Four reasons you might not be using a retinoid (and why you may want to start….)
1. “I don’t think I know what a retinoid actually is.”
Retinoids (including terms you may recognize such as “retinol” and “Retin-A”) are vitamin A derivatives that, when used properly, cause several positive changes in the skin, including helping to unclog pores, boost collagen to reduce fine lines, improve cell turnover to even skin discoloration and texture, and can help decrease the risk of skin cancer when used over a period of time.
As a prescription acne treatment, the first retinoid, tretinoin (Retin-A) was FDA approved in 1971. In addition to improving acne, the anti-aging benefits were soon noticed by dermatologists as well as patients. Currently, there are three prescription-strength retinoids: tretinoin (brands include Retin-A, Retin-A Micro, Renova, Atralin, Avita), tazarotene (Avage, Tazorac), and adapalene (Differin).
As an alternative, there are over-the-counter retinoids available, such as retinol and retinaldehyde. Because retinol is gradually converted into retinoic acid (the active ingredient in the prescription creams) it is somewhat less potent — but also sometimes less irritating.
2. “I want immediate results!”
While some retinoids (such as tazarotene) have demonstrated improvements in as early as four weeks, for the most part, you should not expect to see any changes in your skin for eight to twelve weeks or longer — especially when using over the counter retinoids and lower-strength prescriptions. There are changes that happen in many layers of your skin with consistent and persistent use of retinoids. Additionally, many of the improvements happen within the cells of the skin. So, the trick is to use it consistently and over time.
3. “I think a retinoid will make me sensitive to the sun.”
The ingredient itself is sensitive to sunlight, so it’s important to apply it to your skin at night.
However, as for making your skin for sensitive to the sun, this may be more of a myth. It does “exfoliate” your skin by decreasing the outer layer of dead skin cells. So, similar to buffing or scrubbing your skin, this may make your skin very slightly more vulnerable to UV rays. Actually, the increased humidity in the air may make it easier to adjust to using a retinoid during warmer months. Of course, it is important to be vigilant with sun protection and include sunscreen with at least an SPF/UPF 30 to avoid undoing the positive changes to your skin!
4. “I’m afraid my skin will look worse before it gets better.”
Many of the problems may come from the improper use of retinoids (applying too much, too often, for example). Even when used correctly, the use of retinoids may cause temporary redness, dryness and flaking, but if you ease in you can minimize these transitional effects. After cleansing the face with a gentle cleanser, allow the skin to dry completely (wait 15 min at least), and if your skin is especially dry, apply a light moisturizer. Then, I generally recommend using a “pea-sized” amount dotted and then smoothed on the entire face except the eyelids and lips. For the first two weeks, apply twice a week. If your skin isn’t dry or flaky, it’s safe to ramp up by adding one night a week every two to three weeks as tolerated. I also recommend starting with a moderate-strength, and then increasing to a higher strength once that bottle’s finished if you aren’t having any problems.
The trick is consistent and regular use to see long-term benefit.
Waxing, exfoliating and using exfoliating lotions (such as glycolic or salicylic acid containing moisturizers) may cause excess irritation and redness on retinoid-treated skin. A very small percentage of people with ultra-sensitive skin will never tolerate a retinoid even with a very slow ramp up. If you’re one of them, you will need to be even more conscientious about sunscreen to prevent collagen loss in the first place.
As an FYI, it’s not recommended to use a retinoid if you are pregnant or breastfeeding. Also, be careful when using other products on your skin. For example, benzoyl peroxide and alpha hydroxy acids may deactivate retinoids, so don’t layer them.
Dark circles under the eyes is a common condition we, as dermatologists, see almost daily. Dark circles can be the result of several different causes often working in combination with each other. Over time there have been many home remedies and creams developed to help give some relief, often with disappointing results. Effective solutions range from simply changing your sleeping position all the way to surgery, depending on the underlying causes.
The skin around the eye is particularly sensitive to the surrounding environment and may begin to show signs of aging before the rest of your face. Allergies and eczema are common causes of dark circles and are best treated with antihistamines, topical creams or anti-inflammatory treatments. Dark circles that appear primarily in the morning and go away by evening may be a result of sleeping on your side or stomach. Fluid collects in this delicate tissue and leads to dilation of the blood vessels under your eyes. A binge night of sushi with high salt soy sauce often has the same effect.
Fading or bleaching creams are usually a first line approach to reducing dark circles. Although this seems like a good solution, increased pigmentation is not the only reason for dark circles under the eye. You can usually tell if increased pigmentation is a contributor by moving the skin to the side and stretching it. If blotchiness remains, bleaching creams containing hydroquinone or kojic acid may be helpful.
The primary cause of dark circles is thinning of the skin along with the loss of fatty tissue under the skin beneath the eye. This causes the skin to be loose and to sag. The resulting contour changes create shadowing and the result is dark appearing circles. This can be minimized with Vitamin A derivatives such as retinol and Retin A which improve the skin texture and “thicken” the skin to a certain degree. This also helps hide the underlying vessel, which can contribute to the dark circles. Fillers are also helpful in re-sculpting the natural contours around the eyes thus reducing the shadows.For more extreme cases a surgical approach may be necessary.
Several products are available at Carolina Aesthetics that address under eye circles. Revision’s Teamine Complex and DEJ Eye Cream contain anti inflammatory and brightening ingredients. Dermal Resolutions has a Retinol Eye product and Neocutis’ Lumiere has a combination of growth factors, caffeine and antioxidants for under eye skin health. Speak with your dermatologist or one of our aestheticians to see if any of these products may be right for you. Our skin care consultations are always free of charge and designed to customize a care regimen for your skin.
Aging in human beings is a complex and fascinating biologic process that has been extensively studied in the last few decades. Each individual person has a unique genetic profile that determines their own intrinsic aging process. Extrinsic aging of human tissue comes from external factors that individuals may encounter in daily life, such as toxic chemicals, environmental pollutants, cigarette smoke, and solar radiation. “Antiaging” involves attempts to limit and control exposure to these extrinsic factors.
The use of topical antioxidants has been proposed as a method to aid in the anti-aging process of the skin since these compounds have the ability to reduce “free radical” damage to cells in human tissue. But what is meant by the term “free radicals”?
Free radicals are atoms or groups of atoms that contain energy that can potentially damage cell membranes and DNA. Although free radicals are continuously formed during normal cell metabolism within the body, antioxidants are also naturally found within cells in the body and they serve to block the damage that the free radicals can cause. In short, antioxidants block the damage that can be caused by free radicals. Our natural antioxidant defense system is supported by nutrients such as vitamins C and E, other phytochemicals, and certain minerals such as selenium and zinc.
Physical and chemical influences in our lifestyle and environment can cause the overproduction of free radicals. These are influences such as environmental pollutants and toxins, cigarette smoke and ultraviolet light (sunlight). When this happens, our natural antioxidant defense mechanism is overwhelmed and cell damage occurs. Research has shown that numerous chronic diseases including those of the skin are a direct result of chronic, uncontrolled free radical cell damage. There is growing evidence that supporting the antioxidant defense system by adding dietary and topical antioxidants may help protect cells and alter the course of aging caused
by free radicals.
In addition to the daily application of sunscreen, most dermatologists encourage the use of topical antioxidants to skin. Using topical vitamin C, E, and other phytochemicals such as green tea, coffee berry, feverfew, coenzyme Q10, and pomegranate extract should help provide an environment rich in components necessary for healthy skin defense.
The medical aestheticians at Carolina Aesthetics can show you the variety of products containing topical antioxidants and phytochemicals at our office.
As the days become longer and the weather turns warmer, it is time to stock up on sunscreen for protection from the sun’s harmful rays. Sunlight contains both ultraviolet A (UVA) and ultraviolet B (UVB). These wavelengths of light cause skin cancer and accelerate skin aging. It is important to protect your skin from both types of UV. Sun protection involves seeking shade, wearing sun protective clothing, and wearing sunscreen. It is best to use a sunscreen that is broad-spectrum, meaning it protects against both UVA and UVB. Your sunscreen should also be water-resistant and have a sun protection factor (SPF) of at least 30. Apply sunscreen at least 15 minutes before going outside and reapply every 2 hours if you are outside for prolonged periods.
There are two main types of sunscreens: physical and chemical sunscreens. Physical sunscreens contain zinc oxide, titanium dioxide, or both. These substances are tiny metal particles suspended in cream that physically deflect sunlight away from the skin. They are naturally broad-spectrum. Physical sunscreens are less irritating, making them a good choice for people with sensitive skin. They are also safe for infants and small children. Since the physical sunscreen particles sit on the surface of the skin, they are less water-resistant and their usage can give the skin a pale appearance.
Chemical sunscreens contain substances that prevent UV light from entering the skin, but they break down as they absorb the sun’s energy. Chemicals that block UVA include avobenzone and ecamsule. Chemicals that block UVB include PABA, padimate O, octinoxate, octisalate, homosalate, and oxybenzone. These are just a few of the many chemicals in use as sunscreen ingredients today. Chemical sunscreens absorb into the top layers of the skin making them more water-resistant and sweat-resistant than physical sunscreens. Most chemical sunscreens contain a combination of active ingredients to achieve broad-spectrum protection, and many products contain both physical and chemical blocking agents. It is important to read labels closely to ensure that your sunscreen provides ample protection.
At Carolina Aesthetics you can find a wide range of sunscreen products containing physical and/or chemical ingredients. Whether you prefer a lotion, gel, spray or powder (yes, there is a powder sunscreen), we have a sunscreen product that is right for you. Schedule a free skincare consultation by calling 233-8088 today.
At Carolina Aesthetics, our primary goal is helping our clients achieve and maintain healthy skin. We accomplish this through various means including topical product regimens, treatments and education. This last vehicle, education, is a critical component as it allows our clients to better understand their own particular skin characteristics and how to best protect and care for their skin.
Every client begins their time here with a free consultation with one of our medical aestheticians. During that consult, the aesthetician will review client health history, current medications that might affect skin condition, client concerns and goals and previous skin care products and treatments. The aesthetician will evaluate the client’s skin and then make recommendations for treatment and product options to help achieve and maintain healthy skin. This process alone can be very valuable to the client in understanding why their skin is in its current condition and why various options can repair damage, encourage existing skin cell turnover, support new skin growth and protect skin from future damage.
Carolina Aesthetics offers frequent education opportunities through evening and weekend seminars. Already in 2014, we have conducted seminars on IPL Hair Removal, Acne and Anti Aging. Upcoming events include: Permanent Makeup (May 15th), Acne (June 10th, August 26th), Anti Aging (April 15th, May 24th), Melanoma Awareness & Prevention (May 6th)and Fractional Resurfacing (June 17th). All events are free of charge but require a reservation. Typically, product and/or service specials are made available at these seminars as well.
Finally, our aestheticians are available to come to your office or event to present whatever skin care topic that may interest your group. We have conducted Lunch & Learn seminars at hospitals, city agencies, a local YMCA and private businesses. Our topics can range from Basic Skin Care to specific issues such as Skin Cancer Awareness & Prevention, IPL Hair Removal, etc. We have also hosted small events at our office for special interest groups, clubs and simply a group of friends with common interests in skin care.
Regardless of the nature of your group, we are happy to provide free education whenever possible. If we can help the people in our community achieve and maintain healthy skin, then we will have not only minimized future skin damage but also helped prevent skin cancers. If you would like to sign up for one of our seminars or schedule an event for your group, please call our office at (864) 233-8088.
By: Libby Beckham
Carolina Aesthetics is excited to introduce Theraclear Acne Therapy! Theraclear is a breakthrough acne treatment that combines a gentle vacuum with a painless therapeutic broadband light. The concentrated light assists in destroying bacteria to help improve skin texture and pore size while the Theraclear vacuum technology removes dead skin cell buildup and cleanses blocked pathways that clog the pores deep within the epidermal layers. Theraclear is FDA approved for use on all types of acne – mild to moderate inflammatory acne (Acne Vulgaris), comedonal acne and pustular acne. It can work in conjunction with existing regimens established by dermatologists or as a stand-alone therapy. For optimal results, four to six treatments are required; however, results are visible 24-48 hours after one treatment. TheraClear treatments take less than 30 minutes and allow you to resume your daily activities immediately. It does not interefere with most medications and has been deemed safe for pregnant and/or breastfeeding women. Prior to offering this treatment, our Medical Directors at Carolina Dermatology conducted trials with the TheraClear system in 2013 to establish its efficacy. A wide variety of individuals were included in the study and all of the participants realized good results. As a result, we are excited about offering this treatment to our clients. No referral is needed for Theraclear but a consult is required to provide you with detailed information about the treatments and to review your medical history. During the free consult, a medical aesthetician will provide you with pre-treatment information and answer any questions that you have. Carolina Aesthetics is offering an introductory price of $100 per treatment or a six treatment package for $500, if prepaid. Call Carolina Aesthetics today at (864) 233-8088 to schedule a free Theraclear consultation and find out if this new treatment is right for you.
Merriam-Webster defines cosmeceutical as “a cosmetic preparation that has pharmaceutical properties”. These products claim to correct or improve targeted skin conditions. The trouble with this recently popular category of skin care is that it is not recognized and therefore not regulated by the FDA. So how do you know if the product really does what it claims to do? How much time can a person reasonably spend researching cleansers and night creams?
I have learned in six years as an aesthetician that I am never going to know everything about skin care product ingredients and I seriously doubt anyone who claims they do. Over the last two decades, the skin care research market has grown dramatically and has continued to evolve and thrive, even through the recession. Ongoing discoveries, clinical trials and lab testing constantly change the way skin care products are developed and formulated.
I know that the products I used and the way I took care of my clients’ skin when I began my career in aesthetics are much different than what I do today. This is partially due to training and experience and partially due to the ever-changing world of skin care.
There are some great companies who invest a lot of time and care in the research, manufacturing and testing of their skin care products. Of course, there are also many cosmetic companies that market their lines convincingly without really providing a solid product. Additionally, what may be a good choice for one person may not be right for someone else. Finally, when and how products are used within a regimen can have a substantial impact on how well they perform. For these reasons, I suggest avoiding regimens based on information obtained through talk shows, blogs and/or magazines.
My intent is not to overwhelm you or discourage you from taking care of your skin. Rather, it is to make you aware that our skin is a complex and intricate system of biological, chemical and physical actions and reactions. As a result, careful consideration must be given to gain the best results from your skin care products. It is imperative to seek the advice of trained professionals with whom you feel comfortable and can trust. Obviously, the salesperson at the supermarket, department store or home party is not likely to have the same expertise as a dermatologist or aesthetician. Seeking professional advice will save time, money and the chance of damaging your skin. Prevention and early action give your provider more options for achieving great results. Those who seek a doctor or aesthetician as a last resort may have already caused additional damage to their skin.
The products offered at Carolina Aesthetics have been researched and tested by the dermatologists at Carolina Dermatology for safety and efficacy. They contain pharmaceutical grade active ingredients which are much higher quality than similar products sold at malls or drug stores. In fact, the pharmaceutical companies that produce our products sell only to offices with physician oversight. They cannot be found at the drug store or mall. Our aestheticians are trained in these products’ ingredients and how they can be used by the various skin types and in conjunction with prescription and over the counter medications.
Skin care consultations are always free at Carolina Aesthetics. Our aestheticians are trained and experienced in all skin types and will help you learn the best way to achieve and maintain healthy skin.
So many of our clients at Carolina Aesthetics are interested in what skin care products the Dermatologists use or recommend to their patients to use. We thought it would be fun to ask them to pick their favorites and share them with our clients. Enjoy reading their selections below.
Dr. Van Hale –
Dermal Resolutions “Elegant Moisture” – This hand cream feels WONDERFUL on my hands, and the protection it affords seems to last, even through a hand washing.
Neocutis Bioserum – I think I am giving my facial skin the best treatment possible with this high concentration growth factor serum. This product provides maximal amounts of these proteins so that cells in both the epidermis and dermis will replenish more rapidly and produce more collagen and elastic fibers to counteract thinning of the skin and add volume.
Revision Skin Care Brightening Facial Wash – This face wash is gentle, but a very good cleanser. It removes all of my make up, but does not feel harsh. It leaves my skin smooth and fairly hydrated. The subtle scent is both soothing and rejuvenating. I love it!
Dr. Hutcheson –
For my eyes, I use Neocutis Lumiere in the morning and Dermal Resolutions Retinol Eye serum every evening. I think this is a power combination to fight eyelid aging.
Having had a difficult time tolerating other prescription and non-prescription versions, I now use our Dermal Resolutions Retinol with green tea and have not had a problem with redness or flaking.
Sunforgettable by Colorescience is now my go-to sunscreen. I carry it in my purse!
Dr. Shuler –
The Colorescience Sunforgettable Brush provides a quick and easy way to apply and reapply on-the-go broad-spectrum UV protection.
Dermal Resolutions Clear and Smooth G22 Wash provides a combination of glycolic and salicylic acids that both clear acne and promote smooth skin.
Dr. Kuhl –
The Dermal Resolutions Retinol Serums are an excellent foundation for a healthy skin/anti-aging regimen
Dermal Resolutions Green Tea Exfoliating Scrub is a superb product for smoothing rough skin; warms on contact with water.
Dermal Resolutions Elegant Moisture is a wonderful cream for hand or full body moisturization.
Dr. Unaeze –
I like Neocutis Journee because it provides so many benefits in one simple product – moisturizer, sunscreen, antioxidants and growth factors. I like the feel of the product and it blends and goes on easily.
Blue Oil is great for post procedure patients as it keeps the skin moist without being greasy.
Dr. Jamison –
I use and recommend the Colorescience Sunforgettable brush since there is no other product quite like it.
The Dermal Resolutions Glycolic Treatment pads are great for patients with oily skin. They are perfect to use after exercise/ working out.
Dr. Brown –
I recommend the Dermal Resolutions Benzoyl Peroxide wash (Clear Benz 5 or 10) for my acne patients and the Dermal Resolutions Green Tea Foaming cleanser for my patients with rosacea.
The Neocutis Biocream product is an excellent anti-aging product providing great moisture along with powerful growth factors.
Atopic dermatitis, or “atopic eczema” is a common inflammatory skin disease which typically begins in infancy and childhood. Its most characteristic feature is widespread dry, itchy skin, which is the result of a couple’s genetic defect resulting in the alteration of skin’s protective barrier function. Atopic dermatitis is common, affecting approximately 10-30% of children and 2-10% of adults. Although the skin symptoms of the disease often improve or even disappear with increasing age, patients with atopic dermatitis continue to have more sensitive and dry skin than normal throughout life. The condition is also frequently associated with asthma, pollen and food allergies, and allergic rhinitis. Because of the altered “barrier function” of skin in atopic dermatitis, patients are at higher risk for developing superficial bacterial and viral infections such as impetigo, herpes simplex and warts.
The clinical appearance of atopic dermatitis varies with the age of the patient. Forty-five percent (45%) of affected individuals develop the disease in the first two years of life, and characteristically have red patches of eczema on the cheeks, scalp, neck, elbows and knees, but not in the diaper area. Often there is oozing and crusting of these lesions. After the age of two years, the patches become thickened, the skin much more dry overall, and the flexural areas of arms and legs affected. Teenage and adult atopic dermatitis continue to have more of these features with particular involvement of the head, neck and hands. In all stages, itching is constant and severe. Signs of chronic scratching, digging and rubbing mirror the misery of this unrelenting deep itch.
Individuals with atopic dermatitis require daily care of their skin with moisturizing creams and lotions to prevent worsening of the dryness and itching. These individuals also learn to avoid many environmental and psychological factors that can trigger or worsen their sensitive skin, such as pollen, dust mites, animal dander, harsh soaps and cosmetics, wool clothing, cigarette smoke and emotional stress. For acute flares of the dermatitis, steroid creams or lotions, soothing tub bath soaks and special emollients are required. Antihistamines like Benadryl help control the itching, and sometimes, prednisone and other immunosuppressive drugs become necessary to break the inflammatory cycle and persistent symptoms. Constant rubbing and scratching often trigger bacterial infections of the skin requiring oral antibiotics.
Clients with atopic dermatitis who come to Carolina Aesthetics are treated with very special care. Gentle hydrating treatments, often with phytochemicals and peptides known to have antiinflammatory properties, are always incorporated into their skin care regimens. Many find these treatments to be a helpful adjunct to therapies recommended by their dermatologists. The supportive care and relaxing environment provide a calming and relaxing influence that is especially beneficial in helping control the tension resulting from their chronic itch.
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