatologist explains these to you and monitors you closely while you are on the medication. Gentle cleaning facials are useful in these cases to clear the skin and calm any redness.If Accutane is not a choice you would make, then there are other options and lifestyle plays an enormous role in how you can rebalance and correct acne.
No-one likes a furry lip, heavy brow or hairy chin!! At SkinSense we take care of these areas using a blend of waxes depending on the skin’s sensitivity. A well manicured brow can make all the difference to the shape of the face and for extra emphasis we often tint the brows at the same time. We encourage our clients to come in regularly every two to three weeks to prevent in-between tweezing at home as this can spoil the shape.
For the extra delicate skin and client, we will happily tweeze the brows although this obviously takes a little more maintenance.
Quick tip: Nancee Daly, our veteran facialist, uses a light application of oil on the brow and lip area before waxing sensitive skin. This diminishes redness.
Chin hair often increases along with stress levels and hormonal shifts especially menopause, and in some cases facial hair can become darker at these times. We are cautious at SkinSense about removing facial hair with wax. It can cause break-outs and irritation on more sensitive clients so we often do a very small area to start with. We avoid waxing facial hair on acne conditions – this can exacerbate the break-outs and cause further problems.
Quick tip: Vicki DiPietro, our Brazilian wax expert, often uses two types of wax on lip hair particularly if it is coarse – hard wax first and then our resin wax to follow.
We do not use a honey wax as some clients are allergic to honey and we make sure that clients stop using all prescription and over the counter retinol topicals one week before their waxing appointment. This prevents any skin being lifted along with the hair. Clients on Accutane cannot have any waxing services while taking the drug.
And as for the rest of the body, we offer underarm, regular and Brazilian bikini waxing (see my post: “Wax on, wax off”) full arm, leg and back waxing. Back waxing is very popular with our male clients and as with all our waxing services we counsel our male clients carefully. Exercising before treatment is very important to avoid break-outs and wearing a light cotton shirt rather than a synthetic material post treatment is less irritating to the newly waxed area. Salicylic acid, camphor and tea tree lotions are great for calming any irritation.
We recommend body waxing every 3-4 weeks depending on re-growth. And it is true over time regular waxing does diminish growth. Like many things in life consistency counts!
Great skin requires commitment and discipline – two words that can strike terror in a lot of peoples’ hearts. But the benefits always outweigh the effort. Follow these twelve tips and you will be beaming from ear to ear.
Have regular ( preferably monthly) customized facials and take care of your skin AM & PM.
Use sun screen.
Don’t smoke.
Drink half your body weight in water.
Take your vitamins AM & PM.
Eat at least three fruits and five vegetables a day and keep your diet 80% alkaline and 20% acidic.*
Get to bed by 10.30 pm at least five nights a week.
Exercise at least four times a week for an hour.
Don’t pick your skin.
Don’t drink sodas.
Hang upside down for fifteen minutes every day. (Yoga counts).
Laugh LOTS.
*Read “Stop Aging, Start Living” by Jeannette Graf, M.D.
When reading skin care product labels these days it helps to be a chemistry major. However, not all of us are. So here are some useful tips to clue you in to what you are using to look gorgeous every day!
Although most ingredients are listed in order of their concentration, manufacturing companies today are not required to list percentages. So as a general guideline, pay attention to the top five ingredients to inform you of the product’s main functions. Most active ingredients are also listed separately – for example, sunscreens and acne products. But just to confuse the issue, not all active ingredients have to be near the top of the list and can be beneficial at lower levels. Certain botanicals, vitamins A, C and E are good examples of these ingredients.
Know that there is a difference between ‘fragrance free’ and ‘unscented’ products. The first claim means that raw ingredients used have had their odors removed before blending in a formulation and contain no fragrance at all. The second claim refers to a formulation where ‘masking’ or ‘neutralizing’ agents have been added to the formulation to disguise any odor. Although fragrance free products tend to be more costly, the investment is worth it if you have very sensitive skin. Another point to make here – ‘hypoallergenic’ doesn’t necessarily guarantee that the product won’t cause a re-action. Skin can be sensitive to just about anything! I often see a client who has been using the same products for years and suddenly finds that their skin has become sensitive to those trusted products. Anything is possible and it depends on the expertise of your facialist to find a regime that works for you.
Buy date-stamped skin care products when possible or mark the date of purchase yourself especially on those items that last for a while. Products are supposedly manufactured with a shelf life of two years but it is impossible to know when the product was actually sealed and left the factory for distribution or how long it has been shelved. As a general rule and it hotter climates, keep nothing past six months ( prescription and highly active products no longer than three months) and buy what you need rather than stock piling products. As a precautionary measure, store unopened products in the refrigerator.
Skin is a mixture of oil and water. Therefore an oil-free formulation has to have something in it that will adhere to the skin. Silicone is generally a good substitute in these cases. If you have a real problem with oils, use serums, water based products or powder formulations.
Word to the wise – all products claiming to be organic are not created equal!! Great as they are, by nature, organic formulas tend to show some inconsistencies in both texture and smell with each new batch. Well formulated cosmeceuticals tend to be more consistent and just because you can’t pronounce an ingredient doesn’t mean it is a bad addition to a product. Some of those chemicals are extremely necessary and most are completely harmless. When shopping for organic, look for the NSF and USDA symbols both of which guarantee high organic content in the formulas.
Whatever you use keep in mind that during the day your products should hydrate and protect. At night they should correct and treat.
Stress is a normal psychological and physical reaction to the ever-increasing demands of life. We all experience varying levels at different times and in many situations. Under these circumstances the brain’s hard-wiring system kicks in. When it perceives a threat, the brain signals your body to release a burst of hormones to fuel your capacity for a response. This has been labeled the “fight-or-flight” response and is a normal bodily reaction that is meant to protect us. However, because we now live in a world of nonstop stress most of the time, our alarm systems rarely shuts off!
Without stress management and over time, high levels of stress lead to serious health problems including a myriad of skin issues.
How?
Hormones, neuropeptides and other signaling molecules released during stressful times may be second only to sunlight in aging the skin. And the really bad news? Women are more prone than men. That means wrinkling, loss of tone and increased levels of sensitivity, particularly as we age.
Additionally, proteins and DNA in the epidermis and dermis urn can cause acne, rosacea, psoriasis, eczema and hives.
Feeling bad about the way we look makes us less social and more isolated. This aloneness diminishes the production of Oxytocin, the bonding hormone. And as I mentioned in my last post, encourages compulsive picking and other bad habits.
What to do?
It is unrealistic to imagine we can ever live a stress free life but we can commit to developing coping skills that maintain balance, even at the worst of life’s moments.
Here are six of my favorites:
Getting outdoors and in touch with nature. Hiking, gardening, sitting on a park bench all reconnect us with our natural surroundings.
Breathing deeply. Not just when we are really stressed but at regular times throughout the day.
Disconnecting from social media for a day or if that sounds unimaginable, half a day!
Changing your mindset. When a challenge presents itself, think of it as an opportunity for personal growth.
Have a supportive tribe so you don’t waste time with negative or toxic people.
And finally, my new favorite, get out your colored pencils! Adult coloring books are all the craze right now. They can relief stress and anxiety as well as reconnecting you with your inner child. Check out “Secret Garden: An Inky Treasure Hunt and Coloring Book” or “Enchanted Forest: An Inky Quest & Coloring Book”. They are great fun and thoroughly engrossing.
Confucius once claimed: “True quality of life comes from lasting harmony between body and mind.” This is a goal worth aiming for.
Onychomycosis, or nail fungus, is a common and difficult problem that many of my clients ask me about, especially during the summer months when feet are on display. Until recently, topical treatments were not very effective. However, my dermatologist, Steven Weiss, MD., recommends two new topical solutions, Jublia and Kerydin, that have demonstrated better results. They’re most effective for limited nail involvement and need to be applied daily for 1 year. They require less monitoring than the oral medication, Lamisil (Terbinafine) which can be effective but has certain contra-indications.
By the way, laser treatments, which have been hyped in recent years, are not effective for clearing nail fungus. Recurrence rates are high, and the only thing they affect is your pocket book. See my post about “A Cautionary Tale of A Big Toe and Fungus“.
Here are a few preventative steps you can take to prevent nail fungus:
1. Change out of tennis shoes and socks directly after working out.
2. Check that all your shoes give you plenty of toe room and fit properly so that your body weight hits your heels to prevent any bruising to the big toe.
3. Make sure that you go to a good pedicurist consistently who does not believe in severe cuticle trimming and pushing but regular maintenance.
4. Leave the nails free of polish once in a while. Also, don’t leave the same polish on for too long.
5. After showering make sure the feet and nails are dried properly. Trapped water can lift the nail and provide the perfect place for fungus to take hold.
6. One final tip – avoid too much sugar in the diet. Strange as it may sound, this too can cause foot fungus.
Real Simple magazine has just published a very interesting article on skin cancer. Primarily focused on Squamous cell carcinoma, (SCC), and Basal cell carcinoma, (BCC), the publication quoted some pretty alarming statistics about these close cousins to Melanoma, the most deadly form of skin cancer. According to the American Cancer Society, SCC makes up about 20 per cent of skin cancer diagnoses in America, and BCC accounts for almost 80 percent, making it the most common form of skin cancer for both men and women.
The good news is that these cancers tend to grow slowly so as long as you go for regular (at least once a year) check-ups with your dermatologist, you are very likely to catch any problems in the early stages before anything becomes difficult to remove and requires extensive surgery.
Most often Moh’s micrographic surgery is used to remove trouble spots. This is where one thin layer is removed at a time until the tissue shows no sign of containing any cancerous cells. This is done as an outpatient procedure and once the tissue is clear, the procedure is complete. The great news is that Moh’s surgery is 98% successful. Once the site has healed there is very little sign that anything was ever amiss.
It really all starts with early sun protection and regular self examinations at home every month. The occurrence BCC’s and SCC’s has risen significantly in women under the age of 40. Indoor tanning is the biggest culprit but also incidental sun exposure on a daily basis. (Running errands, driving, walking short distances.) Another factor is the misconception that a covering of tinted moisturizer or make-up with an SPF15 will do the trick. Not even close. An SPF of at least 30 is an absolute must, regardless of weather and climate, and make-up, tinted or full, needs to be applied on top. Don’t forget the ears, back of the neck and chest. Very high SPF’s can irritate the skin and don’t offer a significant amount of extra protection but up to factor 45 works well and if you have sensitive skin, try a physical block that only contains titanium dioxide and zinc oxide.
It is very easy to mistake these skin cancers for pimples, so here is what to look for. Painful or itchy lesions, pimples that erupt, bleed, heal and then return. Crusty patches that look like dry skin, are waxy or pearly in appearance, growths with elevated borders and indented centers. Bear in mind that no matter what your race or skin color, you have upwards of a 40 per cent chance of developing one of these cancers by the age of 65. And they do reoccur.
The other advantage of regular check-ups is that it will allow the dermatologist to keep an eye out for melanoma as well. All this scary stuff is so preventable. Always keep a large brimmed hat in the car and when driving, wear lightweight gloves to protect the hands and a sun-proofed scarf to protect the chest. Any time something looks suspicious, don’t wait to get it checked. It is worth that extra doctor’s visit to be on the safe side.
Shoes remain one of the most important aspects of fashion. The perfect shoe can create an image of professionalism, affluence, the personality within, or just plain height. And women in particular are more willing to pay for ‟the right look” not only with their credit cards but with the comfort of their feet.
This, however, can cause long-term pain in the feet, knees, and back which then leads to discomfort when standing and walking. Heels challenge the body’s ability to balance and all of the muscles of the legs must work to stabilize the ankle. Walking is split into two phases. The swinging phase and stance phase. Any shoe that inhibits the weight from falling where it should can lead to pain. High heels are a major culprit of this because both ‟push-off” and ‟heel-strike” happen mainly on the ball of the foot with little or no support at the ankle. Even those cute little flats, mules, or sandals that don’t offer support to the ligaments of the arch, toe joints, or ankle will throw off the rhythm of your natural gait.
Bunions, hammer toes, and pump-bump (that bony enlargement at the back of the heel bone) can make even the prettiest of shoes lose their luster and let’s face it, when your feet hurt the whole body hurts. So what can we do because we know Manolo Blahnik is not going out of business any time soon?!
First off, buy shoes that are the right size. There is no shame in a size 11 except when it is crammed into a size 8 and there are toes falling over the front edge. Trying on shoes after a full day is best because your feet are already hot and swollen. This will give you a much more realistic idea of how those shoes will feel long-term. (The only ‟breaking-in” will be happening inside of your foot, not the shoe.) And try to look for 2 to 2 1\2 inch heels. This is about the difference of when we stand on our toes therefore our body can still find it’s center of balance. Wearing those spiky, pointy numbers for as little time as possible with down time in between is best.
If you know a pair of shoes becomes uncomfortable after a few hours, have back-up. It seems quite customary now for flatter shoes to be worn at weddings after the main ceremony is over and the eating and dancing has started. I think this is a great idea. And to make dressy heels more comfortable, invest in foot accessories that cushion body weight inside the shoe.
When you get home and can finally give your tired feet some attention, sit down, take off your shoes and swing your ankles in slow circles. Gently massage your arches and Achilles tendons on both feet.
A foot soak is a great idea. (See recipes below.) Start with cool water for about 10 minutes. This will diminish any swelling and discomfort. Then add hot for another ten. Follow that with more circular stretches. Then reward yourself with a light layer of any foot cream with Eucalyptus, Peppermint, Bayberry, or Juniper. Aaaaah!
A full hour of reflexology will directly access the ligaments and tendons in the foot and will help to send a message of healing to other parts of the body, like the lower back. Regular pedicures are also essential. Keeping the nails short makes a big difference to how a shoe fits.
Foot soak recipes:
Fill a bowl with enough hot water to cover both feet to ankle height. Add ½ cup Epsom salts and 1 cup of Baking soda then select one of these three recipes according to your needs. Add about 10 drops of oil collectively to each soak.
For Aching feet:
4x drops of chamomile
4x drops of lavender and 2x drops of peppermint.
For Foot warming:
5x drops of rosemary
3x drops of clove bud and 2x drops of ginger.
For Cooling swollen feet:
6x drops of peppermint
Ix drop of rosemary and 3x drops eucalyptus.
So, yes, wear those gold lamé sling backs with the singular sequined strap around the big toe and the lime-green fur along the insole. But also remember to take care of yourself before and after. That way when you say that your dogs are barking, you’ll be talking about the one’s in your backyard!
We are all familiar with commercials that show startlingly beautiful models with perfect bodies and flawless skin. Most of the time we are aware these images promote an unattainable standard of beauty but there is danger in the representation that this is the only type of beauty that is desirable. Dangerous because for all women – young and old – this can seriously affect their self esteem and unrealistic because there is no preordained standard of beauty, especially the cookie cutter version of the commercial world. In reality, beauty is everywhere. It is diverse, interesting and individual and an essential part of our humanity.
At SkinSense, this beauty starts with the skin. The skin is the backdrop, canvas and stage on which all our features and our body image are projected. We also appreciate that when we are counseling a client it is important to create a safe and comfortable environment for sharing concerns and expectations. We are all our own worst critics and our role as skin care professionals is to listen before we start coming up with solutions and recommendations. With the advent of social media we are all even more aware of how we look. In fact according to the American Academy of Facial Plastic and Reconstructive Surgery, increased photo-sharing has resulted in a higher demand for rhinoplasty, hair transplants and eye surgery, also injectables and Botox.
At SkinSense, we work with doctors who we can confidently refer to when clients ask about these procedures but equally as important, we offer extensive customized facials and body treatments that utilize the latest in electrotherapy and cosmetic chemistry that guarantee results for every skin condition without causing trauma or using extreme measures.
In 1900, the average life expectancy of a woman was 48 years and a man, 46 years. Currently, the average life expectancy of a woman is 78 years and a man 75 years. My point being we are all living a lot longer and need to maintain our skins to stay youthful, competitive in the work place and in society. This is not vanity. It is a healthy choice. People notice good skin – it exhibits confidence, well-being and self acceptance. Our form of photoshop takes longer but it is sustainable. It celebrates the authentic self and that is beautiful. It also guarantees great selfies!
As we all know, oxygen is essential for life. It makes up about 20% of the air we breathe, depending on where we live. It is important when discussing skincare treatments to differentiate between oxygen entering the body through respiration versus the benefits of topically applied oxygen. When applied in too large amounts to the skin, oxygen can have a detrimental effect and produce free radicals.
At SkinSense, however, we use a controlled and measured delivery system that enhances penetration without forming free radicals. This solid state oxygen treatment uses no hydrogen peroxide or gas wands and all the activity is generated by enzyme action which suits a wide variety of skin conditions.
Here are the main benefits of oxygen facials:
Stimulation of cellular activity which reduces the appearance of fine lines by increasing metabolic function. Reduction of redness and bacterial activity associated with Rosacea.
Leaves the skin calm and even.
Soothes inflamed skin and acne.
Provides a calming follow-up treatment after laser, acid peels and microdermabrasion.
Increases the absorption of active ingredients applied after treatment. Improves the appearance of scarring and lightens sun damage.
Tightens the skin surface and leaves the skin glowing and refreshed.
Oxygen facials can be performed as regularly as once a week, but the results are evident after just one treatment. In other words, oxygen facials are the equivalent to a brisk mountain walk in clean, fresh air. Living in Los Angeles that provides all of us a welcome opportunity to have a continually healthy and radiant complexion.
