Askanesthetician's Blog

An esthetician explores skincare issues and concerns

Is There A Correct Way To Wash Your Face? January 31, 2010

The title of this post might seem a bit strange because how can there be an incorrect way to wash your face?  Well it turns out that what seems like a simple and straight forward act is actually more complicated than you might realize.  I think it is also interesting to point out how many people don’t wash their faces daily and find it a hard thing to do.  I wonder if some skincare issues people have could easier be solved with the right daily facial cleanser and cleansing technique?  I think Paula Begoun makes a great point in her book The Beauty Bible, 2nd edition (page 178) that is essential to get the cleansing step of your daily skincare routine “right, and that means thoroughly, but gently, cleansing the face.”

So first things first, you should wash your face daily.  Now do you need to wash your face twice a day?  Until a short time ago I would have answered that question with a resounding yes!, but now I am rethinking that stance.  Currently I am reading the book Simple Skin Beauty  by dermatologist Dr. Ellen Marmur, and in the book she writes that she usually doesn’t use cleanser to wash her face because her skin is dry and sensitive.  Furthermore, she writes that unless you have very oily skin you only need to wash your face once a day.  Dr. Marmur recommends splashing your face with cold water in the morning instead of washing it.  If you have dry skin, Dr. Marmur recommends that you only use warm water and a washcloth to clean your skin (pages 59-65).  Now this isn’t the first time that I have read or heard of a dermatologist recommending that you use only water to “wash” your skin.  I have always found this advice bizarre since it seemed to me that not only did this just move dirt and oil around your face, instead of removing it, but not cleansing your face would lead to clogged pores and breakouts.  I have always thought of the idea of using washcloths as harsh and disgusting because I figured, I don’t know why, that the washcloths were harboring lots of bacteria.  Paula Begoun writes in her book The Beauty Bible, 2nd edition that “using a washcloth can prove irritating for some skin types and should probably be avoided” (page 179).  Ok – so who is right – Marmur or Begoun?  I actually think I am going to side with Dr. Marmur on this one though I would never recommend to anyone to just splash their face in the morning with cold water as a way to wash it.  If you have very dry skin or very sensitive skin then just using warm water and a gentle washcloth to cleanse your face in the morning might be a great solution for you, but overall I think that most people will be just fine using a gentle cleanser twice a day. 

I thought about discussing in this post the different types of facial cleansers, particularly cleansers with added ingredients like salicylic acid or glycolic acid, but I decided that such information should wait for its own separate post.  So let’s get back to the matter at hand – how exactly should you wash your face?

A while ago Allure magazine published an interesting article about new facial cleansers called “Power Wash”.  Included in the article are directions for washing your face.  (By the way, this article also recommends that people with dry skin should only wash their face once a day.)  To wash your face use warm water, lather quickly with a massage like motion, and rinse.  Blot your skin dry, don’t rub.   Pretty straightforward right?  Well if you continue to read chapter 6 in Paula Begoun’s book you will see that not only do you need to be concerned about the temperature of your water when washing your face but also if you have soft or hard water in your home.  Hard water will leave a film on your skin and hair even after cleansing.  Begoun recommends that you try a water softener in your home if you have hard water.  Once you do you’ll find that your skin is softer and smoother.   

I would add one more comment about washing your face.  I love cleansing oils as a first step in your evening face washing routine if you wear any sort of make-up.  I personally use and love Dermalogica’s Precleanse, but I’ve heard (but have yet to try) great things about Shu Uemura Cleansing Oils as well.

So – how do you properly wash your face?

  • remove your make-up
  • wet your face with warm water
  • gently massage your cleanser over your entire face
  • rinse thoroughly
  • pat your face dry (and always have a separate towel just for your face)

Skin Cancer Affects All of Us January 30, 2010


I wanted to write a short post today that would tie into some of the information I mentioned in my post yesterday about winter skincare.  One of the things I discussed in the post yesterday was the importance of using sunscreen (spf 30) all year-long.  Though I would like to devote a longer post in the future about skin cancer and how to prevent it I thought in the meantime I would post some very important information about skin cancer.

According to the Skin Cancer Foundation :

  • Skin cancer is the most common form of cancer in the United States. More than one million skin cancers are diagnosed annually.
  • Each year there are more new cases of skin cancer than the combined incidence of cancers of the breast, prostate, lung and colon.
  • If those statistics aren’t enough to make you sit up and take notice (and put on sunscreen) perhaps reading this article from Self magazine about skin cancer survivors will do the trick: Diagnosis Skin CancerWomen are continually updated with information about the fight against breast cancer.  I wish as much attention would be given to skin cancer.

    Sunscreen Tips:

    First of all, please remember that there is no such thing as a healthy tan.  When your skin gets darker after being in the sun that is actually your skin’s way of protecting itself from damage.  If you love the way you look after getting a tan use make-up (or get a spray tan) in order to achieve that “glow”.

    Use a moisturizer that has spf 30 or higher or a sunscreen with spf 30 or higher.  Be sure to use at least a teaspoon size of either (or both) of those products on your face in order to get enough protection.  Apply sunscreen AFTER your moisturizer (if you aren’t using a moisturizer with spf) and BEFORE applying your make-up.  Reapply your sunscreen every two hours if you are outdoors or in a sunny room in-doors.  If you are in an enclosed space all day reapply your sunscreen before going out to lunch or leaving your office for the day.  (See my post about brush-on sunscreens)  Don’t rely on make-up with spf to give you enough protection.  It is always better to use a separate sunscreen in addition to your make-up to get enough protection.

    Don’t neglect the rest of your body.  Any part of your skin that is exposed, even if it is incidental sun exposure (walking to your car, etc.), needs to be protected from the sun with sunscreen.  You can use a body lotion with sunscreen like Eucerin.

    And remember – anyone can get skin cancer!  Skin color, where you live, and your lifestyle choices may lower your risk of skin cancer, but they will not prevent it.  Use sunscreen daily!

    Recommended Website:

    Once again I’ll recommend The Skin Cancer Foundation’s website.  It is an excellent resource for all your questions about this disease.

    And lastly, what is the single most recommended anti-aging product?  Sunscreen!  So while you are protecting yourself from skin cancer by using sunscreen you are also preventing wrinkles and fine lines.   Do you need any more reasons to use sunscreen?

    Also please read:  Nonmelanoma Skin Cancers a National Epidemic  Skin IncMarch 2010



    I’ve noticed a growing interest in this post in the last few weeks so I thought I would add a few more things to the post.  I’ve written extensively about sun protection in this blog.  I think three of my more relevant posts about sun protection are:

    Also please see my post – May is Skin Cancer Awareness Month – for more links to my posts about skin cancer.


    Winter Skincare Tips Or Don’t Put Away Your Sunscreen January 29, 2010


    It is always important to “check in” with your skin at least four times a year – during each new season.  Now that winter is really upon us I felt it was a good time to talk about some winter skincare tips.

    Generally the biggest skin issue people have during the winter is dry, flaky skin which makes perfect sense, of course.  Cold, wind, and dry air all take moisture from the epidermis, the top layer of the skin, leaving it dry.  Since our dermis is our skin’s shield from external factors it is important to keep it well hydrated.  Even people with very oily skin might find that they need a  moisturizer during the winter.  There are a few ways to get that extra moisture that your skin needs.  You could simply buy a creamier, thicker moisturizer with more emollients to use during the coldest months of the year.  I actually prefer another method since I like both my daytime and nighttime moisturizers a lot.  I started using a little bit of jojoba oil on my face before applying my regular moisturizers (I buy my jojoba oil at Trader Joe’s; it is about $7 for 4 fluid ounces – very reasonable price).  Jojoba oil will not clog your pores so it is a great choice for any skin type.  You can also use a B5 serum since B5 is very hydrating.  Skinceuticals and Dermaquest both make good B5 serums.  Or you could use a hydrating mask once or twice a week in order to help your skin regain some of its lost moisture.

    Make sure that you don’t spend too much time in the shower or rinse your face with water that is too hot.  If you do you are further compromising the skin’s dermis and once again leaving it vulnerable to moisture loss.  If you are using a cleanser with AHA or salicylic acid you might want to switch your cleanser to one without those added ingredients during the winter.  Though both of those ingredients are great they can dry skin out over time and as such generally most people will find that cleansers like that are better suited for the warmer months or when you are feeling especially oily.  Instead of using such a cleanser exfoliate gently about two times a week with a lotion, mask, or gentle scrub.

    I find that my hands become extremely dry and even crack during the winter.  Wear gloves when you wash dishes or clean the house in order to protect your hands.  I am constantly washing my hands, partly because I have a two year old and I am constantly washing my hands after changing diapers and wiping his runny nose, so I find I need extra moisture to combat the dryness and cracks.  Lately I’ve been using a Vitamin E oil in the morning and night.  You can even slather your hands at night with A&D ointment which will create a protective barrier over your skin as you sleep.  (Though this is a post about winter skincare tips I will mention that in the summer I find my hands don’t need quite as much moisturizer as they do during the winter, so I simply use a regular sunscreen on them which works great to both moisturize and give me the sun protection I need.  Last summer I used the Target brand Up & Up Face Lotion spf 70 on my hands) 

    And above all – don’t forget your sunscreen!  People seem to think once it is no longer summer there is no need to use sunscreen.  Nothing could be further from the truth!  According to an article in Skin Inc. –  “Even on gray winter days, about 80% of both UVA and UVB rays penetrate clouds. And 100% of UVA rays penetrate glass.”  Further more The Skin Cancer Foundation points out: “No matter how many layers we wear, one part of the body — our head and neck area — tends to remain exposed to the sun’s damaging ultraviolet (UV) radiation year-round. Not coincidentally, the face, head and neck are where the majority of skin cancers occur.”  I cannot emphasis enough how important it is to use sunscreen daily (I recommend spf 30 or higher and be sure your sunscreen is labeled “broad spectrum” so that it protects you from both UVA and UVB rays) and to reapply that sunscreen before you go outside again after having been indoors. 

    And don’t forget to use lip balm with sunscreen (Blistex, which you can find almost anywhere and is cheap, makes a few types of lip balm with sunscreen.  There are also lots of lipsticks and lip glosses with sunscreen).  Lastly, don’t neglect your hands.  Yes, you will probably be wearing gloves when you go outside because it is cold, but do you take your gloves off while driving?  Your car is a confined space, and you are being assualted by UVA and UVB rays while in the car.  There are lots of really nice hand creams for sale that already include spf in them.  Try Neutrogena Age Shield Hand Cream, Peter Thomas Roth, or Studio Gear hand creams.  (And for my Israeli friends I highly recommend this Crema hand cream – Daily Sun Defender)

    Since dry air is extremely dehydrating to skin think about getting a humidifier to use at home. 

    Sources and further reading:


    Book Review: The Mind-Beauty Connection by Amy Wechsler, MD January 27, 2010


    The first thing I would like to say about this book is – I loved it!  If you are at all interested in the connection between your skin and everything else that is going on in your life – stress, lifestyle choices, etc. – this is the book for you.  If you are wondering how to set-up a skincare regime that you can integrate with a healthy lifestyle (a healthy physical and emotional lifestyle) this is the book for you.

    Dr. Wechsler is both a dermatologist and a psychiatrist (according to her she is one of only two such people in the country.  I assume the other one is Richard G. Fried who wrote the excellent book Healing Adult Acne), and her dual choice of professions certainly shines through in this book.  I loved that this book wasn’t simply about skincare or how the skin functions but instead addresses the effects of stress and lifestyle on your skin and overall health and happiness.  Simply put – Wechsler wants her reader to feel good about themselves and their healthy skin will follow.

    As already mentioned Wechsler is a psychiatrist so her book is pretty interactive; she wants her reader to really give their skincare routine and issues some thought.  As such the book begins with a questionnaire so that the reader can determine how they really feel about their skin.  But the book isn’t all questions, plenty of answers are provided as well.  The book contains clear, concise advice about daily skincare routines, has good product suggestions (though as with all product suggestions don’t take Wechsler’s word as the final word on which products to use; take some time to do your own research on products before buying), and plenty of good tips.  I found two tips particularly helpful.   One tip is that you should have three separate towels in your bathroom – one for your face, one for your hair, and one for your body.  You don’t want products that you use on one part of your body getting to somewhere where they shouldn’t be (for instance hair products getting on your face and clogging your pores).  Another tip Wechsler gives is to moisturize your face before you body so that the lotion you use on your body doesn’t accidently clog the pores on your face.

    The crux of Wechsler’s book is her 9 day program for optimal skin, body, and emotional health.  She clearly outlines her program and how each new step, on different days, will help you achieve your goal of having a happy, healthy life.  Some of the aspects of the program are spending more time outside (I thought this was a refreshing reminder how we take the outdoors for granted), seeking connections with friends and family, pampering yourself, and remembering to reflect on your week.  The great thing about this program is that it is definitely within reach.  Wechsler never asks her reader to give up too much too quickly or make unreasonable changes.  Instead she advocates for self-reflection, self-love, and relaxation.

    Wechsler spends quite a bit of time in the book discussing stress and its extremely negative impact on your life and skin.  After reading that section of the book you should definitely be motivated to give meditation at least a try for one evening.  The book includes clear advice about aging and anti-aging products.  Once again, Wechsler asks her reader to fill out a questionnaire about how they really feel about aging in order to help them determine the best course of action to take in order to either slow down that process as much as possible or embrace what is happening to your body.  As in most books about skincare this book also includes chapters about skin disorders such as acne, eczema, psoriasis, rocasea, and cold sores.  There are also chapters about sun protection and skin cancer.  The back of the book has a chart that lists skin issues and which treatments are available to treat them.  I especially liked the information contained in appendix A which had a chart of “dos and don’ts” for your skin and life divided by age.

    All in all, I highly recommend this book.  Wechsler takes a refreshing and original approach to caring for your skin.  Well worth reading.


    Image from


    Is Your Diet Causing Your Acne? January 25, 2010

    Filed under: Acne,beauty,Recommended Reading — askanesthetician @ 7:52 pm
    Tags: , , , , , ,

    One of the more controversial issues surrounding the causes of acne is the role diet plays in triggering acne.  Experts’ opinions on the subject vary tremendously and are also very polarizing.  For example in her book Rx for Brown Skin Dr. Susan Taylor writes: “Although many women believe that certain foods contribute to their acne outbreaks, there’s no evidence that food contributes to acne.  So the good news is that fried foods, greasy foods, chocolate, soda, and candy do not cause acne!” (p. 173).  Furthermore, Dr. Taylor writes that if you notice breakouts after you eat certain foods you shouldn’t jump to the conclusion that the foods triggered the acne.  Instead she points out: “the foods you may tend to eat when you’re stressed – sugary or greasy comfort foods – are probably just coincidental.”  (p. 174)  The acne that you see after eating sugary or greasy foods is related to  hormonal changes brought on by stress and not by the foods, Dr. Taylor concludes.

    Dr. Doris J. Day takes a similar approach to Dr. Taylor in regards to foods as an acne trigger.  While Dr. Day writes in her book 100 Questions and Answers about Acne that “there is no scientific evidence available to show that high-carbohydrate and/or fat intake has any effect on sebum production or acne” (p.45) she does point out that there might be an explanation to the long held idea that diary can make acne worse.  Dr. Day explains that the hormones that are naturally found in the milk of cows, particularly pregnant cows which produce between 75% to 90% of the milk sold in stores, could play a role in acne formation (p.45).  Further, Dr. Day does suggest that eliminating certain foods from your diet that you deem are acne triggers is ok as long as those foods do not affect your overall health.  Dr. Day will concede that there is one ingredient that, if consumed in large enough quantities, can trigger acne.  That ingredient is iodine.

    At the complete opposite spectrum is the advice of dermatologist Dr. Nicholas Perricone.  As outlined in his best-selling book The Clear Skin Prescription and on his website Dr. Perricone promises a flawless complexion, in only four weeks, if one is to follow his anti-inflammation diet, take the supplements he recommends (which he conveniently sells for a very high price on his website), and use the topical treatments he recommends.  Why is Dr. Perricone so convinced that food does make a significant difference in the appearance of one’s skin and in the formation of acne?  Because Dr. Perricone believes that all acne is inflammatory acne and that a diet that combats inflammation will positively affect acne, i.e. stop acne from occurring in the first place. 

    How exactly does the inflammation trigger acne?  Acne begins to form when pores become clogged with dead cells that have not been properly removed.  In his book Dr. Perricone writes that an increase in blood sugar causes retention hyperkeratosis or the retention of and sticking together of dead cells in the pores.  This same increase in blood sugar causes inflammation on a cellular level and can even increase sebum production in the sebaceous glands.  The inflammation continues working on a molecular level in the cells, and causes the sebaceous cells to secrete proinflammatory fatty acids.  The crux of Dr. Perricone’s reasoning for following his anti-inflammatory diet is that by reducing the inflammation on a cellular level through the foods we eat will radically affect existing acne and prevent future breakouts.

    Dr. Perricone writes that the foods one eats as well as the foods one avoids are equally important.  Dr. Perricone explains that one needs to carefully regulate their blood sugar level in order to have clear, healthy skin.  A rapid rise in blood sugar levels makes the body create insulin which then causes the body to have an inflammatory response.  More insulin equals more inflammation equals more acne, according to Dr. Perricone.  Sweets are certainly rapidly converted to sugars in the body but so are simple starches such as bananas, potatoes, corn, and peas – to name a few.  When you eat these foods your body experiences a rapid rise in blood sugar, which triggers an increase in insulin, and then inflammation on a cellular level (p.57).  In addition to avoiding foods that trigger that above mentioned responses it is important, according to Dr. Perricone, to integrate anti-inflammatory foods into one’s diet.  These foods are usually high in essential fatty acids.  He particularly advocates eating a lot of wild Alaskan salmon, fresh berries and melon, and drinking lots of water ( p.59). 

    Dr. Perricone is only one of a few experts who see a direct connection between food and acne.  Certainly his argument does make some sense and the before and after photos in his book are dramatic and intriguing, but if Dr. Perricone is so right about the role diet plays in the formation of acne why do more experts not agree with him?  In my opinion, Dr. Perricone’s advice is certainly another acne solution to consider especially if one is inclined to seek more natural solutions for health issues as opposed to prescription solutions or if one has tried numerous options and has yet to experience relief from acne breakouts.  Yet for Dr. Perricone’s advise to be taken more seriously more studies have to be done that are independent of his own research.  It will be interesting to see what research about the connection between acne and diet reveals in the future.


     UPDATE:  Since I wrote this post I’ve reconsidered the idea of how diet impacts acne.  See my post Book Review:  The Clear Skin Diet for more information.



    Elective Cosmetic Surgery for the Right Reasons January 24, 2010

    Earlier this week a friend of mine gave me an old copy of More magazine (April 2009).  I had never read More before because I thought there wouldn’t be much in the magazine that I would enjoy since I am not their target demographic (the magazine is meant for women 40 and older, and I have about five years until I reach that milestone).  Much to my surprise I have really enjoyed reading the magazine.

    In the copy of the magazine my friend gave me I came across an article by Annie Groer entitled “From Buyout to Face-lift” about her decision to get a face-lift when she turned 60 and had just been laid-off.  I thought it was a great article – thoughtful, funny, and entertaining.  The article also did a wonderful job at describing why someone would choose to have elective cosmetic surgery and why such a choice isn’t entirely vain or ridiculous.  I know many, many women (and men) who consider elective cosmetic surgery a silly, narcissistic decision.  Of course there are numerous, numerous examples of people who choose elective cosmetic surgery for all the wrong reasons – completely giving in to societal pressure to look young and beautiful, deep-seated self loathing, or they are trying to change their appearance to fit in with a certain desired group.  For all those people there are many others who just want to make a few physical  improvements.  Perhaps the way your breasts look bothers you or perhaps your body (no matter how much you exercise or watch what you eat) never “recovered” from having children.  What is so wrong then with getting a few improvements?  It is clear that when you feel good about how you look your attitude and outlook on life changes, your confidence grows, and your ability to cope with what life throws at you is greatly enhanced.  This article clearly shows how a physical improvement can have those desired impacts on your life.  What I also liked about this article is that the author realizes that a face-lift won’t change her life entirely, but it would as she writes “ease [her] entry into [an] uncertain new phase” of her life.  Groer saw the face-lift as a much-needed ego boost.

    I expect that more than one person will disagree with mine and Groer’s stance on elective plastic surgery, and I think that it is important to continue to have a debate on the subject since there are many plastic surgery “abusers” and “addicts” out there.  But bottom line – if you can find a way to make yourself look better in order to feel better, and have realistic expectations about the physical and emotional results of your surgery, why not do it?  If elective plastic surgery makes you enjoy your life to the fullest than go for it!  For those reasons I don’t consider the decision to get elective plastic surgery to be a frivolous or selfish decision.  Keep your expectations in check but your goals high and enjoy your new look.


    How to be a Savvy Skincare Product Consumer January 23, 2010

    How can you be a savvy skincare product consumer?  I think the answer is actually pretty straightforward – don’t believe the hype and know your ingredients.  Of course following through with those two rules is easier said than done.

    It is hard not to get caught up in the hype over skincare products.  We all want to look our best, and when we see an ad for the newest cream, lotion, or serum, accompanied by a beautiful photo, rational thinking quickly disappear.  If you have some sort of chronic skin issue like acne, redness, or fine wrinkles you can be especially vulnerable to the lures of cosmetic advertising.   It is important to remember that cosmetic advertisements purposely use promising but vague language and plenty of pseudo-scientific jargon to lure in customers, and it is actually legal for them to do so. 

    Yes, it is actually perfectly legal for cosmetic companies to advertise their products using the above mentioned vague and pseudo-scientific language since the Food and Drug Administration (FDA) does not require cosmetic companies to prove their claims.  The only restriction the FDA places on cosmetic companies is that they cannot claim that their products can bring about a permanent change to the skin, but even this prohibition is easy to get around if you are creative.  Both the Federal Trade Commission (FTC) and the Federal Communications Commission (FCC) regulate advertising, but, once again, if you use vague enough language you can pretty much say anything you like about your product.  As such cosmetic ad are filled with phrases like “appears to”, “looks like”, and “may experience”.  Additionally, the results of “studies” that you see listed in advertisements?  As bogus as they come.  Don’t believe a word!

    Ok – so you can’t believe a word of what is written in an advertisement for the newest cosmetic product and the photo in the ad is so photoshopped it barely looks like a person anymore – what are you supposed to do now?  The simple answer to that is – learn how to read labels.  You have to learn about ingredients and know the chemical names of ingredients.  It is also very important to note that ingredients are listed on skincare products in descending order – from the largest quantity to the smallest.  That means if you want to buy a serum with a high concentration of Vitamin C in order to fight free radical damage and to perhaps increase collagen production in your skin don’t buy the product where Vitamin C is found at the end of the list of ingredients.  In order to know that you have an effective amount of an ingredient in a product remember that the ingredients that make up the majority of the product will be between the first 5 to 8 ingredients listed on the label. 

    Not believing the hype and learning about ingredients will help you be on your way to being a more educated consumer.  Yet there are so many products out there and even when you are armed with a good amount of information and the right attitude you can still be overwhelmed and confused.  I believe one way to remedy that situation is to always read about new research, ingredients, and products.  I know that not everyone is interested in this subject as much as I am so luckily there are lots of different resources out there, depending on your level of interest.

    Recommended Reading

    Sometime soon I will devote a whole post to Paula Begoun because I have so much to say about her and her work but in the meantime I will recommend a chapter of her book The Original Beauty Bible “Understanding the Hype” where she goes into much greater detail than I have about cosmetic company advertising, beauty myths, and the psychology of cosmetic consumerism.  Begoun also has a short article on her website addressing this subject.  Paula Begoun calls herself “the cosmetic cop” and though she is neither an esthetician or a doctor or a chemist she has set herself up as a consumer advocate and skincare expert.  I certainly don’t agree with all of Begoun’s skincare tips or even all her product evaluations, but her work is important because she is basically one of the only cosmetic consumer advocates out there.  Begoun is also important because she has been able to reach a large audience and many, many people take her advice as truth.  I actually follow her research and even use some of her Paula’s Choice products.  On her website you can access an ingredient dictionary and sign-up for her weekly e-newsletters that cover a wealth of skincare issues.  But please don’t take her word as the final word on skincare issues!  Though Begoun’s opinions are generally well researched they are still her opinions.  Keep educating yourself.

    In an earlier blog post from January 14th I listed a number of websites and magazines that normally offer sound and interesting skincare advice and information.  Reading any of those will certainly increase your knowledge about skincare products and ingredients.

    Other Ways to Find Good Skincare Products

     Get a facial and have the esthetician recommend products.  Go for a consultation with a dermatologist and ask for advice.  If you have a friend who has beautiful skin you could ask them what products they use.  Of course there is a risk in doing that since your friend’s skin might be nothing like yours.  If you are thinking of buying a specific product look at the reviews for that product on,, or  Seeing what other consumers have to say about a product can really help you make up your mind about whether to buy something or not.  Certain companies do sell sample sizes of their products.  That is always a great way to try a product without making a great financial committment. 

    Bottom Line:

    Before purchasing the newest cream, lotion, or serum take a little time to do some research.  Both your skin and bank account will thank you.


    Book Review: “The New Science of Perfect Skin” by Daniel Yarosh, Ph.D. January 22, 2010

    I was very excited when I discovered this book.  Finally a book about skincare not written by a dermatologist or a plastic surgeon!  Unfortunately by the end of reading the book I was just disappointed and slightly confused. 

    The author Daniel Yarosh is a molecular biologist with over 30 years experience developing and testing ingredients for use in skincare products.  Not only did his lab developed the skincare line Remergent but he also developed ingredients for brands such as Estée Lauder, L’Oreal, and Shiseido.  With a background like this it isn’t much of a stretch that he would think of writing a book about what works and what doesn’t work in regards to skincare, particularly products.  I guess my expectations were high when reading this book because one issue that comes up over and over and over again with clients (or just in “conversations” with myself) is which skincare ingredients really work and which products contain those ingredients?  Understanding skincare product ingredients and product formulations can be a daunting task at time.  I consider it a professional obligation to be up to date about ingredients and their effectiveness.  New ingredients are hyped and promoted all the time in the cosmetic industry, but I always want to understand the science behind those ingredients.  So when I found this book at my local library I thought it would be a guide for me to better understand the above mentioned concepts and ideas.

    The overall theme of the book, which is the “new science” mentioned in the book’s title, is the fact that scientists have found a way to reprogram and repair damaged DNA leading to “undoing intrinsic aging itself” in your skin – quite a promise!  Of course, what products does Yarosh mainly recommend in order to undo damage to your DNA?  His own line Remergent.  I always find it suspect when an expert mainly recommends their own products for use.  So this is the main selling point of this book, and the reason why you should read it instead of all the other books out there about skincare.  Basically, the chapter about DNA repair is the only thing that sets this book apart.  There are so many skincare books on the market that do a better job of explaining both the concepts of skincare and how to take care of your skin.

    The Good and the Bad:

    Chapter 2 titled “Cutting Through the Hype” does a great job of explaining how cosmetic companies formulate, market, hype, advertise, make ridiculous scientific claims about, and price their products.  Yarosh does a very good job at explaining why you can’t believe cosmetic advertising at all (I will definitely be devoting a blog post to this subject in the future) and how you can become an educated consumer by learning to understand cosmetic ingredients.  BUT I don’t agree with Yarosh’s list of “overrated” ingredients since he puts antioxidants on that list. 

    Furthermore, this point connects to what I think was one of the strangest things about this book.  On one hand, Yarosh disparages the emphasis placed on the use of antioxidants in skincare products and in caring for your skin.  He uses Vitamin C and E as examples of antioxidants that are overrated.  On the other hand, Yarosh promotes and recommends those same ingredients as effective anti-aging ingredients.  He even lists Vitamins C, E, and A in his list of ingredients that “work” when found in a skincare product.  I am not sure why Vitamin C, E, and A are great ingredients to look for in a skincare product if you are interested in anti-aging but somehow they same ingredients are not good for anything else like brightening or healing or fighting free radicals.  Yarosh is definitely the only expert out there saying that free radicals do not contribute to aging or harm the skin.  He dismisses the idea of antioxidants almost out right.  He is definitely a lone voice in this regard and so it hard to swallow his message when there is so much evidence to the contraryAntioxidants are a great ingredient to look for in skincare products, and I find it almost bizarre that a scientist who develops and researches skincare ingredients dismisses their importance.  This whole issue was one of my biggest problems with this book.  I found the treatment of these ingredients in the book to be very convoluted.

    Having said all of that there are a few other good parts to the book besides the discussion of cosmetic advertising and hype.  Chapter 3 in the book deals with how to read a skincare product label and also discusses the “all natural ingredient” fallacy as well ( I will discuss the whole issue of natural and organic skincare products in another post).  It was also interesting to read in this book about the whole process of testing ingredients before they get into a skincare product.

    The book also addresses common skincare problems and gives solutions.  I found the part about dark under-eye circles to be very interesting.  Yarosh says that in order to get rid of dark under-eye circles you need to stimulate blood flow to that area of the face.  This blood flow will flush away the dark purplish color that you see when blood accumulates in stagnant veins in that area.  Puffiness will also be reduced. 

    Chapters 6 and 7 in the book deal with sun protection and skin cancer, respectively, and are good chapters but, once again, they offer nothing new or special.  It was interesting to read what Yarosh had to say about peptides since peptides are one of the skincare ingredients that everyone is talking about and promoting at the moment.  Yarosh, and in this case he is not the only one, comes out against their effectiveness.  I found both the instructions and the chart at the back of the book that are supposed to help the reader plan and execute their daily skincare regime to be very confusing.  Maybe that is just me, but I felt like that same information could have been presented in a much better fashion.  Chapter 12 of the book is entitled “Future of Skin Care” and contained some interesting information about products and ideas in skincare that are still being developed.

    Bottom Line:  Skim this book.  The chapter about DNA repair and the chapter about the future of skin care are pretty much the only things in this book that are new or different from all the other skincare books on the market.  The confusing message about Vitamins C, A, and E in the book really bothered me.  One last note – Yarosh does recommend lots of products in the book.  Of course, as already noted, he mostly recommends his products.  Even though there are hundreds, if not thousands, of premium skincare brands out there I consider myself pretty up to date about companies, but Yarosh recommends numerous products from companies I have never heard of.  I think the reader would have been better served if Yarosh had recommended more products that are readily available to the average consumer.


    Why was Accutane Taken Off the Market? January 20, 2010

    Filed under: Acne,beauty,Skincare products — askanesthetician @ 11:59 am
    Tags: , , , , , ,

    I was very surprised to learn a few months ago that Accutane had been taken off the market.  As I wrote in the “about” section of this blog I suffered from terrible acne as a teenager; my acne was “cured” by a dose of Accutane.  At the time I took Accutane I knew nothing of the potentially terrible side effects, and I was ecstatic with the results.  Yes, I had some unpleasant side effects while I was using Accutane but only while I was using it.  My face turned very, very red and became extremely dry and flaky.  My lips were very dry as well.  Those conditions were embarrassing but no more embarrassing than my acne, and once I finished taking the Accutane my skin was blemish free and no longer dry.  Accutane is considered the last resort in acne treatments because it is so strong.  But Accutane is also the only known “cure” for acne making it, in my opinion, irreplaceable.   

     Additionally, it is important to point out that there are great emotional and psychological side effects of acne, especially severe acne.  Having acne takes a terrible toll on your self-esteem.  Everyone wants to have blemish free skin, yet not everyone seems to be able to achieve it.  I am not talking about getting a occassional pimple around your period but about acne that is wide spread, unattractive, and immediately apparent to everyone who looks at you.  When you have acne in some ways it feels like the whole world has beautiful, clear skin but you.  You become upset enough about how your skin looks that you begin to consider using just about any treatment, cream, dietary supplement, or lotion that is marketed at those suffering from acne.  And then when nothing works you get more depressed about how you look.  The great thing about Accutane is that it can  both help you achieve blemish free skin and help you regain confidence and self-esteem.

    What is Accutane?

    Accutane (generic name isotretinoin) was first introduced in 1982 and is an oral drug derived from vitamin A.  Essentially Accutane stops oil production in the sebaceous glands and then shrinks those glands.  After this happens sebum cannot clog the hair follicle which sets off the chain of events that eventually lead to breakouts.  Additionally, Accutane decreases cellular buildup in the follicles, kills the acne bacteria, and even controls inflammation.  Once treatment is complete normal oil production returns and sebaceous glands slowly grow larger again, but they never return to be as large as they were originally.  But what is remarkable is that after using Accutane most acne sufferers never experience the level of break-out that they did before taking the drug.  As such it is the closest thing that can be considered a “cure” for acne.  The Food and Drug Administration approves Accutane for the treatment of “severe recalcitrant nodular acne” – in other words acne that is characterized by many inflamed nodules and cysts that are found deep in the skin.  Doctors today may also prescribe Accutane to patients who have acne scars or have a tendency to scar. 

    The most common side effect from taking Accutane is very dry and irritated skin.  The single most common side effect is excessively dry lips – up to 95% of Accutane patients have this problem. Other side effects include mild nosebleeds, hair loss, aches and pains, rash, increased sun sensitivity, and headaches.  And those are the temporary side effects.  More severe, though less common side effects, include nausea, depression, severe stomach pain, increased cholesterol levels, and yellowing of the skin.  Of course, the most disturbing problems associated with Accutane are very severe birth defects.  The risk of birth defects are extremely high if the mother was taking, even a small amount of Accutane, during her pregnancy.  Birth defects include heart, brain, and central nervous system defects, abnormally small or asymmetric heads, cleft palates, deformed eyes or ears including infants being born without ears.  Accutane babies generally have severe developmental difficulties or can be born mentally retarded.  Because of these severe birth defects doctors are cautious about prescribing Accutane to women of childbearing age.  If the doctor does decide to prescribe the drug the woman must undergo pregnancy prevention counseling and have two negative pregnancy tests before being given the prescription.  Prescriptions are only given on a month by month basis and are only reissued after a negative pregnancy test is obtained.  There has been much talk about a link between Accutane and depression, but the number of suicides of Accutane users and those hospitalized for depression are very small when compared to the millions of people in the US who have used Accutane without a problem since its introduction in 1982.

    Despite the harsh side effects and the very upsetting birth defects that can occur because of Accutane this drug has provided lasting relief and help to millions of acne sufferers.  Though these side effects should not be dismissed lightly the benefits of Accutane must be highlighted.  Accutane has proved to be the cure many people have sought for their severe breakouts.   

    Why was Accutane Taken Off the Market?

    Accutane was manufactured by the drug company Hoffmann-La Roche Inc.  Hoffman-La Roche Inc. said in a statement that they pulled Accutane from the market because of “business reasons“.   Indeed Accutane, when it was pulled from the market, only made up 5% of the isotretinoin product sales.  But perhaps more tellingly Hoffman-La Roche has and continues to fight lawsuits brought by patients who suffered some of the more extreme and terrible side effects of Accutane.  The newest lawsuits against Hoffman-La Roche involve plaintiffs who developed Inflammatory Bowel Disease (IBD) after using Accutane.  A simple google search to  find out information about lawsuits involving Accutane turns up over 350,000 hits.  There seem to be plenty of law firms out there who are willing to take on such a case.

    So now that it seems pretty clear why Hoffman-La Roche Inc. pulled Accutane from the market what is someone to do who suffers from severe acne and who has tried lots of different treatments to no avail?   Even though Accutane is no longer available generic versions of the drug are.  Three such generics are currently available:  Amnesteem™, Claravis™, and Sotret®.

    Bottom Line:  Judging by my own experience with Accutane would I recommend its use?  Definitely, but only if you are under the direct and constant supervision of a doctor.  Your doctor should educate you on the side effects and risks of taking a version of Accutane, but you should be sure to educate yourself as well.

    Here are two great resources for more information about Accutane and about acne in general:

    Breaking Out by Lydia Preston

    For some new research about Accutane see my post:  New Information About Accuntane


    Movie Review: “Youth Knows No Pain” January 19, 2010

    Filed under: Aging,beauty,Movies — askanesthetician @ 3:10 pm
    Tags: , , , , , , ,

    Over the summer I watched the documentary “Youth Knows No Pain” on HBO.  The movie follows Mitch McCabe, the daughter of a plastic surgeon, as she travels the country talking to people about their attitudes towards cosmetic surgery and contemplating the results, both physical and emotional, of such procedures.  McCabe has a unique perspective on the whole subject of cosmetic surgery because of her father’s chosen career.  Tragically, her father was killed in a car accident, and so the movie also becomes a quest for a daughter to understand her father’s life, career choice, and ultimately to see his legacy. 

    McCabe is herself obsessed with stopping the aging process anyway that she can.  Some of the country’s leading dermatologists and plastic surgeons make appearances in the film to both explain some of the newest advances in the anti-aging industry and to explain cosmetic procedures and options.  It is interesting that McCabe is able to address this subject without judging the participants in the film or really herself.  Some of the people who appear in the film almost break your heart with the amount of self-loathing that they have.  No matter how many procedures they undergo, they aren’t happy. 

    I enjoyed the film a great deal though I really would have liked if McCabe had interviewed other members of her family, her mother or siblings or ideally both, about how they perceive the whole cosmetic surgery profession or the subject of aging.  Additionally, McCabe’s own obsessive anti-aging stance made me uncomfortable.  I wondered if she couldn’t use a few good years of therapy instead of spending her money on all the latest anti-aging creams.

    I think the film also exposed the “dark side” of the anti-aging industry and cosmetic surgery profession.  Instead of helping people feel better about themselves so that they are more empowered to lead their lives to the fullest, many of the people in the film just continue blindly on a path of so-called self-improvement.  Though the interviews with the experts are straight forward I think they also expose the fact that much of the anti-aging industry is motivated by money and prestige and not by pure scientific fact.  The film also makes clear how much of the industry is subjective.  Perhaps ultimately that may be the underlying message of the film – beauty and happiness is purely subjective.

    Bottom Line:  If the topics of anti-aging and cosmetic surgery interest you see this movie.  Some people may be turned off by some of the people in the movie, but ultimately the movie succeeds in telling these people’s story without judging or demeaning them.  I saw that the movie has yet to be released on DVD.  Hopefully it will be soon.


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