Facials and Retin A– Good Idea or Bad Idea?

Question and Answer logoQuestion:  I used to have facials  several times a year.  Now that I am using  Retin A,   can I continue  my favorite  indulgence?

Answer:  I  love facials and I love Retin A, but together they may  pose problems.  If you are using Retin A, you need to weigh three issues:

1.How long you have been on Retin A ?

2. How is your skin reacting to Retin A?

3. What kind of facial do you want to use?

If you have just started on Retin A ( less than three months),   the short answer is no.  Retin A  is irritating on purpose and adding  a facial  early in the process can be asking for trouble.  Your skin could easily react with redness and peeling  that would require  stopping Retin A  for at least a month. 

If you are able to tolorate  Retin A every night,  and the benefits seem to be leveling off, a good facial can jump start new radiance.  But if you can only tolorate Retin A every other night, again a traditional facial  might be too much of a good thing.

There are facials and then  there are FACIALS.  I love the Hydrafacial that combines, suction microdermabrasion, glycolic peel,  anti-aging serum infusions and extractions to produce a turely gorgeous glow.  However its an intense process and   you should take a  Retin A holiday that starts 4 days before the Hydrofacial and  3 days afterwards.  A less intensive facial with  just  microdermabrasion and glycolic peel  can also be a wonderful way to  prep the skin for Retin A.   If you are a Retin A newbie,  this facial combo  will  take off   a layer of dead skin cells that are coating the surface and clogging pores.  It will allow Retin A  better access to the skin and speed up renewal process.   Just do it no less than  4 days prior to starting Retin A.

I also like facials that use   different types of  face  masks.  While some  are  designated hydrating and others as cleansing,  all masks  share  the  same benefits- they take off  that pesky top layer that makes the skin look dull and  unhealthy.  And while they  sit on the skin they allow the skin to build up  healthy water levels that  help reduce  lines and creases.   Nice.       

 

 

 

Question & Answer– Am I a Retin A Failure?

Question:  You’ve totally sold me on the benefits of tretinoin but it just doesn’t work for me.  I used Retin A Micro  and  followed your guidelines– washed with  a mild soap, waited 30 minutes after washing, and used it 3X/week– but my skin is constantly  irritated and flaky.  What else can I do to deal with too many years in the sun?

Answer: Before you declare defeat, keep in mind that Retin A is a brand name( like Kleenex or Xerox) and there are different formulations that could be a better choice for  you.  Retin A  Micro is a gel that is actually approved for acne, not anti-aging.   It works well for thicker, oilier skin ( like  mine) but finer, drier skin types  may over react.

To get the benefits of tretinoin without irritation, Dr Heidi Waldorf of Mount Sinai Medical Center recommends Refissa ” This is a full strength .05% formulation in a true emollient base.  This provides the  maximum anti-aging benefits with less dryness and redness.”

Dr Waldorf, director of  Laser and Cosmetic Dermatology at Mount Sinai Hospital in New York, recommends washing your skin at night with a rich cleansing like Cereve Hydrating Cleanser, followed by  application of  a pea sized dab on  your face and another dab on your hands, neck, and chest.  Rub in well.  Follow immediately with a bland moisturizer  like CereVePM.  In the morning wash with gentle cleanser and top with a a rich sunscreen like  Anthelios SX.  Start using it 2-3X/week and gradually work up every night application.  Don’t worry if you can only use it twice a week during dry winter months– you can still get benefits. 

As with other forms of tretinoin, its important to avoid excessive use of exfoliating scrubs, astringents, toners and to stop the retinoid a few days before and after waxing or electrolysis.

Unlike Retin A, Refissa is actually approved by the FDA to reverse signs of aging and sun damage.   You should start to see benefits after two months of diligent use.  After a year, use it 2-3X/week for maintenance.

Q and A– Diluting Retin A?

Question:  I’m concerned that  that Retin A Micro .o4% will irritate my skin.  Can I mix it with  my moisturizer before  applying it?

Answer:    I’ve received this type of comment  so frequently I think it deserves a post of its own.  Mixing  Retin A ( aka tretinoin) with a moisturizer immediately reduces its concentration and  impast on the skin.  If you take a pea size dab of  .04% tretinoin with an equal dab of moisturizer, the concentration is now .02%– lower than any other prescription grade  tretinoin.  If there is more moisturizer than tretinoin, then the concentration is even lower  and the action on the skin will be very limited.  Then there is the issue of cost.  Retin A  Micro .04% runs about $300/tube.  If you dilute it to .02%  you will get more  for  your beauty dollar if you buy  .1% Retinol from Skinceuticals which clocks in at $100.

There are tried  and true  methods of reducing  risk of   redness and flaking with tretinoin products.  Start by choosing  a mild cleanser like Cetaphil and  wait  at least 30 minutes between washing your face and applying  tretinoin.  Ease into a tretinoin regimen  by applying it every other night for several weeks gradually working up to an every night routinue.  If redness develops, stick  with using it only three times a week.  Make sure  you avoid  other products that could cause irritation  including microdermabrasion, glycolic acid peels, exfoliating pads or grains and alcohol based toners.  At night  use a  moisturizer like CerVe PM ( which is brimming with ceramides and hyaluronic acid) over tretinoin to prevent irritation.   Commit to using  at least a 30SPF sunscreen  each and every  morning.  Tretinoin increases sensitivity to the sun  and you can get red and flaky even from sunlight through a window.  It will take at least  six weeks to produce a noticable difference.  Don’t be impatient and stick with the program.  I believe that tretinoin is the foundation of a stong anti-aging plan.  What ever else you do, tretinoin will  supply a daily  boost to skin cell growth that refines the surface and boosts collagen production-  all good things.

One final thought.  I also  hear from women  who apply their tretinoin OVER a moisturizer.  Please don’t do that.  Tretinoin is  one of a handful of ingredients that can actually pass throught he layers of the skin to  provide  real benefits to the lower, living layer of the skin.  Applying a moisturizer just blocks access to the skin and inhibits all the good that tretinoin can do.

Retin A and Acne– What Cleansers and Moisturizers Can I Use?

I got a great  email from a 16 year old  who  is using Retin A micro  for acne control.  Like most of us, she got the prescription with little or no advice about   how to use it.  She wanted to know what  scrubbing grains, toners and moisturizer I would recommend.  She was concerned about the redness and peeling and wanted to avoid these problems with additional  skin  care products

Retin A  was actually originally  developed and approved for acne  management.  This vitamin A derivative helps the skin to empty  pores clogged with debris, shuts down overactive oil glands and helps skin turnover to reduce discolorations from old acne eruptions.   This process includes flaking off old dry keratin that is contributing to blocked pores and breakouts. Some peeling and flaking is necessary and actually good.  However   you need to keep it under control to avoid too much redness and irritation.

The  solution  is to allow  Retin A to do what it does best. Twice a day use an extremely gentle  oil-free cleanser such as Cetaphil Gentle Skin Cleanser and apply with damp cotton pads. Rinse off with handfuls of lukewarm water. Even a washcloth can be too rough in the first months of Retin A treatment   Start by using Retin A every other night and gradually, over three weeks, work up to an every night routinue.

In the early months of using Retin A  its very import ant to avoid additional irritants such as scrubbing grains or pads, toners and even alpha hydroxy acids ingredients  such as glycolic acid.  It certainly takes  a leap of faith to abandon these tried and true acne aids and simply   trust Retin A to clear your skin– but  that’s the best way to succeed.  These products and ingredients  are  simply too irritating to be used at the beginning of Retin A therapy and can make the skin so red and sore that  people abandon Retin A treatment.

Using a moisturizer  to control the peeling  can actually  lead to additional breakouts.  If your skin becomes too irritated and flaky,  use a tiny dab of oil-free moisturizer and take a two day Retin A holiday.  In the morning make sure  to use an light fragrance-free oil  sunscreen such as  Aveeno Ultra Calming Daily Moisturizer SPF 30.  Retin A  increases sensitivity to sun damage and its ESSENTIAL to use a sunscreen each and every day– even when its cloudy.

After six months, you skin will  become comfortable, even bored with Retin A.   At this point you can amp  up the impact by adding exfoliators such as 3M Buf Puf Pads or  my beloved Clarisonic cleanser.  Toners and peels with glycolic acid can   provide additional  benefits  for acne-prone skin.   But if irritation and flaking  reappear,  cut back on the extras and focus on Retin A.

Microdermabrasion or Botox– Which is Better?

Question–  In a few months I’m turning 50.  After half a century, my skin is looking tired and I want to give myself a birthday present.  Which would be better, microdermabrasion or Botox?  You seem to really like both of them.

Answer– Happy birthday!  I do like both  microdermsabrasion and Botox, but  they are very different  anti-aging tools and  deal with different  problems.  Microdermabrasion  takes of the top dead layer  of skin cells to leave the skin smoother, brighter and softer.  In addition, removing these old cells actually stimulates the lower levels to grow.  Researchers have noticed that  mens’ skin seems to age more slowly than women’s– and they believe that part of the reason is the daily  shave which encourages the growth of  fresh new skin every day.

Botox injections at  problem areas  can erase fine lines and wrinkles, especially around the eyes and  forehead.   It can change contours of the face, while microdermabrasion changes the texture and color of the surface of the skin.  The two tools actually work very well together– microdermabrasion  to improve the texture and color of the skin and Botox  to deal with contours that are a half a century old. 

Your question actually gets to the heart of my anti-aging journey–  which tools and techniques  work and how to combine them to get the best possible results.  I decided to start on the dark spots and splotches  from sun damage- first with Retin A and then with microdermabrasion.  When the skin’s surface looked smooth and fresh,  I added Botox to erase the lines at the sides of  my mouth and around my eyes.  You can see these results  on  the No-Nonsense Beauty BLog Facebook Page.  Just click on the Facebook  icon.

Microdermabrasion, as  much as I love the immediate results, lasts only a few days.  For long lasting  results, I suggest starting with a low dose   nightly Retin A  cream.  You should see very nice results within six weeks.  The skin will  look fresher and clearer.  Then  try the Botox to deal with the after effects  fifty years of laughing and talking.  And here’s to  another wonderful fifty years.

Its Fashion Flash Monday!

This weeks hosts are Fashion Flash founders The Glam  Gals of  Fabulous After 40.  I love to read their blog at the start  of each season to give me a cheat sheet on how a women over 40 can master  trends.  They decode the new ideas and then  explain how to use them in real time.  For example, plaids are  going to be  huge this year, but a grandma in a plaid mini skirt in not my idea of chic.  You’ve got to read Fabulous Over Forty to see  what smart ideas they have  for plaid.

And when you’ve clicked through all the great Fashion Flash  sites, please stop on Fab Over Fifty to grab a ticket for Beauty Bash.  Held on Oct 1&2 at the Metropolitan Pavilion at 125 West 18th St, this is an incredible  health and beauty  expo that celebrates women over 40.  On Sunday Oct 2, at 10:30  I will be doing a presentation with Kari of Fabulous Over Forty called “Top Ten Skin Care and Make-up Tips.”  I will be explaining the twelve signs of aging and how to deal with  them easily and affordably.  I’ll also be giving out samples of,  IMO, the two most important  anti-aging  items  we should have on hand.  If you can’t make the presentation, I will be at  a booth with Kari handing out the No-Nonsense Guide to Retin A and will have  more samples.  Please come by to say hello!  If you go to  the Beauty Bash site  and enter the code FOF20, you will get a 20% discount on the ticket price!

Q&A– Am I too young to worry about aging?

Question:  Although I am only in  my late twenties I’ve done everthing I shouldn’t to my skin.  I’ve smoked since I was 15, used baby oil to  bake in the sun ( love the smell) and  never pass up a plate of  hot  fries or a cold beer.  What can I do  not to look 40  before I turn 30?

Answer: LOL. Great question and I hope my answer doesn’t sound too preachy. Up to age 60 about 80% of skin aging is due to lifestyle choices.  Diet, sun exposure, tobacco and alcohol add decades to your skin age.  That’s the bad news.  The good news?  You are young enough to erase this damge and prevent new problems.

Given that you probably have sun damage  I would  jumpstart skin care with an IPL treatment.  ( You can see the great before and after pix of my BFF Judith) To keep the anti-aging process on track, I would use Retin A three times a week.   Give the baby oil to a baby and protect your skin with a 30 SPF moisturizer. You’ve recognized  your own bad beauty habits and I’m betting  that you are ready to walk the walk to healthier choices.  Good luck!

Its Fashion Flash Monday!

Today the  Glam Gals at Fabulous After 40 are hosting Fashion Flash. They recently posted a great article on how boomers can   wear the new sheer styles that are so popular this summer.  Now I get it!  When I saw them in stores, I passed them by without a second  thought.  With Jojami and Deborah’s style eye, I  now see how well they can work for me, especially for travel and summer restaurant dinners.

And now that the sun  has returned, please remember that  90% of skin aging is due to sun exposure.  The best way  to reverse  sun damge is with Retin A and  if you “like”  me on Facebook, you can download a  free copy of my guide to using Retin A.  Called Retin A Road Rules, it explains  how it works, the different types and strengths, and signs that its time to  start using it.

Is Retin A Better than Antioxidants?

This week the questions  concern  antioxidants.  They seem to be everywhere  and in every type of beauty product:

Question 1– Which is more important for anti-aging skin care- antioxidants or Retin A?

Answer — These two wrinkle fighters work in different ways.  Antioxidants  act to reverse  cellular damage caused by UV rays.   Retin A works  by  returning skin cell growth  to youthful levels, promotes exfoliation of old tired skin cells and encourages growth of new strong collagen.  Its not a matter of which is better– you really need them both, especially in the long  sunny summer days.  What’s really good news  that they are an excellent tag  team  for reversing skin aging.   Each offers unique benefits and they don’t interfere with each other.   At night top  your Retin A with an antioxidant rich moisturizer.  During the day, anti0xidants in a sunscreen  add extra protection.

Question 2– There are so  many antioxidants– which one should I choose?

Answer 2– Green tea, soy, alpha lipoic acid, coenzymeQ10, vitamin A, vitamin C, coffee berry, and idebone– how is a girl to choose?  You don’t have to.  We need different types of antioxidants to deal with different types of free radicals. It makes good sense to combine different types of  these age- fighters  in a skin care product, and you can use  different formulations  at night and in the morning.  Another way to get full  advantage of antioxidant benefits is to switch off products.  For example use  a night cream with  coffee berry on Monday, Wenesday and Friday and  another moisturizer with CoQ10 on Tuesday, Thursday and Sunday. That being said,  studies have shown that vitamin C and vitamin C are especially powerful and work even better when used together.

New Respect for Retinol

I have often mentioned my reservations about retinols vs the more powerful retinoids like Retin A.  When applied to the skin, retinols have to convert themselves to  a true retinoid before they can be effective. Researchers estimate that a retinol is only 25% as effective as a Retin A.   For example, a .1% Retinol (  a very common concentration) is equal to a .025 Retin A–  which is actually the mildest Retin A on the market.  And then there is the problem that most retinol products don’t say how much of the power  stuff they actually contain.  You can’t know if a  product is to weak to be effective or too strong and irritating. 

I stayed away from retinol products until wandering in the exhibit hall  of a derm conference, I picked up  free samples of .5% Retinol from Skinceuticals. I was intrigued.  A .5% retinol is at least equal to my current .1% Retin A  Micro. ( I know  this is a lot of  math but  staywith  me– its worth it). And then there was the question of price.  .5% Retinol ( they need to work on the name) is just $50/ tube–  a lot better than the $300 price tag of my Retin A Micro.  But price  is not that important if it didn’t  deliver beauty benefits.  After just three days, I  had new respect for retinols.  I could put it on  shortly after washing my face without developing dryness or irritation–yet I could see a fresher, brighter skin.    What I  loved best about Retin A  is that relieved my pale, pasty skin tones and replaces them  with  pinker, happier looking skin. This retinol product delivered the same “pinking” but without the dryness.

To keep my skin from getting bored, I’ve been alternating between .5% Retinol and .1% Retin A  Micro.  I liked the results so much, that when I had finished my samples,  I paid retail for a full size tube.    Next I want to see if I can use  it before and after an office anti-aging procedure.  IPL and lasers  make my skin especially sensitive and I need to suspend Retin A for as much as a week.  Next time, I’m going to see if I can use .5%Retinol the next day to avoid a break in beauty routinue.  What has your experience been  with retinol products.? How did they compare to Retin A for you?  

For more information, I’ve written a   guide to Retin A.  Like my Facebook  Fan Page and you can download   the four page guide for  free.