Tag Archives: retin-A
Video

Retinols. Because I love them.

4 Nov

Retinol products are the best topicals as long as you use them safely. This means under the guidance of a skin care professional.

I start with my secretary voice… I’m nervous. Video blogging is hard!

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Safety during Pregnancy: What You Should and Shouldn’t Include In Your Beauty Regiment

6 Sep

It seems like it’s in the water with co-workers and friends (as evidenced by the three pregnant ladies to the left from Sylvestre Franc). I’ve had a lot of questions about what is and isn’t safe to do when you’re pregnant in regards to skin care products, laser, and injectables. It is understandable that women want to look their best during this time and hormonal changes during pregnancy can sometimes result in acne, unwanted hair growth, melasma and other skin problems. So what is safe to use and what isn’t?

Not surprisingly (to me anyways), there really is not a lot of information on product safety during pregnancy. The FDA rates products on their risks during pregnancy as follows:

Rating Definition

A

Controlled Studies Show No Risk.  Studies in pregnant women show the medication causes no increased risk to the fetus during pregnancy.

B

No Evidence of Risk In Humans.  Studies in pregnant women have not shown increased risk of fetal abnormalities despite adverse findings in animals or in the absence of adequate human studies, animal studies show no increased fetal risk.

C

Risk Cannot Be Ruled Out.  Studies are unavailable and animal studies have shown a risk to the fetus or are also lacking. There is a chance of fetal harm if taken during pregnancy but the potential benefits may outweigh the potential harm.

D

Positive Evidence Of Risk. Studies in pregnant women have demonstrated a risk to the fetus. However, the benefits of therapy may outweigh the potential risk such as in life-threatening situations.

X

Contraindicated In Pregnancy. Studies in animals or pregnant women have demonstrated positive evidence of fetal abnormalities. The use of the product is contraindicated in women who are or may become pregnant.

Skin Care Products

Most skin care products fall into the Class C category; however, some products are recommended by doctors not to be used during pregnancy (although there is not enough evidence for or against them).


Not Recommended:

  • Retinoids
    • In A Practical Guide to Dermatological Drug Use in Pregnancy (Zip, MD, FRCPC) category B topical such as erythromycin, clindamycin, and benzoyl peroxide were recommended over topical tretinoin. This study states reports of congenital malformations in infants whose mothers used tretinoin during the first trimester.
    • This ingredient is found in anti-aging products such as moisturizers, and acne products.
    • Chemically a form of vitamin A, which in high doses can cause birth defects.
    • Oral retinoids, such as isotretinoin (Accutane, an acne treatment), are known to cause birth defects.


  • Beta Hydroxy acids (Salicylic Acid)
    • Ingredients used for their exfoliating and acne-treating properties. They penetrate deep inside the pores and clean out excess oil and dead skin cells that can clog pores and cause acne, blackheads and dull-looking skin.
    • High doses of the acid in its oral form have been shown in studies to cause complications and birth defects.
    • Small amounts applied topically are considered safe (over the counter face wash for example), but peels containing Salicylic Acid are not considered safe when pregnant.

  • Hydroquinone
    • Clinically used for pigmentation for conditions such as melasma, and it is used cosmetically as a skin-whitening agent. Although a large percentage of this topical agent is systemically absorbed, the use during pregnancy does not appear to be associated with increased risk of congenital defects. This finding, however, is based off one study, with a small sample size (so it is recommended to avoid hydroquinone during pregnancy).


Safe

  • Vitamin C, Glycolic acid, and Lactic Acid: derived from fruit and milk sugars, considered nontoxic.

  • Hyaluronic Acid. This is a product your body naturally produces (which means its safe). Because of its molecular size, hyaluronic acid cannot penetrate the skin’s surface, and it is not systemically absorbed.


  • Benzoyl peroxide. Only 5% of topical benzoyl peroxide is absorbed through the skin. It is completely metabolized to benzoic acid within the skin and excreted.

Self-Tanners

Dihydroxyacetone is a color additive that is found in self-tanning products to produce an artificial tan. Color develops following topical application. These products contain dihydroxyacetone in concentrations ranging from 1% to 15%, and when applied topically, systemic levels are minimal (0.5%), and are considered safe to use.

Hair Removal and Bleaching Agents

  • Sodium, calcium, and potassium hydroxide, which are also found in depilatory creams, disassociate into sodium, calcium, potassium, and hydroxide ions, which are all present in the human body. Topical application of these products would not disrupt serum levels and would not be considered a problem for use during pregnancy.
  • Hydrogen peroxide. Hair-bleaching creams contain low concentrations of hydrogen peroxide, making it unlikely to be systemically absorbed. In addition, should it be absorbed, hydrogen peroxide is rapidly metabolized. Therefore, use of these products during pregnancy is not expected to be a concern when done in moderation.
  • Laser has some controversy as to whether or not it’s safe; again, there isn’t a lot of information. Lasers do not penetrate very deep and there is not chemical exchange into the body. One interesting thought from me, (not speaking from personal experience) the body becomes more sensitive during pregnancy, and some laser treatments hurt to begin with. I’m not sure I’d want to get laser under those circumstances!

Botox and Fillers

The safety of Botox injections during pregnancy is unknown (Class C), and while I wouldn’t recommend intentionally getting Botox injections during pregnancy, many women receive injections prior to being pregnant or when they do not know they are pregnant, and have not had any problems. Botox Cosmetic has never traveled systemically, and works only on the muscles into which it has been injected. Therefore, one could presume it is safe to undergo this procedure. But I still don’t recommend it.  Unless you’re planning on having a “Toddler and Tiara” baby.  Then it’s ok.

 

xoxo,

not pregnant LK


More on Retinoic Acid (my fav!)

22 May

I LOVE RETINOL.  Every Woman Should Own A Retinol Product.  (Although the strength shouldn’t be the same for every woman!)

It is not just for acne; this cream has revolutionized nonsurgical treatments for sun-damaged skin (wrinkles!). Research shows it improves signs of both photoaging and photodamage.

Physical Change Results
Thins and compacts the top layer of the epidermis Smoother, softer skin texture
Thickens the lower layers of the epidermis Tightens the skin
Reverses keratinocyte atypia (some big acne word) Improves acne
Disperses melanin throughout epidermis (color of skin) Improves discoloration
Increases glycosaminoglycan deposition (sugars used for skin health) Increases dermal volume and tightens the skin
Increases neovasularization in dermis (blood flow) Gives a pinker, rosy hue to the skin

(Funny Story: My BFF Alexis recently read an article “Has facebook made you a narcissist?” … I told her “No, I’ve always been this way”… but really, your face is ALWAYS available to the public now.  Even if you’re not famous, you ARE!  Make sure you always looks picture perfect!  Nice skin makes life SO much easier AND more low maintenance.)

I’ve always recommended patients start on using a retinol product once a week and working their way up, but I’ve been reading that it should actually be done daily, starting at a low dose and working your way up. Retinol comes in several different formulations, the lowest being .01%. It can take two weeks for the skin to become acclimated to this product, and a little bit of redness or peeling can be expected.

If you are younger, and have less photodamage, or if you are older with sensitive skin a conservative approach to retinol therapy will give a good result (which will have little to no peeling or redness). Aggressive therapy is the only approach for thick, tough skin with severe sun damage. Peel baby peel (but don’t worry, the peeling will only be for two weeks or so, until your skin gets used to it… or physiologically… until your skin gets rid of all that dead stuff on top that’s making it look dull and yucky.)

If you are seeing an aesthetician and doing aggressive treatments like Microdermabrasion. or in-office chemical peels (‘Tis the Season for Chemical Peels! –but the summer is NOT) you should not use retinols until you are done with your treatments. AND hopefully after your treatments are finished you can use a more conservative retinol product to keep your skin looking good after treatments.

Retinol comes in 3 forms:

  1. Cream (.025%, 0.05%, 0.1%)
  2. Gel (0.01%, 0.025%)
  3. Liquid (0.05%)

But guess what. The carrier of the product can intensify the results. Creams are more moisturizing. Gels contain alcohol, and this makes it penetrate deeper. Alcohol also has a drying affect, which can irritate the skin even further. The liquid also is drying due to the effects of alcohol content.

(Yes. I really own this much retinol)

How to Use:

More is not better! Start with a pea size amount for your entire face.

(Retinol products are always yellow-ish in color).

My Skin:

I personally use a night cream that has Retinol and Glycolic. Once a week or so I add a Retinol booster (liquid retinol) to my moisturizer which sometimes makes my skin peel a little because it boosts the effect of the retinol by allowing it to penetrate. I recommend retinal products for everyone. Remember, this product makes you photosensitive; i.e. you should not be in the sun when you use it! …But you shouldn’t be in the sun anyways. SUNBLOCK cough.  It’s Sunny Out! (A Post in Honor of Sun Block).  Also, because of this photosensitivity don’t put these products on during the day.

A Client of Mine…

Came in for Botox and I couldn’t get over her skin. I asked her what she was using. She said to me, I’ve been using that cream I got from you once in the morning and once and night. The cream she was talking about was the Reconstructive Repair Crème with the retinol in it. Well…. she looked amazing, and thank god it was during the winter time and she wasn’t out in the sun! She also told me she always used the sunblock/moisturizer on top of the crème. I’m not recommending anyone do this! I’m just saying, it made SUCH a difference in her skin! I could feel the difference when I injected her. Of course, I told her not to do this in summer time. J Mistakes are how we learn!

Product
Spotlight!

Image Reconstruct Repair Crème:

A highly concentrated blend of retinol, glycolic acid and oil soluble Vitamin C to resurface, rejuvenate and repair aging skin. Leaves skin youthful, firm and radiant after just a few applications.

Reconstructive Retinol Booster:

Mix two drops with the Vital C anti-aging serum or the MAX serum as directed. Must not be applied directly onto skin without prior mixing! Use only at night.

It’s Sunny Out! (A Post in Honor of Sun Block)

20 Mar

90% of Aging is due to the sun.  NINETY.

If I was stranded on a desert island and could only have ONE beauty product, it would be sunscreen (tinted of course!).  I bet you would neverrrrr think of your sunscreen as a beauty product, but it is ESSENTIAL to anti-aging.  Only sunscreen and retinol are proven to topically prevent fine lines and wrinkles and are therefore the two most ESSENTIAL products I recommend to people.

During the summer months, I decrease my use of Retin-A, because you can’t go in the sun when you are using this product.  This is also why I would choose sunscreen over Retin-A if I was ever to be stranded in a warm place.  😉

What is SPF?

A sunscreen with an SPF of X allows you to stay out in the sun X times longer without burning then you would with no sunscreen on.  THEREFORE the difference between the protection of SPF 15 and SPF 30 isn’t really as significant as you think.

  • SPF 15 blocks 93% of UVB rays
  • SPF 30 blocks 97% of UVB rays

As you can see… a 4% increase.



SPF – Doesn’t Measure Everything!

The SPF of a sunscreen only measures the UVB rays but there are UVA rays that are emitted from the sun which are just as dangerous.  The FDA is currently working on a star rating system that will help the consumer better choose a sunscreen.  Until that happens (we all know how quick the FDA is…) look for a sun block that is a physical barrier or a chemical barrier that says: broad spectrum coverage.

Physical vs. Chemical Barriers

Physical (Sun BLOCK):

Create a reflective surface on the skin that reflects UV light or scatters it off of the skin’s surface. The active ingredients in these sunscreens are zinc oxide and/or titanium oxide. These types of sunscreens are very effective in blocking both UVB and UVA sun rays and are considered to be the safest sunscreens to use.  The best products of this type will contain all-natural ingredients.

These are the sunscreens I use. I couldn’t get a picture that was clear… so I copied the exact text (with possible spelling errors. Sorry.)




Chemical (Sun SCREEN):

Contain ingredients that absorb UV light before it can cause any skin damage. These sun screens (which include most commercial brands) have been proven to be effective in preventing sunburns, but the chemicals in them have never been tested and approved for safety.

To get “broad spectrum” protection with chemical barrier sunscreens, you need to purchase a product with more than one active chemical ingredient, which increases the likelihood of the product being potentially hazardous.

I happened to have this bottle of Sea & Ski in my bathroom, but I have never used it. It was $1.99 at Christmas Tree Shop. As you can see, UVA and UVB coverage does not make the product more expensive.



Best advice:  Use a physical barrier sun block.  Wear a hat.  And don’t use your Retin-A (for now).  Enjoy the warm weather Boston!

Evaluating Your Skin

23 Jan

Like your personality, everyone has different skin, and there are many extraneous factors that affect the physical condition of your skin.  Even though I know a lot about skin, I don’t pretend I know it all, and I often ask my aesthetician friends what they think about my skin’s appearance. Usually, when my skin deviates from the norm, it’s from something I did.  By looking at your skin, an aesthetician determines the classification (Skin Care Classification Systems.) but they should also ask you the following questions to evaluate the overall health of your skin. 

Skin Evaluation Questions 

(Marmur, Ellen, M.D., 2009, Simple Skin Beauty:
Every Woman’s Guide to a Lifetime of Healthy, Gorgeous Skin, 20-21)

  • How does my skin usually behave?  Does it tend to be dry or oily?  Does it get irritated or red or hyperpigment easily (a sign of sensitivity).

My skin is normally a little oily, with rare break outs (because I regularly see an aesthetician and use products that are appropriate for me–but trust me–I’ve had my fair share of acne, hyperpigmentation, and dryness).  Because I take care of my skin, I no longer easily get irritated, red, pigmented, or break out.  But that’s MY skin). 

  • What is my lifestyle like?

I think there is not a woman alive that doesn’t have a high stress lifestyle.  But, when our stress levels get higher than normal, that’s when we can run into problems!  When I opened my first office, I’ve never had such HORRIBLE skin.  I was under so much stress!  I wasn’t eating, drinking, or sleeping (healthy right?).  I was broken out and my skin literally had a blue hue to it from not having enough oxygen and water.  It was NOT attractive.  Now I’m back to a regular level of high stress.

If you look at woman from other countries, you usually see they have nice skin.  Even though they smoke.  Well, the American life-style is high stress.  Women juggle families and careers and high levels of stress due to the pressure to achieve, and I think this is especially true of the Boston Woman.  Read more about  Skin Under Stress.

  •  Have I been doing anything differently in the last few weeks?

First Rule in Nursing:  have you done anything different?

Second Rule in Nursing:  stop whatever it is you did.

Did the symptoms stop too?  Cause and effect!  When it comes to skin reactions I like to ask if you have started using any different skin products, or have you changed your detergents?  (I personally am allergic to dryer sheets and I sleep with my face on a pillowcase… that would have touched a dryer sheet!)

  • What climate do I live in, or have I traveled somewhere recently?

Ugh, it is officially winter.  I know I have my heat on 80 right now and I am so thankful it is not forced hot air!  The type of heat you are using to heat your home will affect the air and your skin. (Check out Hydrating Ingredients in Skin Care Products.)  When the temps start warming up, of course we have the humidity… “it’s not the heat it’s the humidity!”  which can cause our skin to feel more greasy.

Changing climates from the dirty city are to the clean country air can affect your skin.  My skin likes the city 😉

  • What foods have I been eating recently?

Your diet DOES effect the appearance of your skin.  I’m not saying chocolate causes acne (don’t worry, there is zero truth to this one), but certain vitamins and minerals feed the skin.  Certain foods are healthier for your skin, just like certain foods promote a healthy liver (off the top of my head I can think of one food that is bad for your liver- alcohol)!  Avoid things high in sugar, they promote bacterial growth.  Look for foods high in vitamin A, C, and E.

  • What kinds of products do I use on my skin and how often?

I really hope by now you’ve gotten my point about over the counter products, and how they don’t do much but put a hole in your wallet.  But, pharmaceutical products aren’t always good to use everyday.  Case in point – Retin-A.  LOVE IT.  I really think Every Woman Should Own A Retinol Product.  But I don’t  think it’s for everyone EVERYDAY.  I recently upped my topical Retin-A usage to every other day.  My skin looks AMAZING, but if I use it everyday it gets red, dry, and flakey.  Ew.

**I would like to add that I also just read in a medical book that Retin-A and sunblock are the only PREVENTATIVE topicals when it comes to fine lines.

  • What kind of makeup do I wear?

I ask my clients this all the time.  Usually I ask it like this:  “Do you wear MAC make-up”  and they say “yes.”  NOOOO.  Don’t get me wrong.  I love MAC’s eye-shadows.  I love their fake eyelashes.  But their face make-up is “stage make-up” which is NOT for everyday use!  It clogs your pores and can make acne much worse.  PLEASE stop using this product everyday!  Start using good skin products, and throw out your make-up!  Be natural!  (Yes, the Botox Queen supports natural!).  When I do feel the need to wear a face make-up, I stick to mineral make-up.

***Also, did you know that if your skin tends to be greasy you should use powder based foundation, and if it tends to be dry you should use liquid based foundations?

  • How many showers a day do I take?

I know we love long, hot showers in the winter, but try to keep it quick.  Not only does it make you “green,” but long, hot showers dry out your skin.  Moisturize!

  • Do I have a stressful job?

Obviously!  I’m not even going to start on this one!

  • Do I smoke?

I hope the answer to this is no.  It’s funny.  We know how bad smoking is for your health, but for some reason people still do it.  Well, if the threat of cancer hasn’t stopped you, and the insane cost hasn’t stopped you, perhaps this will:  smoking is bad for your skin.  It prematurely ages you.  It thins your dermal layer, destroys your cell’s DNA, and gives a yellow hue (from toxins).  I pray that if you have stopped by medical reasons, perhaps vanity can play some roll in ditching the cancer stick.  I know it’s hard, but it is really, really bad for your skin (and health and wallet).

  • Do I take any medications regularly?

There are TONS of medications which can interfere with the health of your skin.  Read your bottles.  Do any say stay out of the sun?  I promise you, the bottle is not lying to you.  Hypersensitivity to sunlight is a common side affect with many medications.  Be extra careful to wear sunblock, even in the winter.  Please and thank you.

  • Am I pregnant?  Have I recently had a baby?

I can safely say no to these questions, but, as I’m sure you all know, pregnancy comes with MANY hormonal changes.  And do not sound fun (I recently learned from patrons at a Botox Party the most important word to know during pregnancy- Epidural).

  • Have I had surgery or any health problems in the last year?

When your immune system is down, or your body is in a state of repair, the essential vitamins and nutrients your skin requires may be diverted to other organ systems that need them more.

  • Do I wear sunscreen?

EVERYDAY.  Even in the winter.  Like I said earlier, sun damage is the number one cause of fine lines.  Do you know how men can tell your age?  By looking at your hands, because they are always exposed to sunlight.  Ok, it’s winter, we go from home to car to job to home (at which point the sun is already probably gone).  So many of us think we don’t need sunblock.  WRONG.  You are exposed to UV rays in the car.  When looked at under a skin lamp, the drivers side of a face displays 90% more sun damage.

Check out There’s a fine line between tan and looking like you rolled in a bag of doritos.  (It is one of my most highly viewed posts!)

  • Do I pick at my face nervously?

I do.  It’s so bad.  I was actually put on Celexa at one point for this nervous habit.  I’m so glad I was too, because it worked!

  • How many products do I use on my skin and hair everyday?

You don’t need to be using a crazy amount of products, and you don’t necessarily need to be using everything, everyday.  We have this notion that if a little is good, a lot is better.  Not true.  Follow the directions for usage from your aesthetician, or at least the instructions on the products you are using (that are pharmaceutical grade).  As you can see from the picture, I have a lot of products–but I don’t use every one everyday.

  • Do I touch my face a lot?

As a nurse, I can tell you, nails are DIRTY.  Hospitals have banned acrylic nails for nurses in hospitals because of the germs they carry.  By touching your face, you are introducing those germs and bacteria to your skin.  One of the biological roles of skin is to protect the internal organs from infection.  If you are picking at your skin you are essentially breaking the barrier, and allowing an area of access for bacteria.

The skin is a protective barrier against dirt and bacteria.

Bacteria is under your nails.

Picking at your skin with your nails tears the skin.

THEREFORE:

Picking breaks the protective barrier and at the same time introduces bacteria and dirt from your nails.  BAD.

  • Do I use hair gel or pomades?

I don’t know what a pomade is….. I guess that is for short hair! I do know this… I often break out on my hair line when I am on day 3 of not washing my hair (you shouldn’t wash your hair everyday).  Hair products can contains skin clogging ingredients, or might contain ingredients that your skin is sensitive to.

**I’m not sure if I took this picture crooked, or hung the shelf crooked?            ———————–>

  • Is there a specific area on my face that is constantly a problem?

Like perhaps you break out where your cell phone constantly touches?  Swab down your phone with an alcohol pad, daily!

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