Botox or Laser- Which is Better?

Q&A2Question:  My Mom  reads your blog and  has been talking about getting Botox  or the “lunchtime laser.”  I want to get  her a treatment for Christmas but don’t know which one to choose.  I can afford  only one  and I want  her to see the biggest results.

Answer:  What a great question and you’re a great daughter! Both  Botox and  Intense Pulsed Light  laser  ( also known as the lunchtime laser) will make a major  difference in her appearance.  The choice depends on the condition of her skin.  If she has spent many  happy hours in the sun, its likely that she has lots of freckles and dark patches.  An Intense Pulsed Light treatment  will literally vaporize this aging pigmentation and leave her skin younger and refreshed.  The results are permanent but brown spots will return if she goes out without sun protection.  If she was not a beach bunny and  her skin  has   lines along the cheeks, forehead and  and around the eyes, Botox will erase them– for about 3-4 months.   Because lasers leave the skin extra sensitive for a few days,  you can also give her a stocking  filled with a gentle cleanser ( eg Cetaphil), sunscreen ( Neutrogena for Sensitive Skin)  and soothing water spray ( eg Dermalogica UltraCalming Spray).

The Right Tool  at the Right Time

Which anti-aging tool to use  and when to use it  was the fundamental question   behind the No-Nonsense Beauty Blog.   Initially, I planned to start with  Retin A  to reve up the circulation and skin growth, add Botox to reduce lines and polish things up by removing  large freckles and age spots with a laser.  But  as it turned out,  lasers work best on darkest spots, so I started the anti-aging journey  by removing them with a   traditional laser and then continuing with  my  plan. 

But in the past  few years since I started, there have been so  many new options  that  my new plan has become  an exploration  of new forms of Retin A, new lasers and new machines that  deal  both singly and in combination with a slew of aging issues.  At a recent dermatology  conference at Mount Sinai, the experts  came up with an effective anti-aging game plan  that started with   gentle lasers like Intense Pulsed Light  to brighten and Botox to smooth the skin.

I’d love to hear which treatment you chose.  Happy holidays!

The New Wrinkle Busters

It sounds  like a plot of a new Steven Spielberg movie, but its real.  Turns out that our fat is loaded with stem cells  and  that when injected into the face, stem cells actually encourage regrowth  for  healthy fuller contours.  I learned about this and other anti-aging techniques that are  just on the horizon  at a press event hosted by  cosmetic surgery expert Wendy Lewis.  One of the smartest women I’ve ever met,  she assembled a blue ribbon panel  of dermatologists and  surgeons to explain these new wrinkle busters at Waldorf Astoria press conference.

Park Avenue plastic surgeon Dr Z. Paul Lorenc explored new fillers that  actually stimulated the growth of new healthy collagen.  So when the filler is gradually absorbed, the skin stays smooth and young because of  strong fresh skin cell growth that restores youthful contours.  Dr David Golderg, director of Laser Research at Mount Sinai School of Medicine discussed the role of lasers in cellulite control.  He explained that the lasers don’t destroy the cellulite, but rather tighten the skin, making the cellulite far less obvious– eg less jiggle; Dr Sidney Coleman who is associated with NYU-Langone School of Medicine focused on the benefits of fat grafts to aging, sun-damaged and scarred skin.  Not only do the  grafts restore normal skin  appearance, the benefits become better with time.  Research  indicates that the stem cells in the fat injection are stimulating the regrowth of  healthy tissue.  I was especially impressed by the use of fat grafts to cover up dark undereye circles. Dr Coleman has a grant  from the Department of Defense and he is  using these techniques to repair wounds that soldiers suffered  in Afghanistan and Iraq.  Its amazing to see  once flattened and distorted faces returned to normal.  And  just a side note-  cosmetic surgery techniques that we use today  to turn back time, were originally developed  after World War I  as doctors struggled to repair disfiguring wounds.

But keep in mind that NONE of these new anti-aging developments are legally approved in the US and are still waiting for FDA approval.  ( They are found in other parts of the world and that’s a topic  for another post)  And be aware that non-MD’s are pouring into the field offering   all sorts of anti-aging injections and a wide variety of unapproved techniques.   To avoid dreadful complications ( there were some pretty awful photos at the conference)  make certain you  get treated by a certified dermatologist or plastic surgeon.

And speaking of treatments, today I am actually going to Dr Lorenc for his  super cleansing hydro-facial.  I will post  before and after pix  next  Wednesday.

Me and My Decollete

Since I started   my anti-aging journey I think that  the most frequent problem which my friends and  co-workers  shared with me  for was the freckles and sun damaged skin on their chest, AKA the  decollete.  Often their chests seemed permanently sunburned and a few had developed  skin cancers which needed to be surgically removed.  Polling my all-star team of dermatologists for a solution, I got a range of different answers.  Some suggested salicylic acid peels, while other suggested Fraxel laser, CO2 lasers  or skin lightening cream.  

Before I vounteered a friends’  chest freckles for science, I decided to try out some of these options  on a large brown spot on my chest.  First approach– a laser.  The series of photographs show  this bad boy freckle before and after treatment.  First photo show that  that its not  that  bad, but in a strapless dress or cami top,  it does look out of place. The second photo is the day after my freckle  met a laser.  The area  was red and aw  but the procedure was not uncomfortable and over quickly.    The  shiny stuff is Aquaphor for  healing.   I wore a bandaid over it for the first week to protect the area from infection and to protect my clothes from the  ointment.

The last photo is 10 days after the laser treatment .  I’ve still got some healing to do.  The brown spots that were removed on my neck and face  healed quicker than on the chest.   I wonder if chest discolorations are more resistant to treatment than those on other parts of the body.  This particular brown spot is in the medial line in center of the body and I know that this  area tends to produce scars  more easily.   I’m really glad that I’m testing out different methods on myself before I involved a friends’ freckles.  Have you ever treated your decollete?  I’d be really interested to hear what worked as well as what didn’t.

My BFF– Best Friend with Freckles

Intense Pulsed  Light (IPL) is a type of photorejuvenation  that uses  a blast of light to remove freckles, unwanted hair and  little red lines on the skin.    Often called the “lunchtime laser”  it does not burn off the top layers of the skin like a tradtional laser and the skin looks beautiful and smooth within a week.    I had IPL  last year in June  with Dr Marmur and was so pleased with the results.  I thought  it made my skin look tighter and fresher and I posted before and after pics on the blog.  My BFF ( best friend with freckles) liked  the changes so much that  she went  for her own IPL date.  I think her results were even better.  Not only does she look 10 years  younger, her skin  has a new radiance.  She is so pleased with the results, that she  has now joined  me in my anti-aging journey.

First we developed a plan.   In the morning  she is using a strong sunscreen  to prevent  the return of freckles.  When she  was in school, BFF was a super athlete.  Her current passion is gardening and she is developing a new style of wall garden.  For either activity  she is often in direct sun, and needs  an uber sunscreen.   At night she is using Retin A to stimulate  circulation and new collagen. After a few months on Retin A, she will have Pelleve and will share the results on No-Nonsense Beauty Blog.  Have you tried out an anti-aging  tool or technique?  It would be wonderful if you could share your experience and before and after photos.  There are so many options out there its hard to know  which work and which are empty promises?  As Mulder would say to Scully–” The Truth is  out there”.

Red Carpet Shoulders

Watching the celebs walk the red carpet during awards season, I began to focus on the flawless  chests and creamy  shoulders of the stars  in their strapless gowns.  Was I  the last woman in America with  age spots  on my upper body?

The short answer is  no.  This is an often overlooked spot until a dress or bathing suit suddenly reminds you that sun damage doesn’t stop at the chin. That’s the bad news.   The good news?   There a buffet of spots removers including skin bleaches, IPL, lasers, Fraxel, peels and  microdermabrasion. The question is  which one  is the best.   According to Dr Marmur, I have several  different types of discolorations that require  different types of treatments.  For example the true freckles can be easily treated with a YAG or Ruby laser– the same type that I used on the freckles ( aka age spots) on my face and hands.  The raised spots are actually skin tags that are best cut off or burned away with electrocauterization.  As you can see  from my before photo, the red spots are atually more numerous and I’ll find out what they are  and how they are treated when I  get them removed tomorrow.  Its a good thing its still scarf weather here, since I  know from past experience that I’ll have a bunch of red scabs  on my neck for at least a week.

New Help for Old Hands– Part 2

Judith’s   hands  healed rapidly after her  IPL treatment. On Day One ( top left) the freckles  looked a bit red, but were not painful. Other than a sunscreen, Judith  did not need  to put anything on them   or to wear a bandage. Over the next week (bottom left )  her hand   developed  numerous  small brown spots which were exploded freckles. These   soon rubbed off  revealing  fresh new skin. The bigger freckles developed  crusted  over, which then   fell off to reveal  pale  spots.  After three weeks( bottom right) her  hands  had a  brighter, softer surface with just a few freckles that were much lighter than  before. 

And as an additional bonus, IPL  took care of the fine  lines   which made  her hands fresh and young.  Dr Lefkovits  has scheduled another visit  to totally erase the  remaining  shadows of the old freckles.

New Help for Old Hands

I had my freckles ( aka age spots) lasered off the top of my hands and posted the progress on my blog.  I was very happy with the results, but wondered how IPL ( also called  photo rejuvenation) would have worked.   To answer that question, Dr Lefkovits offered to use IPL on the freckles of a friend.

I knew just who to call.  Judith has had my back since we worked together in advertising. Dealing with some pretty difficult clients, she was always the island of calm in any storm.  Since I started my blog, Judith  has been an enthusiastic supporter and when Dr Lefkovits  made the offer, I punched in her number on my cell.  Tall and slim, she is a terriffic athlete who spent   many happy hours on tennis courts and sunny beaches– and has the freckles to prove it.

Dr Lefkovits and his technician Eleanor examined Judy’s hands.  He explained that her olive tone skin needed to start with low dose IPL to avoid uneven skin color.  Before we even started, Dr Lefkovits predicted that is would take two IPL treatments to remove freckles from Judith’s hands.  They spread on a thick layer of ultrasound gel, handed out blue goggles for everyone  and fired up the IPL equipment.  Each time the IPL wand touched Judith’s hand, there was a flash of light.  This first session was over in 10 minutes. The smaller freckles were now red and the larger ones were slightly darker.  As they heal, the darkened skin will flake off.

Over the next few posts, I’ll upload  pix of Judith’s  progress.  I was running out of body parts to rejuvenate and its awesome that I’ve got new people to  help me explore beauty options.

Can Women of Color Use Retin A?

I get frequent questions from Asian and Latina readers who are interested in using Retin A , but are concerned about the side effects.  On one hand Retin A has the ability to lighten  dark patches  and make  the skin look fresher and brighter.  On the other hand Retin A can be very irritating– and deeper skin tones tend to develop darkened areas when inflamed.

There’s a boatload of conflicting advice about the topic and I needed  an expert to provide answers.  Asking my colleagues  in beauty for the best source of information, I was referred to the noted Chicago-based cosmetic surgeon, Dr Seven Dayan.  In addition to seeing patients, Dr Dayan is the founder of DeNova Research, a center that  has extensive experience studying skin care in women of color.  According to Dr Dayan, Latina, Asian and African American women  need to use Retin A very very cautiously. ” To avoid problems I recommend a very mild form of Retin A ( such as Renova) and use it only every three days.  In addition , when using even Renova it is important to avoid products  that can be irritating such as exfoliating grains and brushes”

Retin A is just one of the anti-aging tools that need to be used carefully by women of color.  Lasers, IPL even  gentle gylcolic peels can cause needless problems like melasma  and I’ll be talking more with Dr Dayan to  learn the safest and most up- to-date information on this often undercovered topic.  For more information about Dr Dayan and his ongoing research studies go to www.denovaresearch.com