The Good, the Bad, and the Ugly about Exfoliation

In continuation of last week’s article, let’s start with the good.  The “good” is of course the reason everyone wants to exfoliate.  Exfoliation sheds dead cells.  Since the skin has to maintain a balance, this in turn stimulates the production of new cells, or renewal.  Consequently, the skin looks fresh and healthy, with a smoother, softer texture.  So what you want is a pace of exfoliation that is faster than what the skin wants to do on its own.  Aside from the pace, you want it to be consistent and long term.  Fresh, new, exfoliated skin doesn’t stay that way on its own.  Stop stimulating renewal, and the skin will revert to its baseline, which can be dull and drab.

So how can exfoliation be “bad”?  Exfoliation makes the skin more sensitive to chemicals or other treatments.  For example, say you’re using an exfoliating glycolic product regularly, and all of a sudden, some of the other products you use regularly start to burn or itch when you apply them.  Or maybe you get a brow wax and notice that the skin stays red and tender for a few days afterwards.  In short, depending on your skin type and exfoliating regimen, you may have to change some of your other skin care routine to compensate.

Last but not least, the ugly.  You can go from fresh and smooth to red, dry, itchy and irritated skin.  Apply some other products to soothe and it only gets worse. What’s happening?  You’re exfoliating too much or too aggressively.  I see this commonly when my patients are using an exfoliating cream like Retin-A and the clarisonic device.  It’s too much.  Rule number one: don’t combine exfoliation methods.  For example, don’t use a scrub (mechanical) and use Retin-A (medicinal) at the same time, or apply Retin-A the week after your chemical peel(chemical).

In conclusion, with some of these tips in mind, you should get only “the good” out of your exfoliation regimen.

By: Oscar Hevia, MD

Beauty 101: What causes “Lip Lines”?

After reading with interest the beauty article entitled “Is chewing gum giving you wrinkles?” http://on.allure.com/ysUaTm by Sophia Panych, I thought it would be great to write about the things that are much more likely to cause wrinkles around the mouth than the somewhat controversial, and debatable, chewing gum-causes-wrinkles theory.

Almost all wrinkles are caused by what I call “movement stress” on the skin.  In other words, specific areas of the facial skin are subjected to movements, either by expressions (smiling, frowning, etc.), or during sleep, from the pillow pressing against the face.

Now back to the lips, or more specifically, the skin around the lips. It wouldn’t surprise you to know that the skin around the lips is subjected to incredible movement stress, which is due primarily to speech, and to a lesser extent, certain expressions.  The real culprit here is the circular muscle (the orbicularis oris if you must know) around the lips, that purses your mouth, like when you suck out of a straw or pucker them to give a big “air kiss”. So the most practical thing you can do to prevent wrinkles around the mouth is: avoid drinking through straws and don’t smoke!  Both of these acts will worsen your lines.

By: Oscar Hevia, MD

BEAUTY 101: “WRINKLES” VS “FOLDS”

The title of the blog “The Wrinkle You (Kinda) Want”, by Elizabeth Siegel, (http://on.allure.com/J7DLNp) was eye-catching.  What wrinkle could that be, I wondered?  I liked the gist of the article, since it’s always a good idea to leave some facial features well-enough alone and not get obsessed about removing every little thing. Nonetheless, I would like to clarify what feature some of us might want to keep and “not necessarily lose”.

We all know what wrinkles look like, so no need to delve here.  It’s more about the “folds”. Another word for the term “fold” is the word “groove”.   The “nasolabial” fold is the natural groove that extends from the bottom corner of the nose, at an angle, to near the corner of the mouth. Lots of kids and young adults have them, so they’re obviously not necessarily a sign of aging. What you don’t see at a younger age, however, is a wrinkle in the nasolabial fold.  This only happens as you age, although when it appears varies greatly, depending on skin type, genetic factors, and sun exposure.

So to treat, or not to treat, is always a good question.  I always try to be as descriptive as possible with my patients so they can make the right decision.

By: Oscar Hevia, MD

Beauty 101: Exfoliation

In the beauty world, everyone wants to “exfoliate”. Yet I’d bet you that almost no one really understands what exfoliation really means.

Exfoliation means shedding.  Under normal conditions, our skin sheds everyday, and the process is invisible.  In fact, our skin (the top layer, or epidermis, to be exact) replaces itself roughly once a month. So what’s so exciting about this process of exfoliation?

Well, it turns out that with age (and genetic factors) the normal renewal cycle of the epidermis can slow down.  This results in dull, lifeless and rough skin.  Speed the process up, and you stimulate renewal.  All of a sudden your skin looks fresh and smooth.  How do you stimulate the natural exfoliation process?  Or Speed it up?

There’s three basic ways to do it: Mechanical, medicinal, or chemical.  Mechanical methods include scrubs, buff pads, or those devices that scrub, like Clarisonic. You’re literally scrubbing dead cells off.  Medicinal methods include the use of “retinoid” creams, Vitamin A derivative substances that stimulate cell receptors to speed up shedding.  These include products like Retin-A, Retinol, etc.  Finally, chemical methods involve the use of acids which technically kill cells and then stimulate their replacement, hence shedding.  These include fruit acids, like glycolic acid, TCA, or salicylic acid.

So there you have the basics.  Stay tuned next week, and I’ll tell you the good, the bad, and the ugly about exfoliation.

By: Dr. Oscar Hevia, MD

Achieving The Bridal Glow

Rarely does a wedding take place that someone doesn’t comment about how the bride is glowing.  It is, after all the most special day of her life. The glow is a natural part of the joyful experience, but if you’re like most brides, you’re concerned about looking your very best. That’s why I believe getting camera-ready and achieving the bridal glow should be as much a priority as the dress and the veil.

As a cosmetic dermatologist, I encourage you to consider your skin care as early as six months before the wedding.  I recommend my brides-to-be begin with a skin care consultation where I evaluate their needs so I can personalize a pre-wedding skin care regiment and treatments.  These treatments could include exfoliating facials, microdermabrasion, light therapy, infusion of oxygen, laser treatments and chemical peels.

Beyond the healthy glow of the skin, it’s common for brides to have cosmetic procedures such as fillers to give the lips and cheeks more fullness or injections to smooth out those furrows and squint lines around the eyes.  A few simple injections can give the face a flawless appearance for the photo shoot.  Cosmetic procedures should be done at least 2-3 months prior to the wedding, as some procedures take time to fully activate and multiple treatments might be required to achieve optimal results.

For brides who are prone to breakouts from recurring acne or the stress of wedding planning, I recommend regular exfoliating facials and products that keep the pores clean, eliminate bacteria and prevent the spread of breakouts.  Additionally, getting plenty of rest will also help to eliminate stress-related breakouts.

If you’re a sun worshipper, overexposure to the sun can cause discoloration of the skin and pigmentation.  Recommended treatments typically combine exfoliation, skin lighteners and laser treatments.  However, I always emphatically encourage my patients to avoid overexposure to the sun and include sunscreen as part of their tanning regiment.

By allocating time and resources for your personal appearance in the months leading up to your big day, you’ll surely be a blushingly beautiful bride.  Congrats!

By: Oscar Hevia, MD