TRUTH in SKINCARE

CBD for Skincare

2020-12-13T22:46:00.000-05:00

It seems like CBD is everywhere these days. It's in the medication that treats rare forms of Epilepsy and the products that promote skin health. From CBD infused moisturizers to CBD infused lip balms, you can find all kinds of CBD products for skin care in the market, but is there any scientific evidence of the benefits these CBD skincare products provide? Let's take a look.

CBD and Types of CBD Skincare Products

CBD is one of the 113 known cannabinoids of the cannabis plant. Unlike its cousin THC, CBD is non-psychoactive and doesn't intoxicate the user or make them feel high. The naturally occurring cannabinoid is more prevalent in the hemp plant, but it is also found in THC-rich strains of the cannabis plant.

Manufacturers are infusing CBD in almost all kinds of skincare products that you can ingest or apply directly on your skin. Usually, these products contain one of the three main types of CBD; isolate, broad-spectrum, or full-spectrum. Ingestible CBD products for skincare include CBD oil, while CBD topicals include creams, balms, lotions, moisturizers, salves, bath oils, masks, soaps, serums, cleansers, etc. All these products are almost the same as their non-CBD counterparts but with the added benefits of CBD.

CBD for Acne

Acne is a chronic inflammatory skin disorder and it is the most common skin disease in the United States. Acne treatments target various acne-causing factors, but anything with soothing and anti-inflammatory properties can reduce acne breakouts and redness. CBD is considered to have both soothing and anti-inflammatory properties, and there's scientific evidence to support that statement. According to the Bioorganic & Medicinal Chemistry Journal, CBD effectively controls inflammation. The Journal of the American Academy of Dermatology suggests that CBD may have the ability to temporarily turn off the signals that make us feel an itch. The Journal also suggests that when paired with creams and lotions with skin-soothing ingredients, CBD may even relieve an itch.

Overproduction of sebum is another reason for acne breakouts. According to the Journal of Clinical Investigation, CBD has the potential to regulate sebum production and balance the flow of skin oil, which may help reduce or prevent acne breakouts.

CBD for Anti-Aging

CBD is derived from plants, so naturally, it has anti-oxidative properties, and due to these anti-oxidative properties, CBD topicals may reduce or prevent signs of aging. CBD, particularly CBD in anti-aging creams, reduces the damage caused by inflammation and counteracts free-radical damage, which visibly diminishes skin issues related to aging, including ruddy skin tone, wrinkles and skin dullness.

CBD for Sensitive Skin

CBD may exert soothing effects when ingested or applied on the skin. It may also be effective for minimizing issues related to skin sensitivity, including reactivity and redness due to its skin normalizing and calming effects. Regardless of the skin type, environmental stressors can affect anyone but the good news is that the soothing mechanism of CBD may help keep their skin in check.

Takeaway

The research about the skincare benefits of CBD is relatively new but shows promising initial results. Researchers studying CBD and its benefits agree that we need more scientific and conclusive evidence to be sure about the benefits of CBD.

Ceramides: How Do They Work In Skincare?

2020-12-13T20:18:00.002-05:00

Ceramides make up around 50% of the epidermis, the outer layer of the skin. They are naturally found in our skin cells and belongs to a class of fatty acids called lipids. Ceramides are more commonly known for their central role in the development of the nervous system and the brain, but recently, they have been gaining popularity in the world of skincare due to their potential to promote skin health. Nowadays, you can find all kinds of skincare and cosmetic products containing ceramides. In this article, we’ll see what science says about the role of ceramides in skincare.

Ceramides and Skincare

Made up of long-chain fatty acids, ceramides promote cellular function as they bind with other important molecules. Ceramides prevent permeability by creating a barrier on the skin and locking the moisture in the skin. As a result, it helps prevents irritation and dryness. Our skin is susceptible to environmental damage and according to a review by the American Journal of Clinical Dermatology, ceramides may protect the epidermis from environmental damage. Wrinkles and fine lines become more noticeable when the skin is dry, so by locking in moisture, ceramides may minimize their appearance and exert anti-aging effects.

As mentioned earlier, ceramides are found naturally in our skin, but over time, our skin loses these fatty acids. This can result in dry and dull skin. By adding ceramides to your skincare regimen, you may be able to minimize these effects and promote skin health with additional ceramides. If your skin cells are bricks, then the ceramides in your skin are the mortar between the bricks. Ceramides form a protective layer in the skin and prevent the moisture from escaping; as a result, they protect against environmental damage and help hold the skin together. Additionally, ceramides are considered to be anti-aging powerhouses and are considered to be as supportive of skin’s dynamic nature as peptides, retinol, and niacinamide. Sphingolipids and phytosphingosine are two precursors of ceramide and can help our skin to produce more ceramides.

As of yet, we don’t know for sure if ceramide levels can reduce or increase the risk of developing underlying skin disorders; however, studies have noted that psoriasis and eczema patients have lower levels of ceramides in their skin. People with mature skin may also benefit from ceramides.

We also don’t know if ceramide skincare products are more beneficial than ceramide supplements or food. According to the American Journal of Clinical Dermatology, ceramide treats underlying skin conditions from inside out, so people with certain skin problems are more likely to benefit from ceramide supplements. On the other hand, ceramide topicals are more suitable for dealing with dry skin or aging symptoms.

Takeaway

We certainly more conclusive evidence to be sure about the skin health benefits of ceramides, but the data suggests that skincare products containing ceramide may form an additional barrier to certain dry skin cases and help soothe dry-skin related irritation.

Organic Deodorant

2020-08-15T15:48:00.005-04:00

It's nice to present some "natural" alternatives to typical products. Many people are interested in natural deodorants, so I'll present one. I came across one by erbaviva. It's a "Jasmine & Grapefruit organic deodorant".

Here's the ingredient list: Alcohol, grapefruit peel oil, cypress oil, ginger root extract, cederwood oil, orange peel oil, lemon peel oil, jasmine flower oil, sage oil, benzyl benzoate, citral, eugenol, geraniol, limonene, linalool.

The product claims to be made with over 99% organic ingredients. It's totally possible. Analysis Well, let's just say, I believe that it does in fact work as a deodorant. However, simply put, it does smell. It claims to be "floral", I'd say it's more "woodsy/musk". Sometimes natural oils are not the best things to use directly on the skin. However, sage oil and cypress oil have been used directly on the skin without any research showing any significant adverse effects. Just a side note: if using products with a lot of natural oils, check to make sure the oils are okay for the skin. Some good points It lacks highly synthetic active ingredients and has no artificial fragrances. And these are some significant good points. Not so good points Not too much. Lemon oil is not particularly great for the skin. In fact some research has shown that it can cause some degree of phototoxicity. But this is probably not much of a worry since the amount of lemon oil is not highly concentrated in this product. If you want to be really really cautious then don't use it before going out to the beach. Overall To be honest I don't like the smell too much, but there are other scents available. I would give this a THUMBS UP!

Demystifying Ingredients; The GLYCOLS / PEG

2020-08-12T21:56:00.002-04:00

Pick up some of your skin or hair care products and chances are one of the ingredients will be a "glycol". So let's demystify the "glycols" so you will know just what they are and what they are doing in your favorite products.

Background
So basically let's start with this. "Glycol" is the same thing as "diol" and they both mean that the chemical structure of said ingredient contains two "-OH" groups (better known as a hydroxyl group, the O is oxygen (see red molecule in image), the H is hydrogen). So what does that mean? Well, kinda nothing yet. Because there are oh so many different compounds with this double hydroxyl group. So let's narrow our focus to the ones most likely to pop up in your products. Namely, Propylene Glycol (pictured), Butylene Glycol, and the famous PEG (Polyethylene Glycol). As for the latter, we see many ingredient lists with PEG in them, so now we know that PEG is really just short for another type of glycol polymer.

What are they doing in my products?
Propylene Glycol, Butylene Glycol, and Polyethylene Glycol (PEG) are used as humectants, solubilizers, stabilizers, and to help increase product absorption into the skin. Many products have a ton of ingredients and without solubilizers/stabilizers (as well as emulsifiers, matrix creators, etc) the products would be a clumpy, non-uniform, seperated mess. Now that wouldn't sell, huh? Ok, so it's in there mostly to help the product formula come together basically, and with some added benefit of being a humectant (being able to draw in water i.e. to help moisturize) and to increase absorption.

So what's the difference?
Besides the chemical structure, not much. But what I want to cover relating to this blog, is their safety profiles. After reviewing scientific research and the MSDS data on all of these ingredients, it's pretty much safe to say, that out of all 3 listed glycols above, only propylene glycol (yes, the one used to make antifreeze) has safety concerns that are worth noting.

As far as butylene glycol and the PEGs, there really is not much data indicating any toxic or irritant potential to be concerned about. However, for propylene glycol, it's well known (at high levels) to be very toxic and certainly fatal if ingested! And remember, it is absorbed by the skin!

What does this mean?
Well, from previous posts, and ingredients in general, just because an ingredient itself has irritant/toxic potential in its purest, concentrated form, does not necessarily mean that it is not safe to use in personal products. That being said, I think it's wise to use ingredients that we know to be safer instead, hey, it's better to err on the side of caution isn't it?

Don't get all freaked out if your favorite product contains propylene glycol, there still is no reliable research showing it's not safe to use in skincare products (but also remember that this isn't easy to prove either way!). I would, however, stick to products, if given a choice, with one of the other glycols instead.

The other concern is the absorption of these ingredients. Remember, when you see these ingredients in your skincare, it means that they may actually help your skin absorb the other ingredients in the product as well. So if there's a bunch of ingredients in the product you are using that are "yucky" or you wouldn't want to be absorbed into your skin, well, than just note that their absorption can, in fact, be increased with the addition of these glycols.

Hey, remember, I can't tell you for sure whether to use certain products or ingredients all the time, just simply due to the fact that science hasn't gotten around to proving the safety/toxicity or long-term effects of many of these ingredients. But what I hope to do is just to get the thinking process started, so that we can simply be aware of what these ingredients are, their indirect/direct safety profiles, and how they work with other ingredients. After all it's all about being a wiser consumer, especially when it comes to products that you apply (and will be absorbed) by the body! Remember, if there are definitely research outcomes proving the dangers of any skincare ingredients, I will certainly try and cover them here on Truth in Skincare!

A shame: price gouging on dermatology medications.

2020-08-03T21:04:00.000-04:00

Here's a story about the massive increases for some dermatology drug prices. I know so many patients whose lives are truly held back because they have to shell out thousands of dollars fort medications a month. It's shameful and absolutely unacceptable. Follow the link to learn more.

Steep price increases hit patients using dermatology drugs

Is the Botox Facial really a thing?

2019-04-19T17:25:00.006-04:00

The Botox® Facial is pretty much one of the latest crazes in the medical cosmetic world. This nearly $1000 facial procedure is a completely different twist on the typical use of Botox®.

Typical use of Botox® involves the injection of deeper muscles in the face in order to paralyze them and prevent their movement... resulting in relaxing lines and wrinkles.

The Botox® Facial is a completely different use of Botox®. During this procedure the Botox®, along with nutrients, vitamins, and typically hyaluronic acid are introduced more superficially via microneedling. The Botox and complimentary ingredients are placed into the dermis itself. This works by paralyzing the muscles attached to sweat glands and follicles. The result is a more superficial smoothing of the skin, decreased oil and sweat production, and decreased pore size.

To be honest, the procedure absolutely does work in delivering the promised effects. However, results will depend on how much Botox® is used in the procedure as well as the other ingredients used in the concocted serum. And, of course, the other thing to weight is the price itself. Overall, if done properly, there in minimal concern for any significant side effects. I would make sure that the microneedling device uses disposable tips for the most hygienic practice.

Facial Exercises: 5 Things to Know

2018-01-23T21:15:00.003-05:00

Facial exercising for a more youthful appearance seems to be coming back into vogue. The idea of facial exercising for a more youthful appearance is certainly not new, but what do we really know about the truth behind exercising the face.

1. Does it work? Well, it depends what the goals are. Facial toning and exercise have long been part of the physical therapy realm, helping stroke patients and others to recover and retrain the facial muscles to improve tone, function, and regain ability. Research clearly proves that proper facial exercise does indeed keep the muscles toned and supple, preventing atrophy which is key to a "plumped" voluminous face.

2. Will it give me an improved appearance? Although promoted by many, there aren't many well conducted scientific studies measuring objective "youthfulness". However, a recent study done at Northwestern University revealed results that showed a significant improvement in the "age appearance" of test subjects who did facial exercises. The study used widely accepted medical assessment models and techniques.

3. How much do I have to exercise? Now that's the crucial question! In the above mentioned study, participants did facial exercises for 30 minutes a day for the first 8 weeks, and then 30 minutes every other day after that. After 20 weeks, the results were more dramatic, revealing a roughly 3 year decrease in "age appearance" as judged by Dermatologists.

4. Are there any drawbacks to facial exercise? As far cosmetics go, one should be aware that repeated facial movements also contributes to the formation and deepening of wrinkles. Facial exercises may contribute to the overall improvement in volume, which is a large contributor to a youthful appearance, but, unfortunately, it may worsen fine lines and wrinkles as well.

5. How does this interplay with cosmetic procedures? Regular users of Botox will not be able to do the required exercises simply because the muscles are paralyzed. An aside, one of the things we are concerned about with long term Botox use is the atrophy of those injected muscles. This means the muscles lose volume over time and which may work against a more youthful appearance. Fillers are an effective way of temporarily increasing volume in the face (but fillers can not typically be injected just anywhere). There are also other ways to enhance volume (threading, stem cell, fat transfer, etc) which we'll get into in other articles. Facial tightening (one of my patients' favorite procedures) is also a very effective (and a semi-permanent) way to tighten, lift, and decrease lines and wrinkles in the face but won't do anything for volume.

If you want to learn more about the study done at Northwestern University and the exercise regime they used, click here. Of course nothing beats taking care of yourself from the inside out. If you've had experience in facial exercise, let us know what you think!

Can Your Blood Pressure Medication Prevent Skin Cancer?

2017-04-24T18:53:00.002-04:00

Some new and exciting research is showing that one of the most common type of blood pressure medications, better known as carvediol (brand name Coreg and Coreg CR), may help prevent skin cancer. Carvediol is a type of medication known as a beta-blocker and is one of the most common types of blood pressure lowering agents used today. Tens of millions of prescriptions for carvediol are written annually.

Recent research aimed at studying whether carvediol was associated with cancer risks showed surprising results. To their surprise, it appeared to actually show protective effects against skin cancer. Soon after the initial findings, laboratory studies were conducted in mice which showed that skin cells exposed to UVB were offered surprising levels of protection by carvediol. In fact, the study showed that carvediol protected epidermal cells even better than sunscreens (shocking, yes) preventing both cancer development and a decrease in the amount of tumor growths.

The researchers' hopes are that one day a dermal spray formulation can be developed with the active proponent of carvediol to help protect skin from UVB damage. As of yet, the exact mechanism of this anti-cancer effect is not yet known.

In practical terms, a real world product is probably years aware from development. However, this is a major breakthrough in finding new ways to protect us from the most common form of cancer.

It is estimated that over 85,000 people in the United States will be diagnosed with skin cancer this year alone.

Biotin: The Beauty Vitamin

2017-02-17T13:10:00.003-05:00

Happy Friday! Make sure to get enough Biotin in your diet. We call it the 'beauty vitamin' because it helps keep skin, hair, nails, and metabolism in tip top shape.

Skincare Trivia

2017-01-08T14:57:00.001-05:00

True or False? Citrus Essential Oils Are Good For The Skin.

The answer is FALSE. Many essential oils from citrus fruits (lemon, orange, grapefruit, etc) are actually quite sensitizing to the skin. They can cause sensitivity reactions, including causing photosensitivity. Excessive use of these citrus essential oils can actually harm skin causing redness, irritation, and even pigmentation changes. They are often used as fragrances in many skincare products because they simply smell wonderful. We would advise against using skin products with any significant amounts of these essential oils.

Skincare Trivia

2017-01-04T09:36:00.001-05:00

Here is the first in a new series of quick trivia on Instagram!

True or False: High concentrations of SD Alcohol are good for oily skin?

The answer is... false. SD Alcohol is found in many #skincare products. In high concentrations, it can have a serious drying effect on the skin which at first may seem great for #oilyskin but actually causes the skin to respond by producing even more oil.

You can follow our Instagram page here.

Catching Melanoma Early

2016-12-22T14:36:00.004-05:00

Knowing risk factors could help catch melanomas.

A new study, published by JAMA Dermatology, identifies high risk patients who may benefit from tailored surveillance.

The incidence of melanoma that occurs on the skin is increasing in predominantly white-skinned populations and Australia's incidence is among the highest in the world.

The study's objective was to characterise melanoma patients and the clinical features associated with their melanomas according to patient risk factors: many moles, a history of previous melanoma, and family history of melanoma, to improve the identification and treatment of a higher-risk subgroup.

Thirty nine (39) per cent of patients were defined as higher risk due to family history, multiple primary melanomas or having lots of moles. The most common risk factor in this group was having many moles, followed by a personal history and a family history.

The authors report the average age at diagnosis was younger for higher-risk patients (62 versus 65 years) compared with those patients at lower risk because they did not have these risk factors. However, that age differed by risk factor: 56 years for patients with a family history, 59 years for those with many moles and 69 years for those with a previous melanoma.

Also, higher-risk patients with many moles were more likely to have melanoma on the trunk of the body, those with a family history were more likely to have melanomas on the limbs, and those with a personal history were more likely to have melanoma on the head and neck.

Dr Watts stated: "The results of our study suggest that a person's risk factor status might be used to tailor their surveillance program in terms of starting age and education about skin self-examination or more intensive surveillance. For instance, doctors could encourage people with many moles or with a family history of melanoma to start skin self-examination and monitoring at an earlier age than other people, and discuss the body sites that require particular attention."

Limitations of the study include risk factors based on physician recall and patient medical records. The authors also did not assess the reliability or validity of the risk factor data.

Medical Spa Dangers: Unapproved Dermal Fillers

2016-12-22T07:00:00.001-05:00

You're putting WHAT in my face?!

If there is one rule I repeat often to my patients and friends it is this: If the price seems too good to be true, it probably is. One of the most alarming practices I have heard of while running my medical spa is the use of unapproved dermal fillers in patients. I'm not talking about using fillers like Restylane®, Juvederm®, Sculptra®, Radiesse® in unapproved locations in the face, no, I'm talking about the use of products that have no place in aesthetic dermal filling.

In my work I regularly come across industry insiders and pharmaceutical reps who spill some shady secrets of some cosmetic practitioners. The most shocking revelation I've heard is the use of knee injections as facial fillers. That's right, these knee injections known as 'viscosupplements' appear to be used by some cosmetic practitioners who are likely trying to increase their profit margin. Known by their brand names such as Orthovisc®, Synvisc®, Euflexxa® among others, these knee injections are also made up of hyaluronic acid gels similar to dermal fillers, but they are NOT the same.

It's not likely to be a health hazard per se, but the consistency and molecular weight of the knee injections' hyauluronic acid is not the same as those in dermal fillers. Thus giving sub-optimal results both in appearance and in longevity, as many of the knee injections can be reabsorbed by the body much quicker. This also eats up any potential cost savings as well. Rest assured this is not likely a widespread problem, but nonetheless, it is something to avoid.

How can you make sure this doesn't happen to you?

Ask to see the package of dermal fillers. You don't have to come across as distrusting, just be curious. Make sure the package is new and opened up just for you. All these dermal fillers are packaged well with safety features.
Avoid super inexpensive dermal filler deals. These products are expensive even for physicians to purchase, so an unbelievable deal may just trouble. Expect to pay a few hundred dollars for just one syringe of dermal filler.
Any $99 deals are cutting corners somewhere. Either that or the practice is taking a massive loss (which would not be a common practice, even for marketing purposes).
Always start with a consultation. Please make sure to have a consultation with any new practitioner prior to receiving any treatments. I have always offered free consultations to ease patients, help offer them education on a variety of treatments, and to explain my personal philosophy on cosmetic treatments. You should always listen to your guy and feel at ease with your cosmetic practitioner.

If you've ever had a nightmare experience while having cosmetic treatments done, please send us an email...we'd love to hear your stories.

Stay safe and enjoy this Holiday weekend!

-Dr. David

5 Things You Might Not Know About Argan Oil

2016-12-08T19:48:00.007-05:00

Argan Oil (Argania spinosa) is under the Ingredient Spotlight. There is good reason this natural oil, sometimes called "liquid gold", has become massively popular over the last 30 years. Argan Oil's benefits for skin and hair are well established (so much so that we have been using our own medical grade, organically-sourced Argan Oil for years on our medical patients). The benefits, however, go beyond the skin and hair. Here we present some lesser known facts of Argan Oil.

1. Argan Oil is amazingly nutrition-packed. Loaded with a remarkable nutrient profile, Argan Oil contains:

Phenolic compounds such as vanillic, syringic and ferulic acids and tyrosol
Squalene
Fatty Acids including oleic acid, linoleic acid and palmitic acid
Sterols including schottenol and spinasterol
Tocopherols (E vitamins)
Vitamin A, B vitamins, and vitamin C

Argania spinosa

2. Argan Oil makes up part of a healthy Moroccan Diet. Argan oil has been used in the Moroccan diet (among other places) both for its nutty flavor and health benefits. Scientifically established properties (to name a few):

Anti-Oxidant
Anti-Inflammatory
Lowers Cholesterol
Improves the Glycemic Profile
May possibly prevent Diabetes and be Cardio-Protective (very limited research)
May improve Blood Pressure (research limited to rats)

Argan fruit on the tree

3. Significant clinical research on Argan Oil is lacking. So you may hear claims that Argan Oil can fight cancer, treat dermatitis, fade scars, but please take that with a grain of salt. Current research is actual lacking to a very significant degree. One reason: it's hard to profit off Argan Oil as it can't be patented. This takes away motivation from any industry to use it for research trials.

4. Argan Oil may boost Testosterone levels. Maybe this will get men to start adding Argan Oil to their diet. Research studies done on adult males have shown a significant increase in testosterone when Argan Oil was used in their diets for 3 weeks. Testosterone levels were increased nearly 20% after the three weeks. It should be noted that similar results were also found with a similar trial with Extra Virgin Olive Oil.

Local Moroccan woman working at a cooperative

5. Argan Oil production has uplifted many women and children in Morocco. The growth of women cooperatives has helped to progress the lives of women in the region. The work has allowed local women to earn an income, become self-reliant, and even send their children to school. The Argan Oil industry is helping to change the traditional roles and views of women within a society that desperately needs this social change.

Infographic: Trends In Botox Use

2016-12-08T15:01:00.011-05:00

Here's an info-graphic on the increasing use of Botox. Although many more younger patients are using Botox for cosmetic purposes, the encouraging finding is that the proportion has remained stable. Data has been obtained from the American Society of Plastic Surgeons and numbers are estimates.

5 Things To Know About Botox and Xeomin

2016-11-29T23:08:00.002-05:00

1. Botox®, Xeomin®, and Dysport® are practically the same.

For practical purposes these are all similar products, but not identical. All use a form of botulinum toxin, produced by the bacteria Clostridium botulinum. The structural differences between Botox® and Dysport® are due to the accessory proteins they are complexed with. Xeomin®, however, is free of these complexing proteins. These toxins all work in the same fashion to block nerve impulses from initiating muscle movement in the muscles into which they are injected.

Common treatments include the forehead, crow's feet, depressed eyebrows, neck bands, 'smokers' lip lines, gummy smile, etc. It is increasingly being used to treat excessive sweating of certain parts of the body including the palms, feet, and armpits.

All three brands have similar effectiveness and side effect profiles. For most patients, biochemical differences among brands do not matter. There are no conclusive studies proving one brand better or worse than another. Overwhelmingly, research has established excellent safety profiles, especially since Botox Cosmetic® was first introduced in 2002. Effects beyond 20 years is unknown.

Tip: I usually use Botox® and Xeomin® because their dilution factor is the same (1 Unit of Botox® is equivalent to 1 Unit of Xeomin®) and I have found the results to be very consistent. I tend to generally recommend Xeomin® for its cost savings (more on that next).

2. How much should I be paying for Botox or Xeomin treatments?

These treatments are not cheap. Prices will range anywhere from $8 to $20 per unit. The one advantage of Xeomin® is that it costs significantly less than Botox® for your physician and these differences should be reflected in your per-unit pricing. The savings add up when you are treating multiple areas.

Depending on the area treated, expect a minimum of roughly 20-30 Units for any particular treatment area. Expect a minimum cost of $250-350 per treatment area.

Tip: It is tempting to find the lowest cost Botox® deals, however, I can personally tell you there are unscrupulous widespread practices throughout this industry. Commonplace (and illegal) practices include excessive dilution of toxin, use of foreign obtained toxin, and use of non-cosmetic Botox® for cosmetic procedures to just name a few. Be wary of discount pricing.

3. Upkeep is required.

Many people try botulinum toxin once and are so impressed with the results they end up having it done regularly. All three brands have roughly the same 'freezing' duration. Paralysis generally lasts between 3-6 months depending on the area involved. Highly active areas such as around the eyes and mouth tend to last for only 3 months. Areas such as the forehead and neck should last around 6 months. Some patients see longer lasting results.

Duration is also patient-specific. Some patients metabolize the toxin quicker than others and may need more frequent treatments. Some people find that if they are not frequent users of botulinum toxin, their results may last longer. A small number of patients may develop immunity to one brand, rendering treatments less effective and either requiring higher doses or switching to a different brand.

Tip: If you do find that your paralysis effects are not lasting as long as expected, try switching to another brand. Some people's immune systems will degrade the product found in one brand quicker than a competing brand. This is not a common problem, but it does exist.

4. What you need to know about your injector.

Make sure your injector (whether a Physician, Nurse, or Physician Assistant) is qualified and experienced. You do not need a Dermatologist or a Plastic Surgeon to perform these injections, but your injector should be well trained and certified if possible.

Dangerous side effects and complications are rare, but are always a real possibility. Even respiratory failure and death are technically risks. Many conditions can preclude someone from receiving botulinum toxin, including pregnancy and breastfeeding.

Tip: Spend quality time during a consultation period. Make sure to have all your questions answered and ask for your Doctor's recommendations.

5. Take the extra step to ensure the best outcome.

Bruising is common. It can also be quite annoying. In my practice I have recommended Arnica for patients to minimize bruising and swelling. Notify your physician prior to taking any new supplements.

Consider icing of the area just prior to the procedure to decrease the pain of injections. You can additionally ask for a topical anesthetic. Neither icing or topical numbing will completely dull the pain because the injection goes deeper into the muscle layer.

Have your injector take his or her time marking or making note of your blood vessels in the treatment area so as to avoid them to prevent excessive bruising.

Follow up appointments for touch ups are sometimes required for additional dosing or corrections. I recommend starting with a lower dose, because more can always be given later. Once your injector is familiar with how you respond to previous injections, follow ups will not likely be needed.

Author's Note: This article should not be seen as my advocating for the use of botulinum injections, but because this is by far the most popular cosmetic treatment, I am offering my thoughts. There are so many anti-aging treatments available today, so it is imperative to understand all your options prior to proceeding with any and all cosmetic medical procedures.

This article is not intended to address treating, diagnosing, or managing a disease or illness. Consult your physician if you would like to learn more about Botulinum Toxin injections.

Medical Spa Procedures That Work! Dr. David Loves Micro Needling.

2016-11-26T02:57:00.001-05:00

I wanted to start sharing some of my favorite aesthetic techniques I have used over the years. Micro Needling is probably my favorite due to its efficacy, safety, and quick recovery time. I have to admit, when I first started performing this micro-puncture technique in my practice, I never expected to see such powerful results, much less the absolutely stunning level of patient satisfaction.

Non-recommended dermal roller (L) vs Recommended motorized micro needling device (R).

So what is Micro Needling?
It is actually a very basic technique that has been used for over a thousand years. Simply put, it is the puncturing of the skin using needles. However, in today's medical age, the process has become supremely advanced and much more effective. The system I have used in my medical spa is the Dermapen. This pen-like device contains 12 very fine needles that puncture the skin thousands of times with a motorized system.

What can I use to compliment the Micro Needling procedure?
I always use some type of topical treatments when using this procedure. These topicals can range from using hyaluronic acid to the high end of using PRP (Platelet Rich Plasma) which we isolate from you blood just prior to the procedure. Using topicals with micro needling is key as the skin has thousands of open puncture channels that can absorb these nutrients more effectively and much deeper than intact skin. I use a various array of hyaluronic acid, peptides, vitamin/mineral solutions.

Side note: I actually created my Healing Oils Serum just for this procedure actually, because I wanted a natural, organic formula to help calm and nourish the freshly treated skin. I was surprised with how effective it was and that is the reason why I started to sell it publicly apart from using it as a part of my micro needling recovery process.

Does it hurt?
No! This is one of the most painless procedures because I use a topical anesthetic (such as lidocaine) prior to the procedure. There might be some slight discomfort in sensitive areas (nose, around eyes, etc), but this is usually minimal and I have never had a patient unable to tolerate the procedure.

What results can I expect?
We recommend this treatment to nearly everyone to reverse the effects of aging and to improve the quality and appearance of the skin. It can be used for fine lines, discolorations, scars, acne scars, skin tightening, etc. One of the most remarkable results that patients notice is their skin is more even and homogeneous, resulting in a "glow" and fresh appearance. The results continue to improve over weeks as the skin produces collagen, regenerates and repairs itself. The results are so impressive, in my own practice, nearly every patient has requested this procedure repeatedly!

What is the recovery period?
Immediately after the procedure, your skin will be quite red and will look something akin to a sunburn. Every patient is different, some can appear to have had nothing done in just a few hours. The redness for the most part will be gone by the next day, you can return to work without issues, just apply makeup to the areas that are still red or bruised (bruising is minimal as well). Some patients request more aggressive micro needling (i.e. for acne scars) and the redness will persist for a few days, but again can be covered with makeup.

Is it expensive?
The good news is that micro needling procedures are usually some of the most affordable aesthetic medical procedures. They usually cost less than a laser session and likely similar to the cost of a very high end facial.

What about Micro Needling roller devices?
I absolutely do not recommend these. They create uneven puncturing of the skin and the results are extremely poor compared to a medical micro needling procedure such as the Dermapen. You must make sure that the device's needles enter perpendicular to the skin, which is something rollers can not do. I also don't recommend rollers from a cleanliness perspective. Some devices are marketed for home use, but I advice against doing this at home. This is a process that should be done in skilled hands.

I'm excited about Micro Needling, what should I ask my cosmetic physician?
First make sure they are not using a rolling device! I prefer the Dermapen, or another device that works similarly. Ask what depth they will puncture (I usually recommend 0.25mm to 0.75mm for most procedures, deeper for more significant wrinkles or scars). Ask what topicals they recommend (I recommend PRP, although this can be quite costly, if not, some form of sealed vitamin/mineral/hyaluronic complex). Then use a natural-based gentle moisturizer after the procedure.

__________________________________________

I am posting a video of Dermapen for educational and illustrative purposes only. I am not receiving any financial or promotional compensation from Dermapen, but I do absolutely believe that their microneedling device is superior (after all I use this in my practice!) and effective.

Hope this helps! Remember stay safe, and only receive cosmetic treatments by a medical professional you trust. Send us a message if you have questions about the procedure or tell us about your micro needling journey.

--Dr. David

Great Read: Making Cosmetic Claims That Stick

2016-11-18T16:01:00.004-05:00

I came across this excellent cover story article written by Marc Reisch for Chemical and Engineering News. The story encapsulates much of what I have blogged about including blatant lies of "All natural", false claims, and the intricacies in the deceptive skincare marketing world. It examines the world of cosmetic testing and the companies that do the research.

You can read the article here.

New developments in uva protection

2016-07-23T19:04:00.002-04:00

A new compound is showing promise in blocking UVA.

Good read on the lack of skincare product regulation.

2016-06-08T13:38:00.002-04:00

This is nothing new to our readers, but here's a great story illustrating the lack of regulation over the skincare industry. What upsets me the most is how products can be targeted towards the most susceptible populations (babies, chemotherapy patients, etc) with no oversight.

Here is the article that appeared in yesterday's NY Mag:

No One Is Monitoring What’s in Your Skin Care

Air Pollution Linked to Facial Dark Spots

2016-02-25T13:16:00.003-05:00

It may be common sense, but research is now proving that air pollution and traffic pollution contributes to skin aging and to the formation of liver spots. Research at the IUF-Leibniz Center in Germany reveals that increased nitrogen dioxide concentrations in air pollution is now associated with skin-aging and the development of these unsightly liver spots especially in the cheek area.

Ten Cosmetic Ingredients to Avoid - Part two of two - Santa Clarita Magazine

2016-01-02T03:04:00.001-05:00

http://www.santaclaritamagazine.com/2016/01/ten-cosmetic-ingredients-to-avoid-part-two-of-two/

Butt Rash from the Toilet?

2015-12-31T10:00:00.001-05:00

A resurgence of high end wooden toilet seats and chemical cleaners may be behind an increase of toilet seat dermatitis, a skin condition once thought to be wiped out in the U.S.A. Recent research has helped point out something that we as physicians may overlook sometimes. Wooden toilets are porous and can not be cleaned as effectively as plastic and may harbor bacterial and fungal growth. Chemicals found in many current cleaning solutions are well known to be irritants. All this could lead to either an infectious or contact dermatitis in the butt and thigh areas, these areas tend to stay a bit moist as well, which further helps incubate microorganism growth.

Here's just a couple basic recommendations to avoid this problem:

Clean your toilets regularly, but if you are using harsh chemicals, after they've dried, wipe down with water or at least a wet cloth to remove any left over caustic ingredients. You'll have to let the toilet dry first in order for the chemical cleaners to maximally disinfect.
Stick with the good old plastic toilets which can be cleaned easier and are less allergenic than wooden toilet seats. However, you can always cover the seat as well.
And a personal caveat . . . avoid using public restrooms if possible :-)

Scientific Study: Victoria's Secret Perfume Is Actually A Mosquito Repellent

2015-11-12T07:30:00.001-05:00

Last week we discussed a research study focusing on non-DEET based products. We mentioned the surprise finding that Victoria's Secret Bombshell Perfume did a good job at repelling mosquitoes, albeit using a heavy amount of perfume.

Here's another article written by Gizmodo talking more about the study.

Scientific Study: Victoria's Secret Perfume Is Actually Mosquito Repellent
// Gizmodo

Here's an excerpt from the Gizmodo article:

You can see that people wearing one of those "natural alternative" mosquito skin patches made with vitamin B actually attracted more mosquitoes than the control, which is kind of hilarious.

The big surprise, as Rodriguez noted, was the Victoria's Secret perfume, Bombshell. You can see that it's almost as effective as the DEET-laced repellents (attracting only 17% of mosquitoes), and stays effective for 120 minutes.

So if you want to keep mosquitoes away, wear DEET – or really fruity, flowery perfume like Bombshell.

Read the full article in the Journal of Insect Science.

Natural-based alternatives to DEET mosquito repellents

2015-11-04T19:35:00.002-05:00

Cutter Lemon Eucalyptus

Finally proof that non-DEET insect repellents work! It's always nice to find products that use natural active ingredients that are actually effective.

A recent study compared 10 different insect repellents, and one of the products tested was Cutter's Lemon Eucalyptus based insect repellent. The research showed that it was extremely effective against two types of mosquitoes that cause serious diseases such as yellow fever and dengue fever.

Some of the other non-DEET products tested included:

Victoria Secret Bombshell Perfume: surprisingly this worked quite well but not as well as the DEET or lemon-eucalyptus. The research authors noted that this was counter to the previous beliefs that heavy floral perfumes would attract mosquitoes. Important to note, however, is that a heavy amount of perfume was used during this study.
Vitamin B1 based Skin Patch: this was not effective in this study.
Avon Skin So Soft Bath Oil: this was effective on only one of the mosquito species.

To read more about the research study testing these 10 repellents click here.