Askanesthetician's Blog

An esthetician explores skincare issues and concerns

Test Your Label Knowledge February 28, 2010

Back in March, 2009 Shop Smart  published a quiz called:  What’s Your Beauty IQ? .  This quiz tested readers knowledge about label terms on cosmetic products such as “natural” and “cruelty free” and claims made by cosmetic and skincare companies about their products.  The quiz does a great job of debunking many myths about cosmetic and skincare labeling and really educates the consumer about what the government regulates and does not regulate in terms of cosmetic and skincare products.

This quiz ties in perfectly with my previous post – How to Be a Savvy Skincare Consumer so I thought it would be a good idea to share the quiz.  As I explained in my earlier post, the more you know how to read a product label the better choices you will make when it comes to buying cosmetic and skincare products.  This quiz is a great way to educate yourself.


Further Reading:



Toner: What Is It? Do You Need One? February 27, 2010

I suspect that I am not the only person you spent a good deal of her high school years drying her face out with the use of toner.  I used a drying, alcohol based toner because I believed that this was a very necessary step in my skincare regime in order to prevent acne.  Luckily I finally realized that the use of an alcohol based toner was unnecessary in order to prevent acne.  It took me some more time to learn that not all toners are created equal and that there are some products labeled “toner” that actually can do some good things for your skin.  Let me explain.

What is Toner?

Toners are a liquid skincare product that is applied to the skin after cleansing, just before moisturizing.  Their use is advertised as a way to remove residue or make-up left behind after cleansing, restore the skin’s natural pH level after cleansing, to close pores, and to even hydrate and treat the skin.  There are actually three different types of toners:

  • Freshners have either no alcohol content or up to 4% alcohol content.  The use of this product is meant for dry, mature, or sensitive skin since too much alcohol will dry out and damage those skin types. 
  • Toners  have an alcohol content for between 4 to 15% and are meant to be used by those with normal to combination skin.
  • Astringents have a very high alcohol content – up to 35% – and are meant for oily skin.  They are meant to remove excess oil from the skin, but because of their high alcohol content most people will find them too drying.  This product is rarely needed since it can do more harm than good.


Do You Need A Toner?


When you don’t need a toner:    I don’t think that you need a toner every night in order to make sure that you have removed all your make-up or cleanser.  Using  a good make-up remover and the proper cleanser is definitely more than enough in order to make sure that your make-up is all off (the only place you might feel the need to go over again would be the eye area since waterproof eye make-up can be hard to remove).  If after washing your face you feel that you still have cleanser on your face than switch your cleanser.  A properly formulated facial cleanser will certainly wash off your face easily without leaving residue behind.  

The claim that toners will close your pores is a silly claim.  First of all, there is no need to seal your pores shut.  Toners will give you a temporary tightening effect but why do you need that anyhow? 

The issue of your skin’s pH level being disrupted because of cleansing is really only a problem if you use soap, which is very alkaline, to wash your face.  If you use a facial wash or cleanser you won’t have to deal with the issue of your skin’s pH being disrupted.

When you could consider using a toner:  There are lots of toners available that can actually hydrate the skin and even leave behind a number of beneficial antioxidants.  These types of toner are good for use during the summer when your skin feels more oily and you don’t feel that you need to moisturize (your skin isn’t actually producing more oil during the summer; it just feels that way because of the increased humidity in the air).   In addition, there are some people who don’t feel the need to use a lot of moisturizer ever so using a toner could be a great way to add some moisture to the skin and get some antioxidant benefits as well.

If you have combination skin (oily T-zone, normal skin everywhere else) you might consider using a toner with witch hazel extract, lactic acid, or salicylic acid just on your T-zone.  But don’t go overboard since too much toner with the above mentioned ingredients can be drying.  Use them on as needed basis and no more than once a day.

Some toners have ingredients that can actually soothe the skin and reduce inflammation so using a product like that if you have sensitive skin might be a good option.

Lastly, in a previous post I mentioned that some people who have very dry or irritated skin may want to forgo washing their face in the morning.  If you don’t feel comfortable just splashing your face with warm water in the morning consider using a gentle, alcohol free toner in the morning instead of your facial wash.  You will very gently clean your skin that way and also hydrate at the same time.






Paula “The Cosmetics Cop” Begoun: Friend or Foe to the Skincare Consumer? February 23, 2010

If you are interested in cosmetic and skincare products you have probably come across Paula Begoun’s best-selling books and even visited her website.  In my estimation, Begoun is the best known and most prolific consumer advocate working today who concentrates solely on critiquing and evaluating the cosmetic and skincare industry.  Begoun and her staff are constantly turning our product reviews (of make-up, hair, and skincare products), answering questions from consumers, and researching ingredients.  In addition, Begoun even has her own line of skincare and make-up products (more about that later).

Paula Begoun has written numerous books of which the best known was are Don’t Go to the Cosmetic Counter Without Me and The Beauty Bible.  I own the older editions of both books; new editions of both books (8th and 3rd respectively) have just been published.  You can find all of Begoun’s books at your local chain bookstore.  If you spend some time on Begoun’s website and sign-up for her weekly email updates it is obvious that many, many people admire her and turn to her for seemingly unbiased advice about the cosmetic and skincare industry and its products.  For all of Begoun’s positive work I still have some issues with her reviews and some of her statements about skincare.  I’ll elaborate below.

The Good

The cosmetic and skincare industry certainly needs a reality check, and I applaud Begoun for devoting her career to being a consumer advocate, to helping educate the public, and to helping people make better choices when it comes to buying skincare and make-up products.  The cosmetic and skincare industry is based upon hype, false hopes and promises, unattainable beauty, youth, and even in some cases out right lies.  It is great that Begoun and her staff try to cut through all the lies and illusions in order to help the public make educated choices about what make-up and skincare products to buy and how to take care of their skin.   Another hallmark of Begoun’s work is how well researched it is.  She always cites her sources (which I greatly appreciate) and it obvious that she and her workers are really looking into subjects from numerous perspectives before publishing their opinions.

The Beauty Bible has a great chapter all about why sun protection is so important.  In addition the book explains very well how to see through all the hype of the cosmetic industry so that you base your consumer decisions on facts instead of marketing claims.  There is mostly thoughtful information in the book about how to care for all the different skin types.  I even thought that the discussion about animal testing, at the back of the book, was interesting and a worthwhile addition to the book.  This book can be a good resource for information about skincare.

Don’t Go to the Cosmetic Counter Without Me contains tens of thousands of product reviews.  It is exhausting just to look at.  Begoun conveniently labels and rates her reviews with faces – smiley faces for great products, neutral faces for so-so products, and faces with frowns for products she doesn’t like.  If she considers the products a good buy there is a check next to the review.  Prices and  a brief explanation about why the rating that was given to the review are included.  Product companies are listed alphabetically so it is easy to find the review you are looking for.  The book includes skincare tips, ingredient explanations, and an explanation of how the product evaluations were done.  Certainly this book is the most exhaustive collection of product reviews currently available.

As someone who likes to play with make-up but is very far from being a make-up artist, I greatly appreciate Begoun’s make-up product reviews.  I find those reviews helpful so that I can spend my money on the right products to get the results that I want.  I appreciate her research about skincare ingredients, and I do find myself looking up what she has to say about different ingredients before making my final decision on how I feel about the ingredient.  I think her research, which is well done, is a definite help to anyone who wants to be better educated about skincare ingredients and formulations.

The Bad

At times I have been confounded by Begoun’s skincare advice and upset that such a wide audience of people was receiving this advice.  Begoun actually began her career as a make-up artist.  When she refused to sell products she didn’t believe were effective her career as a consumer advocate began.  It should be pointed out that Begoun never trained as an esthetician and certainly has never had any medical training.  She is an extremely well-educated, but self-educated, lay person who has made an interest in cosmetics into a very successful career.  I certainly don’t believe that just because Begoun is not a licensed esthetician or a physician that her advice is no good, quite to the contrary at times.  But I do think there is a big difference between someone who examines skin up close on a daily basis (and touches it) and their knowledge compared to someone who deals with all these issues in a simply theoretical way.  There is a huge difference between talking about skin versus caring, looking at, and touching it.  Certainly when it comes Begoun’s reviews of products I find that the lack of actually using and trying the products versus just looking at ingredients in order to evaluate the product is a big issue.  I disagree with some of Begoun’s product reviews for that reason.  Some products she pans I have used with great success and recommend them to my clients.  I haven’t done a scientific study about this but I would say that her product reviews lean toward being generally neutral to negative.  Now is that more a reflection on her exacting standards or on the sad state of cosmetic and skincare industry?  I don’t have an answer for that.

Begoun is extremely opinionated on every cosmetic and skincare topic and product.  I guess you need to be to that way in her line of work, but I find her attitude a bit off-putting at times.  I generally think that you need to stay open-minded when it comes to skincare issues.  There are always new products and research to discover.  You need to able to bend a bit in order to stay abreast with the latest findings.

Begoun has declared war on fragrance in cosmetic and skincare products.  Yes, it is true that fragrance can cause irritation and people with sensitive skin should look for products that are fragrance free but should all fragrance be banned from make-up and skincare products?  I don’t think so.  But when I read Begoun’s The Beauty Bible I think I figured out why she is so against fragrance.  Begoun suffered from severe eczema for many years, and so I believe that her hatred of fragrance is purely personal.  I wish her own personal issues wouldn’t loom so large over her reviews.

Another bit of advice that Begoun gives just annoys me.  She writes the following in The Beauty Bible (page 190, 2nd edition):

“If you have dry skin, dry, wrinkled skin, or dry areas (like on the cheeks or around the eyes), you need a moisturizer; otherwise you don’t.  It’s that simple.  If you don’t have dry skin or you have normal to oily skin, you can obtain many of the benefits moisturizers contain (antioxidants, anti-irritants, water-binding agents, natural moisturizing factors) in a well-formulated toner.  Avoiding using a cream-, lotion-, or serum-style moisturizer when you don’t have dry skin can help prevent breakouts and feeling greasy and shiny through your makeup by midday, and encourage your skin to do its natural exfoliation.”

I couldn’t disagree more!!!   Even if you have breakouts you definitely could feel that you want to use a moisturizer.  It is very wrong to tell people that if they use a moisturizer they can cause breakouts.  I know few people who don’t need a moisturizer.  As a matter of fact, many dermatologists even say that a lot of the skin redness and irritation that they see on patients could simply to relieved by using a good moisturizer.  I have never been able to figure out why Begoun continues to give the above advice.

Begoun began her career as a make-up artist so it was strange for me to read her come out against experimenting with eyeshadow color in her chapter about make-up.  Since make-up washes off it is a great medium to experiment with and cosmetic companies certainly offer plenty of color options with which to do so.  I feel that once again this is a personal preference of Begoun’s passed off as fact.  I wish she would encourage “free thinking” when it comes to make-up colors.

The Ugly

As I have already mentioned Begoun has her line of skincare products called Paula’s Choice.  Full disclosure – I use one of her sunscreens and love it.  I also have a client of mine using one of her BHA lotions nightly with great results.  Yet I do have an issue with a consumer advocate having her own products particularly because Begoun shamelessly self-promotes.  In Don’t Go to the Cosmetic Counter Without Me she even goes so far as to review her own products!  Not surprisingly she gives all her products her highest rating.  I found that ridiculous, self-serving, unnecessary, and even slightly unethical.  I turn to Begoun for unbiased reviews; I don’t need her to review her own products as well.

And lastly, none of Begoun’s books have indexes.  Is it too much to ask for a book that is so full of information to have an index???  I don’t think so.  I find myself wasting lots of time trying to find information in The Beauty Bible because of the lack of an index.  I also find the format of “the best product summary” in Don’t Go to the Cosmetic Counter Without Me to be hard to read.

Bottom Line:  I’ve said this before and I’ll continue to stand by it – Paula Begoun is doing important and needed work as a consumer advocate but don’t take her word as the final word on cosmetic and skincare products.  Use her as a reference and do your own research as well.

For another perspective  on Paula Begoun read Caroline Hirons excellent post with her take on the good and bad when it comes to Paula Begoun.


How Acne Forms February 22, 2010

Filed under: Acne — askanesthetician @ 7:26 pm
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Acne forms over the course of several weeks and through a series of complex events in the skin. The pimple that you see on your chin as if it appeared overnight, has in fact been hard at “work” below the surface of your skin for weeks before you see it.   Below I’ll describe the entire process of how acne forms.

Acne begins its life in the hair follicle or pilosebaceous unit.  This unit consists of the hair follicle itself and an attached sebaceous gland which produces sebum or oil.  There are three types of hair follicles: vellus, terminal, and sebaceous.  In the first two types of follicles the hairs (though at different stages of development and appearance) fit closely into the follicles which is to say that the diameter of the growth channels are the same as the hairs themselves.  Because of this tight fit there isn’t room for debris or sebum to remain in the follicle and subsequently form a pimple.  But what then happens in the sebaceous follicles?  The hairs in those follicles are small and frail leaving more than enough room for debris and sebum to accumulate and get stuck there.  These sebaceous follicles are concentrated on the face, neck, shoulders, upper chest, and back subsequently explaining why these are the areas where people experience breakouts.  Furthermore, these follicles are largest and most numerous on the face. 

People who are prone to acne tend to produce abnormal amounts of sebum; this production of sebum is triggered by hormones known as androgens.  There are different types of androgens but the significant one in terms of acne breakouts is testosterone which circulates in the body via the bloodstream and reaches the hair follicles that way.  In the hair follicle an enzyme changes the testosterone into a chemical called dihydrotestosterone, or DHT for short, which then signals the sebaceous glands to start producing sebum.  Just because you suffer from oily skin or acne does not necessarily mean you suffer from a hormonal imbalance or an overabundance of DHT.  Typically it just means that your sebaceous glands are very sensitive to the above mentioned hormones and then your oil production becomes excessive. 

Yet even if you have oily skin you might never breakout and even people with dry skin can breakout.  So how does that happen?  The main cause of acne are comedones or blocked pores.  The pores or openings that lead down into the sebaceous glands are the issue here.  Comedones are formed when something goes wrong with the skin cells lining the follicular channel.  If the skin processes are working normally then the sebaceous glands are continually expelling dead skin cells or keratinocytes onto the surface of the skin along with the normal flow of sebum.  But this process can malfunction and two things can happen – the follicle can actually step up its production of keratinocytes thus creating a huge amount of debris or dead skin cells and then secondly, that excess amount of cells stick together much like if they were cement.  So instead of leaving the follicle as they should these dead cells remain where they are and mix together with the sebum already in the follicle.  This produces a microcomedo.  Doctors call these microcomedones “precursor lesions” to acne, and if you suffer from acne your skin is full of them.  The microcomedones take about six to eight weeks to form and by the end of that time period enough dead cells and oil have accumulated in the follicle in order to produce a closed comedone which feels like small bumps on your skin (you can see them as well).  This closed comedone can mature into what is known as an open comedone or a blackhead.  As it grows the comedone presses the pore open at the surface, and then the accumulated oil and dead cells oxidize turning black.  Some sources say that the skin pigment melanin is what accumulates at the top of the pore and turns black.  Blackheads can grow to anywhere between 2 to 5 millimeters and remain in place for months and even years.  Inside the follicle of a blackhead cell production slows down considerably and the sebaceous glands all but stop secreting oil.  Another form of a comedone is a whitehead which like a blackhead in that the pore is filled with oil and dead cells.  But unlike a blackhead the accumulation takes place beneath the surface of the skin and the mixture of materials does not oxidize.  People who have what is called non-inflammatory acne suffer from a mixture of whiteheads and blackheads and rarely form the red bumps most people associate with acne. 

Having now explained non-inflammatory acne it is time to explain inflammatory acne.  This type of acne is characterized by pimples, papules, pustules, nodules, and cysts.  Inflammatory acne is caused by a rod-shaped bacteria called Propionibacterium acnes or P. acnes for short.  This bacteria thrives in places without oxygen and as such is found deep in the skin which explains why many acne products cannot destroy this persistent and tough bacteria.  P. acnes multiplies quickly inside closed comedones and additionally excretes chemicals that damage the lining of follicle.  In addition to this damage these toxic chemicals attract the attention of the body’s immune system which seeks to destroy the bacteria.  It is at this point that one feels a slight elevation under their skin and/or a tenderness.  The P. acnes find their targets in the follicles and release enzymes which destroy part of the follicle’s wall creating a rupture or break.  Sometimes the body repairs the break quickly and what might have been a major pimple in the making does not occur.  Other times the rupture will become a papule – a raised, red spot without a visible head.  The redness of the papule comes from a network of blood vessels, and the swelling is caused by lymph and other fluids. 

If the body does not repair the follicular rupture quickly then the contents of the follicle spill out into the surrounding tissue.  The contents of follicle include sebum, hair, bacteria, and skin cells.  The body then sends neutrophils to the area to isolate and destroy the foreign materials.  As they go about their job the neutrophils destroy more of the follicle wall and the surrounding tissues’ dermis.  This activity will produce a pustule or a white or yellow capped acne lesion filled with pus.  The pus contains white blood cells, bacteria, and other debris.  Eventually the top of the pustule breaks and the pus escapes taking along with it the remnants of comedone.  Sometimes this could be the very end of the pimple, but if bits of material are left behind another pimple could form in exactly the same spot and so the cycle of breakouts continues.   

Nodular or cystic acne is most severe type of acne.  It consists of large, painful, and solid acne lesions that are lodged very deep in the skin with only a small opening to the surface of the skin where the follicle exits the skin.  They can feel hard to the touch, and these lesions can last for months leaving behind crater like scars when they finally heals.

Now that you have a better understand of how acne forms you can determine how to treat your acne is a more effective manner.  The two keys to treating acne are unclogging pores and killing the acne bacteria.  Gentle and regular exfoliation can help unclog your pores, and benzoyl peroxide can kill the acne bacteria.


Sources and Further Reading



Are Parabens In Skincare Products Safe? February 21, 2010

I have been asked more than once if it is safe to use skincare products that contain parabens.  My answer would be yes.  Let me explain why.

What Are Parabens?

Parabens are chemical preservatives that are used in food, cosmetics, and skincare products in order to prevent the growth of bacteria in those products.  Without preservatives products are very susceptible to contamination.  Not only are parabens the most commonly used preservative in skincare products, they also have the best safety record when it comes to preservatives, and have been used since the 1920s in skincare products.  Parabens are found in very low levels in skincare products, from 0.01% to 0.3%,  and usually a combination of preservatives are used in order to provide the best protection from bacteria, mold, and fungi.  But the safety of a few parabens – methylparaben, propylparaben, and butylparaben – have been called into question.

The Controversy Over Parabens

In recent years concerns have arisen over parabens.  The concerns include that parabens may cause allergic reactions, disrupt our body’s hormones (parabens are said to mimic estrogen in the body), and even contribute to breast cancer.  Theoretically it is thought that parabens build up in our bodies over time since so many products contain them.  Even if a given product contains just a small amount of parabens it is thought that this is enough over time to contribute to significant health problems. 

In regards to allergic reactions there are actually “natural” preservatives that are more likely to cause allergic reactions than parabens.  These include Vitamin E, tea tree oil, thyme essential oil, and phenoxyethanol.   If you do think that parabens are causing your allergic reaction than a dermatologist can do a patch test to check.

The greater concern over the use of parabens has to do with a link between parabens and breast cancer.  Starting in 2002 a number of studies looked into a possible link between underarm deodorants with parabens and breast cancer.  Though some of the studies found that there were high concentrations of parabens in human breast cancer tumors there has never been a conclusive link between parabens and cancer.  These studies for instance did not look at paraben levels in normal, non-cancer, tissues in order to offer a comparison.  In 2005 a study concluded that there was no way that the maximum daily exposure to parabens could increase one’s risk of cancer.

Paraben Safety

In 1984, 2003, and 2005 the Cosmetic Ingredient Review (CIR), an industry-sponsored organization which reviews cosmetic ingredient safety and publishes its results in open, peer-reviewed literature, investigated the safety of parabens.  All three times the CIR concluded that parabens were safe as long as they did not constitute more than 25% of a product’s content.  Once again let me point out that parabens are found in levels ranging from 0.01% to 0.3% in skincare products.  Additionally, the FDA has determined that parabens are safe for use in cosmetic products.

How To Determine If The Product You Have Has Parabens

Parabens are actually very easy to identify on your skincare product label since they all end with “paraben”.  You’ll find them at the very bottom of the list of ingredients.  Skincare products that are paraben-free usually list that somewhere on the front of their label.  If you do choose to go the paraben free route keep in mind that these products will spoil quicker than those with chemical preservatives in them.  Look for expiration dates, and if the product doesn’t have an expiration date call the manufacturer (by law the manufacturer’s phone number must be on the label) to find out the product’s shelf life.

Sources and Further Reading



Not Just Lip Service: Your Lips Need Spf Too February 20, 2010

If there is a “theme” or “mantra” to this blog I believe it would be – always use your sunscreen!  As I have mentioned before in my posts no matter what time of year it is or what type of weather it is you still need to use sunscreen daily, and you need to reapply your sunscreen. 

One part of your body that is ALWAYS exposed to the sun’s rays, 365 days a year, are your lips, but I think many of us forget that even our lips need sun protection.  Get into the habit of using lipsticks, glosses, or chapsticks that contain spf 15 or higher.

I thought I would highlight some lip products that have that needed spf 15:

FYI  – The above products are just suggestions for use, not endorsements.  I have only tried the Blistex products myself. 

If you have a favorite lip product with spf please feel free to comment below.


Ridiculous iPhone App? February 17, 2010

Filed under: Acne — askanesthetician @ 4:45 pm
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I don’t have an iPhone.  I don’t have any kind of smart phone even though my husband and numerous friends have repeatedly recommended that I get one.  I don’t have one not because I am opposed to smart phones; I don’t have because I am afraid if I have one I’ll never put it down.  I fear that my time sucking habit of internet surfing will simply over take my life if I have a smart phone so in lieu of just gaining some much needed self-control I  decided to just have a simple cellphone instead.  For now all I can do with my phone is make and receive phone calls and texts.

Having said all of that, of course I am still well aware of all the different apps that are available to smart phone users.  When the app craze began I even tried to recruit my husband, a former computer programmer, to write an app so we would make lots of money and live without financial worries ever again.  Alas that never happened because of my lack of a cool app idea, not for lack of will.  Nevertheless I still am interested in new apps and was very intrigued when I saw the following article today on WebMD:  Can You Treat Acne with an iPhone App? AcneApp Promises to Clear Skin With Light Therapy; Dermatologists Express DoubtsMy first thought was – is this a joke?  Really – treat your acne with your phone??!! 

The idea behind this app is that your phone gives off blue light (which fights acne) and then red light as well (which helps heal the skin).  The use of light therapy to treat acne is not a new idea, and there are even numerous hand-held devices that you can use at home that claim to help heal acne.  Light therapy, when administered at a physician’s office using medical grade machines, can be part of a treatment option to help alleviate acne.  The home devices are an expensive option that rarely works.  The main reason these home gadgets don’t work is that the light intensity in these devices isn’t strong enough to do anything.  The light intensity must be kept low because these devices are sold for home use and as such must be consumer safe.

I think this iPhone app is nothing but a gimmick full of false hope.  This level of blue light will not heal your acne.  Get on a good anti-acne home care regime that is tailored to your specific type of breakouts and see a professional for light therapy if you choose that option.   Use your smart phone for calls, texts, the internet, etc., etc. but leave caring for your acne to a professional.

Sources and More Information:



Give Your Hands Some TLC February 15, 2010

I think many of us don’t think about our hands enough.  When it comes to skincare almost everyone concentrates on caring for their face and neglects their hands.  Your face may be wrinkle and line free (and acne free as well), but in the end your hands are covered with sun spots and full of wrinkles.  It is time to treat your hands with as much respect as you would your face.

Basically, whatever products you use on your face you can use on your hands.  Whatever treatments you would do on your face – laser, chemical peels – you can also do on your hands.  And the number of products aimed at treating hands has grown exponentially in the last few years so there are plenty of products to choose from.

First and foremost, use sunscreen on your hands so that you protect your hands from age spots and collagen deterioration.  If your hands are on the dry side use a hand cream with spf.  A few to consider are Neutrogena hand cream, Peter Thomas Roth hand cream,  or Studio Gear hand cream.  Or if your hands don’t need extra moisture then just use sunscreen on your hands every day and don’t forget to reapply throughout the day.  Buy a few hand creams and/or sunscreens and leave one in the car, one by your kitchen sink, one in your bathroom, and one in your purse.

Don’t forget to exfoliate in order to remove dead skin so that your moisturizer and other treatments can work better.  You can safely use any type of scrub on your hands in order to exfoliate.  Additionally, you can even consider an esthetician or doctor administered microdermabrasion treatment on your hands in order to exfoliate and stimulate collagen production.

If you have sun spots on your hands consider using products with brightening agents (like vitamin C) or hydroquinone in them.  (For a in-depth discussion on treating hyperpigmentation see my blog post Help for Hyperpigmentation)  If you want more immediate results get a chemical peel on your hands.  Not only will the chemical peel help to remove hyperpigmentation and smooth your skin considerably it will also stimulate collagen production in the area of the peel.  You can even get laser treatments on your hands in order to remove the age spots.  For both the chemical peels and the laser treatments you might need a series of treatments in order to get the results you desire, but generally you will see a difference faster than when just using a brightening or lightening serum.

Just as you would use Retin-A, Renova, or a OTC retinol product on your face to fight wrinkles and lines and build collagen you can do the same on your hands.  The prescription retinol products can even reduce crepiness and make veins less obvious.  Or consider injections in your hands.  Restylane, Radiesse, or Sculptra can all be injected into the hands to add volume and make veins less visible. 

In the meantime, while you consider your treatment options or wait for the product you applied to work you can use make-up on your hands.

Lets give our hands a little extra thought and TLC today.  You’ll thank yourself in the future.


Sources and Further Reading:


FYI – Ellen Sirot, who calls herself the world’s “most successful hand model” has a line of hand creams.  I’ve never tried them and interestingly enough the creams do not contain spf.  You might enjoy looking at her website.


What Causes Acne? February 14, 2010

Filed under: Acne — askanesthetician @ 2:57 pm
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Even with all the research that has been conducted about acne the debate still rages about the causes of acne.  The exact causes of acne are not entirely known and subsequently because of this there is no actual cure for acne.  At the moment experts believe that acne results from several related factors. 

The related factors that trigger acne can be broken down into two general categories:  intrinsic and extrinsic.  Intrinsic factors are genetics and the body’s response and sensitivity to hormones.  We have no control over these issues.    For example hormonal fluctuations around a woman’s period can lead to breakouts.  Hormones both affect oil productions, and the body’s hormonal levels fluctuate both at different points of the month and over a person’s lifetime.  And anything can raise your hormonal level – stress, your period, pregnancy, or nursing.  Genetics can play a significant role in acne formation.  Genetics can be responsible for creating a defective oil gland, a pore lining that does not shed dead cells properly, and even for the production of abnormal sebum.

There are multiple extrinsic factors that cause acne.  Extrinsic factors are a large and diverse category of factors that we have much more control over.  This category can include medications, external stress and emotions, and products used on the skin and hair.  So for example the over use of topical corticosteroids can lead to acne just as using oily make-up can.  Another extrinsic factor that contributes to acne is the misuse of skincare products.  For example the natural balance of the skin can be upset by the misuse of skincare products, especially harsh and strong skincare products, thus destroying the outer layer of the epidermis and kicking into high gear a series of processes that lead to acne.  If the skin is irritated or overly dry because of the use of harsh and drying skincare products then skin starts to produce more oil to make up for the lack of it thus continuing to perpetuate a cycle of breakouts.  I should point out that not all experts agree about that last point.  Over drying or stripping your skin of moisture by over washing it or using too harsh products could perpetuate a cycle of breakouts because dead skin cells (or kerantinocytes) clog your pores instead of being removed.  Or since your skin senses it is damaged or under stress because of the excessive dryness an inflammatory stress reaction kicks in and you end up with more pimples in the end. 

Figuring out exactly what causes you to breakout can be a daunting task especially when there are so many factors to consider.  In his book Healing Adult Acne Richard G. Fried devotes an entire chapter to helping the reader identify their “acne triggers” (chapter 3).  He presents his readers with a 15 point questionnaire that includes such questions as:

  • “I seem to break out more when I am feeling stressed”
  • “I seem to break out more when I am eating more milk products”
  • “I seem to break out more the week before my menstrual period”

Fried makes the important point that there is no one size fits all generalization for finding the cause of one’s acne.  For this reason he made up his acne trigger questionnaire so that acne sufferers would take the time to find the very personal factors that cause their acne.  Though there are many acne causes that are so prevalent that they may even be called universal, each individual needs to determine what triggers their own acne breakouts.  Finding your personal acne triggers helps you find the right treatment for your acne.  As already mentioned above, one person’s acne may clear up by simply changing hair or make-up products while another person might need medication that controls their hormone fluctuations in order to find acne relief.

Stress and Acne

Many acne sufferers and doctors are convinced that stress plays an important role as an acne trigger.  Stress, which is caused by many psychological and physical occurrences, has a deteriorating effect on the body including the skin.  Stress can cause acne in several ways.  Stress can affect the ovaries, testes, and adrenal glands leading to the increased release of androgens throughout the body which causes an increased production of sebum or oil in the body.  Additionally stress can release more inflammatory chemicals into the body leading to more inflamed acne.  Furthermore, stress produces heightened levels of cortisol in the body that can both aggravate existing blemishes and can cause an inflammatory reaction in the hair follicles that lead to microcomedones (blackheads) developing into papules and pustules. If  you are stressed out sleeping and eating habits are adversely affected which leads to a disruption in positive habits such as exercise, healthy eating, and good skincare routines all of which can trigger an acne outbreak.  Feeling that you have no control over your breakouts can lead to more stress and more breakouts creating a vicious cycle that is difficult to break.

If you have tried numerous acne treatments to no avail I would highly recommend trying to figure out what your acne triggers are.  Chapter three of Richard Fried’s book is an excellent guide to helping you discover those triggers and hopefully finally find relief from your acne.


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No Mixing Allowed: Skincare Ingredient Combinations to Avoid February 13, 2010

So you’ve researched what skincare products to buy and finally made your purchase.   But did you know that if you use different skincare products at the same time you could actually cancel out the benefits of the very ingredients you purchased the product for?

Don’t mix copper peptides and vitamin C –  using the two together, even if they are in separate products, just cancels out the effects of both.

Don’t mix retinol and benzoyl peroxide – both ingredients are great for fighting acne but if they are used at the same time they simply counteract one another.

Don’t mix retinoids or hydroquinone with glycolic acid – once again if you mix these ingredients they become inactive. 

Hydroquinone and retinoids can only be combined together in specially formulated products like Tri-Luma (which is used to fight hyperpigmentation).

And sometimes too much of certain ingredients is just bad for your skin:

Be alert to signs of redness, irritation, or excessive and prolonged peeling if you use products with AHA (alpha hydroxy acids like lactic, glycolic, malic, etc.), vitamin C, and retinol all at once.  For instance all in one day you may use a cleanser with glycolic acid, a moisturizer with vitamin C, and a retinol cream or serum at night.  You may find that your skin becomes sensitive to the use of so many potent ingredients.  If that is the case cut out one or more of the products with the strong ingredients or stagger the use of the products (skip a day or use a product just once a week).

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