Posts for category: About Your Skin
As we age our skin changes. Perhaps the most important factor causing these changes is exposure to ultraviolet (UV) light from the sun. When these UV rays hit the skin they produce harmful free radicals. Free radicals are certain molecules that damage the skin in a number of ways. They cause the breakdown of collagen, the protein in the skin that holds it together, giving it a youthful and tight appearance. This leads to the formation of fine lines, wrinkles, laxity, and enlarged pores. It also thins out the deeper layer of the skin called the dermis. This makes the skin looks and feel thinner. UV rays also produces broken capillaries which become visible to the naked eye. Additionally, UV rays lead to formeation of sun spots by causing certain cells in the skin called melanocytes to produce a molecule called melanin, the pigment that gives the skin its color. This is what happens when we get a tan. Also excess melanin is seen in freckles, age spots, and melasma.
There are many of things we can do to protect ourselves from and correct this damage. Using suncreen every day is the most basic way to prevent sun damage. Dr. Alex recommend using a sunscreen with SPF of at least 30 with broad spectrum (or UVA and UVB) protection. Our most popular sunscreens are the Elta MD UV Clear sunscreen and the Alastin Hydratint sunscreen. Other skin care products to use include antioxidants (such as vitamin C and green teat extract) to block the harmful free radicals, retinoids (such as retinol and retin-A) to stimulate collagen production and a firm appearance, and brightening creams (such as the A E Skin Brightening Cream) to remove the dark discolorations. Brightening products include ingredients wuch as hydroquinone, kojic acid, arbutin, licorice extract, and many more. Treatments include facials, microdermabrasion, chemical peels, and various laser treatments. These are designed to exfoliate or target specific things in the skin such as dark discolorations and broken capillaries. Dr. Alex recommends a combination approach by using products at home and getting treatments that focus on your specific concern. This combination approach provides the best results and a continued youthful appearance.
One of the most common questions is “Do I need to apply sunscreen even if I don’t go outside?” The answer is yes and the reasons are described here.
How does the sun affect the skin?
The sun provides light and heat to allow us to live. The light emitted from the sun has many different colors or wavelengths, some of which are harmful to the skin. Specifically, UV rays (or ultraviolet rays) damage the skin over time. When UV rays reach the skin, they cause changes in the skin. The cells in the skin produce something called free radicals. Free radicals lead to a number of changes in the skin. They damage and degrade collagen, the protein in the skin that keeps the skin tight, firm, and youthful. As a result, the skin becomes loose and saggy and fine lines, wrinkles, and enlarged pores are seen. Another change is the formation of dark discolorations, sometimes called sun spots. The harmful free radicals stimulate the skin to form these unsightly dark spots. Other effects include thinning of the skin, decreasing the skin’s protective barrier function, and leading to the formation of broken capillaries or generalized redness. In order to prevent all of these changes it is important to protect ourselves from the harmful UV rays.
What sunscreen should I use?
Dr. Alex recommends using a sunscreen with an SPF of at least 30 every day. Also make sure it has broad spectrum (or UVA and UVB) protection. Ingredients such as zinc oxide and titanium dioxide provide such protection. If outdoors for long periods, reapply sunscreen every one to two hours. Also reapply if your skin gets wet such as when swimming. Avoid direct sun exposure and try to stay in the shade as much as possible when outdoors, especially during the middle of the ray when the UV rays are the strongest.
When should I apply sunscreen?
Many people feel that it is only necessary to apply sunscreen when doing certain activities such as going to the beach. But exposure to harmful UV rays occurs even with short exposure to the sun such as going outside to get the mail. It is also important to understand that the temperature is not related to the amount of UV rays. For example, although it may be cold in the winter months, there is still sun exposure so it is important to apply sunscreen during all four seasons. At the same time rainy weather does not block all UV rays. Many people do not apply sunscreen when it is overcast or raining. However, the harmful UV rays can penetrate the clouds and still damage the skin. Therefore, it is important to apply sunscreen on rainy days too. Also, UV rays penetrate through glass such as car windows and windshields. Although not technically outside when driving, you are getting exposure when driving. Additionally, many people work in offices where sunlight enters through windows, exposing them to harmful UV rays.
So even though you may think you’re not outdoors, you are still getting a lot of sun exposure. Over years, this exposure to harmful UV rays damages the skin, leading to changes associated with aging such as fine lines, wrinkles, uneven color, and redness. Applying sunscreen every day will prevent these changes.
Melasma is a common condition characterized by the appearance of dark patches on the skin. Any area on the skin can be affected; the most common areas are the forehead, upper cheeks, and above the lips. Melasma is caused by an imbalance of hormones on the inside which makes the skin very sensitive to the sun. When exposed to the sun, the patches appear and become dark. The pigment that is produced in the skin can be deposited either in the surface layers, deep layers, or most commonly both. The dark patches are seen more frequently in the summer months when the suns rays are stronger and when people are outdoors more. Melasma affects women more frequently than men and is common when hormone levels change such as during pregnancy, after delivery, and when going on or off birth control pills.
Since the cause of melasma is internal, unfortunately there is no cure. So melasma is a condition that is controlled, not cured. Treatment is multi-factorial and can often be frustrating. The most important aspect of treatment is applying sunscreen every day and minimizing sun exposure. Look for a physical sunscreen with active ingredients such as zinc oxide or titanium dioxide that has an SPF of at least 30. These provide broad spectrum coverage, meaning they protect against UVA rays which causes aging and UVB rays which cause burns. The next step in treatment includes the use of a good skin care regimen that prevents the skin from producing excessive pigment. Dr. Alex recommends the A E Skin Brightening Cream, Exfoliating Serum, Triple Antioxidant Serum, and Hydrating Serum. Look for products that reduce pigmentation. Active ingredients in such products include hydroquinone, kojic acid, vitamin C, alpha-arbutin, licorice extract, and a variety of others. Ingredients such as retinol, retin-A, salicylic acid, glycolic acid, and lactic acid will help to exfoliate the skin to get the pigment out faster. Often times these products will dry or irritate the skin so it is important to moisturize the skin twice daily. Lighter moisturizers work well for youthful skin, while heavier moisturizers work better for mature skin. Adding products with hyaluronic acid to the regimen will increase the hydration and benefit the skin. It is important to use a good skin care regimen for three months prior to having any treatments. This will correct the skin before the treatment and prevent the risk of worsening of the melasma with treatments.
There are a variety of treatments available for melasma. After having a good skin care regimen in place, the most important aspect of melasma treatment is to be conservative. Treatments must be mild and six to eight sessions are often required. Treatments are usually performed every four to eight weeks. The mildest treatments include basic facials and microdermabrasion. Microneedling and Ultra Microneedling are also effective treatments. Chemical peels and laser peels serve to exfoliate the skin and get the pigment out to the surface faster. Contrary to what most people hear, IPL photofacials can be used to treat melasma. Such treatments are useful especially when the pigment is closer to the surface. Not all IPL photofacial devices are versatile. But the Forever Young BBL IPL photofacial by Sciton that Dr. Alex uses has many settings that can be adjusted for safe treatment of melasma. Dr. Alex uses higher wavelengths of light, lower energy settings, longer pulse widths (the time that the light is on), and colder temperatures to ensure safe treatments. When the pigment is in deeper layers of the skin, fractional lasers such as Pro Fractional or fractional CO2 can be used. These create tiny hole sin the skin which allow the pigment in the deeper layers to come out. Again, many people say not to use such devices for melasma. But they can be effective when appropriate settings are used, the dwell time should be minimized and treatment densities should be low. Combining multiple of such modalities will provide even better results.
The amount of sleep you get each night can have an effect on the appearance of your skin. While everyone is different, most people require seven to eight hours of sleep per night. Not getting enough sleep affects the appearance of the skin. This is seen commonly as puffiness under the eyes because the blood vessels around the eyes open up and bring fluid into that area. Additionally, when you do not get enough sleep your body releases the stress hormone cortisol. Cortisol leads to breakdown of collagen in the skin, the protein that gives the skin its tightness. Over time, this leads to fine lines, wrinkles, and laxity. At the same time, when you get enough sleep your body produces an adequate amount of human growth hormone, which thickens the skin. A recent study by Estee Lauder demonstrated scientifically that inadequate sleep speeds up skin aging. Specifically, poor sleep correlates with increased amounts of fine lines, wrinkles, laxity, and discoloration. So before starting a new skin care regimen or doing treatments, be sure that you are treating your body and skin right by getting enough sleep, eating a healthy diet, getting regular exercise, protecting yourself from the sun by applying sunscreen daily, and avoiding bad habits such as smoking and drinking alcohol.
As we age our skin changes. Perhaps the most important factor causing these changes is exposure to ultraviolet (UV) light from the sun. When these UV rays hit the skin they produce harmful free radicals. Free radicals damage the skin in a number of ways. They cause the breakdown of collagen, the protein in the skin that holds it together, giving it a youthful and tight appearance. This leads to the formation of fine lines, wrinkles, laxity, and enlarged pores. It also thins out the deeper layer of the skin called the dermis and produces broken capillaries which become visible to the naked eye. Additionally, UV rays will cause certain cells in the skin called melanocytes to produce a molecule called melanin, the pigment that gives the skin its color. This is what happens when we get a tan. Also, excess melanin is seen in freckles, age spots, and melasma.
There are a number of things we can do to protect ourselves from and correct this damage. Using sunscreen every day is the most basic way to prevent sun damage. Other skin care products to use include antioxidants to block the harmful free radicals, retinoids to stimulate collagen production and a firm appearance, and brightening creams to remove the dark discolorations. Treatments include facials, microdermabrasion, chemical peels, and various laser treatments. These are designed to exfoliate or target specific things in the skin such as dark discolorations and broken capillaries. People that get the best results are those that combine a good at-home skin care regimen with regular treatments in the office. For this reason Dr. Alex's philosophy is to have a combination approach, by preventing and correcting in multiple ways for a sustained youthful appearance.
Skin care during the summer months is extremely important. Sunlight can cause a lot of damage to the skin including fine lines, wrinkles, age spots, and skin cancer. So it is important to protect yourself every day.
Dr. Alex recommends applying a sunscreen with SPF 30 or greater such as the Alastin Hydratint sunscreen or Elta MD UV Clear sunscreen. Look for sunscreens that have broad spectrum protection. Remember that you are receiving sun exposure when inside a car through the windows. Apply a liberal amount of sunscreen at least 30 minutes before sun exposure. Don’t forget areas from the neck down which may be exposed such as the chest, back, arms, and legs. These areas can get sunburned too. If you are outdoors for prolonged periods, reapply sunscreen every two hours. Also reapply sunscreen if your skin gets wet such as when going in the swimming pool. Avoid sun exposure during the peak hours between 10 AM and 4 PM. When outside, try to stay in the shade as much as possible. Wear protective clothing such as hats, long-sleeved shirts, and hats. Finally, be sure to stay hydrated by drinking six to eight cups of water daily.
Some of the most common concerns on the skin include fine lines, wrinkles, uneven color, and broken capillaries. The major cause of these concerns is sun damage which occurs during childhood. Therefore, it is important to begin protecting the skin at a young age.
The sun damages the skin in multiple rays. Ultraviolet (UV) rays from the sun damage the cells by creating free radicals. These result in uneven color, dark spots, and age spots. They also lead to the formation of broken capillaries. In addition, UV rays damage collagen, the protein in the skin that is responsible for maintaining the tight and firm appearance. Over time the skin can become thick or thin, uneven in color and texture, and appear damaged. Therefore, it is important to protect the skin from the sun.
How to protect your skin from the sun
The most important thing a person can do to protect his/her skin from the sun is apply sunscreen every day. The American Academy of Dermatology recommends using a sunscreen with an SPF of at least 30 every day throughout the year, including the winter months. While it may be cold during the winter, there is still sun exposure and protection is important at all times. This also includes days in which it is overcast because UV rays can penetrate the clouds. It is also important to use a sunscreen that has broad spectrum protection, meaning that it protects against both UV rays that cause aging and UV rays that cause burning. Physical sunscreens such as those containing zinc and titanium are outstanding in this respect. If outdoors for prolonged periods, re-apply the sunscreen every two hours. This includes when driving because the UV rays penetrate through the windows and windshields. Protective clothing can also be worn to protect the skin and it is important to avoid sun exposure during the mid-day when the rays are the strongest.
Protecting Children’s Skin
Interestingly, the majority of a person’s sun exposure occurs during the first two decades of life. This is because children often play outdoors when in school or at camps. Therefore, it is critical to protect our children by applying sunscreen. Sunscreen should be applied as early as six months of age. Physical sunscreens such as zinc and titanium work best because they have minimal risk for allergic reactions. While we have tools such as Botox, Voluma, and fractional CO2 laser resurfacing to address many concerns, it is much easier to prevent them in the first place by protecting the skin at an early age.
One of the most common concerns people have is a loss of their jawline definition. Instead of being sharp and defined, over time the jawline can become softer or even invisible. We now have a number of treatment options to help improve jawline definition.
What causes loss of jawline definition?
The jawline is seen be the protrusion of the jaw bone, or mandible. Over time there are many changes that affect the appearance of the jawline. These occur from both above and below the jawline.
Above the jawline, the fat pads in the mid-face get smaller. At the same time the bony structure of the face changes; the cheekbones move downward and inward. These fat pads and bony structures normally hold up the face and, as a result, the face moves downward. Over time we also naturally lose collagen, the protein in the skin that keeps it firm, tight, and youthful in appearance. As collagen is lost the skin becomes loose and saggy and with gravity the skin of the mid-face and lower face goes down. All of these changes make the jawline less defined.
Below the jawline other changes occur. One is the increase of submental fat. This is the fat under the chin commonly called the double chin. A double chin can be due to age, weight gain, or genetics and is very common. When this gets larger the protrusion of the jaw bone is not as evident and we lose the definition of the jawline. Simultaneously the muscle in the neck just under the skin called the platysma becomes stronger with more use over time. This muscle pulls down on the lower face and when contracted it can also distort the jawline.
How can jawline definition be treated?
To improve your jawline definition all of these factors can be addressed. First it is important to apply sunscreen daily to minimize the effects of sun damage. The sun destroys the collagen in the skin, causing looseness and sagging of the skin.
Voluma is a filler used in the mid-face to restore lost volume. By placing fillers such as Voluma high on the cheek bone, the entire lower face becomes lifted, improving the visibility of the jawline. It also restores the youthful apple of the cheek that is naturally lost over time. By pulling up on the face Voluma also addresses other concerns such as laugh lines (nasolabial folds) and marionette lines.
Fractional CO2 laser resurfacing stimulates your body to naturally produce new, fresh, and healthy collagen. Doing this will tighten the skin, providing a youthful appearance while pulling up on the jawline. Fractional CO2 laser resurfacing has other benefits including treating fine lines, wrinkles, discolorations, and acne scars. Fractional CO2 laser resurfacing can also be used to treat surgical scars and stretch marks. Results are seen slowly with this treatment so patience is important.
Kybella is the first and thus-far only FDA-approved non-surgical injectable treatment for the double chin. The active ingredient in Kybella is a naturally occurring substance produced in the body. When injected into the double chin Kybella will dissolve the fat and it is eliminated naturally by your body over time. A series of Kybella treatments is required over several months. Unlike other treatments such as Botox and fillers, with Kybella maintenance treatments are not required. When the fat in the double chin is removed, the jawline appears more visible and defined.
Botox is a purified protein used to address muscles associated with facial expression. In the neck, Botox can be placed in the platysma muscle, a thin muscle just beneath the skin that pulls the lower face downward. When it becomes very strong sometimes vertical neck can be seen. Botox can be placed in this area to relax the muscle, softening the bands and preventing the muscle from pulling down on the lower face. When this happens the lower face and mid-face are lifted thus improving the jawline definition.
Dark circles under the eyes are a common concern for many people. There are many factors that contribute to it such as genetics, age, and lifestyle. Fortunately, there are several things we can do to improve dark circles under the eyes.
Get enough sleep
Getting enough sleep is critical to improving dark circles under the eyes. If you get enough sleep every night, the areas around the eyes will appear brighter in the morning and you will look more rested. In today’s day and age getting enough sleep is difficult with crazy work schedules. Although most people require about eight hours of sleep every night, some people require less and some require more. And this can change with age; usually we need less sleep as we get older. Having good sleep habits will help. Try to have a routine every night so that you can relax and fall asleep easily at the same time every night.
Eat a healthy diet
Eating a healthy diet is another lifestyle change that can affect the appearance of the eyes. What the doctor tells you to eat is not only important for your health, but also for the skin. Changes in the skin are often manifestations of what is going on in the body. Make sure to eat enough fruits and vegetables every day and avoid foods that are high in fat or sugar. Try to eat foods that are high in antioxidants. Antioxidants help neutralize free radicals that damage the skin. At the same time avoid habits such as smoking which increase free radical formation in the body. Equally important is drinking enough water. About two thirds of the skin is water so it is important to have enough water in your body for appropriate function and appearance of the skin. When your body is dehydrated, the skin becomes dry and the areas around the eyes have a sunken appearance.
Exercise is the third lifestyle habit that will improve the appearance of dark circles under the eyes and the skin in general. Exercise is great for all parts of the body, the heart, the brain, the skin, and many others. Exercise allows for blood flow to the skin, providing nutrients to allow the skin to be healthy and function normally. When this happens, the skin looks better.
Use sunscreen daily
Sun damage is one of the most common causes of aging in the skin. The sun leads to many changes associated with aging including fine lines, wrinkles, sagging, dark spots, redness, and skin cancer. It is therefore important to protect your skin from the sun every day with a sunscreen with a minimum SPF of 30. Apply sunscreen every day of the year, even when it is cold outside because there is still sun. Also, apply sunscreen if it is overcast because some of the sun’s rays penetrate through clouds. Many people do not apply sunscreen because they are not outside much. But it is important to understand that when you are driving in your car or sitting inside near a window, the sun’s rays are still hitting your skin. Around the eyes sunglasses provide further protection.
Use a good eye cream
Eye creams can help improve the appearance of dark circles under the eyes. The new A E Skin Green Tea Essentials Enlightening Eye Cream is a great example. It includes multiple ingredients such as vitamins A, C, and E, retinol, and hyaluronic acid. These ingredients serve to improve the skin in a number of ways by hydrating the delicate skin under the eyes, providing volume, and stimulating collagen formation to tighten the skin.
Fillers under the eyes
Dermal fillers such as Restylane are commonly used to address dark circles under the eyes. One of the most common causes for such dark circles is loss of volume and hollowing under the eyes. In regular light a shadow is cast from the forehead to the tear trough, giving the appearance of a dark circle, which makes people look old and tired. Fillers such as Restylane can restore the lost volume and provide a healthy, youthful, and rested appearance.
We all know the risk of smoking on the health including lung damage, heart disease, increased risk of cancer, and others. But many people do not know the effects that smoking cigarettes has on the skin over time. A new study conducted by Dr. Haruko Okada and colleagues at Case Western Reserve University in Cleveland, Ohio published in the November 2013 issue of Plastic and Reconstructive Surgery demonstrates these effects. The study compared photographs of twins, one of which smoked and the other did not, or one of which smoked at least five years longer than the other. The photographs of the smokers demonstrated significantly more signs of facial aging including eyelid laxity, under eye bags, fine lines, deep lines, sagging skin, and discolorations. In the image from the study shown here, the twin on the right smoked 14 years longer than his brother. Although they are the same age, the smoker has more wrinkles and deeper wrinkles and appears older. Like sun exposure, smoking leads to the formation of harmful free radicals in the skin. These harmful free radicals have multiple effects. They damage the collagen in the skin, the protein that holds the skin tight, leading to fine lines, wrinkles, and sagging. It also leads to discolorations which are commonly known as age spots. Sunscreen can block the harmful effects of the sun, but it can not protect the skin from the free radicals generated from smoking. Topical antioxidants such as vitamin C can neutralize these free radicals to prevent aging. But the best way for smokers to prevent aging is to quit smoking. Other elements of a healthy lifestyle include sun protection, eating a healthy diet, getting regular exercise, and getting enough sleep. Making healthy lifestyle choices will lead to healthy and youthful appearing skin