Hannah's Blog

Gluten Free Skin Care?

April 22, 2012 / 4:19 pm

Gluten-free diets are increasing in popularity. In the US, 1 in 133 people are intolerant to gluten, which is also know as celiac disease.

What is gluten? Gluten is a protein found in wheat, barley, rye and millet.

There is controversy about whether individuals with celiac disease need to avoid topical skin care products containing these wheat proteins. Oral consumption of gluten can cause eczema, psoriasis, and dermatitis which is sometimes called “gluten rash”. Some people worry about cross contamination i.e. using a hand lotion with wheat proteins then preparing food.

If gluten in your skin care is a concern, avoid ingredients like barley, wheat, and triticum. Oats and oatmeal do not contain wheat protein but are usually processed in a facility where cross contamination is possible.

Wheat germ oil is commonly used in skin care products but the wheat protein has been removed so it shouldn’t cause a reaction.

It is best to avoid lip balms(and any products that may be ingested) that contain wheat proteins.

All of my products are gluten free and I recommend Intense Moisture Therapy to sooth eczema rashes.

Do you have any personal experience with gluten intolerance and skin care? Please feel free to share!

Do I need to use the same brand for all my skin care?

March 25, 2012 / 2:06 pm

Q: Can I mix skin care products from different brands or do I need to use the same brand for all my skin care products?

A: Yes. If you like a product and it works for you, use it. They only person that will tell you different if the person trying to sell you a their entire line of products!

That being said, be careful of using multiple products that have similar ingredients. the most common example of this is using more than one product to exfoliate and ending up with irritated skin.

What’s the difference between Retin A and Retinol? And should I be using one?

March 14, 2012 / 2:34 pm

Q: I hear a lot about Retin A and skin creams with retinol…should I be using one? And what’s the difference?

A: There are a variety of skin care products on the market that incorporate Vitamin A derivatives, commonly called retinols or retinoids. These products benefit the skin in multiple ways but most importantly they increase skin cell turnover. This increased cell activity helps prevent blackheads, smooths fine lines, lessens the appearance of wrinkles, and lightens pigment spot from age or acne.

Tretinoin (the generic name for Retin A) is a prescription retinoid. Tretinoin is sold under several brand names: Retin A, Retin A Micro, Renova, Atralin to name a few. These products require a prescription so your dermatologist will determine which one is best for you based on your skin type.

Many over the counter products contain retinol. Nightly Therapy is one of my best selling products, it contains time released retinol and is safe to use around the eyes.

Most people can benefit from incorporating a retinol into their skin care routine. Retinols should always be used at night since sunlight breaks down the active ingredients. SPF must be worn during the day because the increased skin cell turnover will leave your skin less protected.

If your have no breakouts and very few fine lines, use a light retinol once or twice a week at night to exfoliate and help prevent the signs of aging.

If you have acne, visit a dermatologist and get a prescription for tretinion.

If you are fighting more pronounced signs of aging, use a retinol every night. Layer it under your moisturizer if your skin is dry.

Retinols are a great tool for increased skin health!

Pregnancy and Skin Care

February 22, 2012 / 7:01 pm

With all the hormonal changes your body goes thru during pregnancy and breast feeding, your skin can feel like it’s on a roller coaster ride.

Many over the counter and prescription acne treatments aren’t safe to use during pregnancy and breast feeding. Salicylic acid, benzoyl peroxide, tretinoin (Retin A, Tazarac etc.) and retinol are NOT recommended for use when you are pregnant or breast feeding.Glycolic acid based products are the best way to control excess oil and keep acne to a minimum without affecting your growing fetus or tainting breast milk.

Professional glycolic peels and cleansing facials with extractions also help keep the skin balanced and healthy during this time.

Melasma is a common concern during pregnancy. The excess hormonal activity can trigger what is commonly called the “mask of pregnancy”, large patches of dark skin on the cheeks, forehead or jawline. Most discoloration fades within 6 months but the process can be helped along with glycolic acid peels and microdermabrasion.

Jessners Peels are very helpful in removing hormonal pigmentation but should not be done while you are pregnant or breast feeding.

“I have red bumps on my upper arms, help!”

February 8, 2012 / 2:38 pm

Q: I have red bumps on my upper arms. They get worse during the winter and got really bad when I was pregnant. It’s embarrassing to wear sleeveless tops! What can I do to treat them? Help!

A: Red bumps that appear on the upper arms are known in the medical community as keratosis pilaris. It is a very common problem, often due to genetic factors and can be easily kept under control. The bumps arise from excess keratin production which can clog the hair follicle. Use a gentle cleanser and a glycolic body lotion on the affected area to keep the skin smooth and clear.

If the problem persists or worsens, make an appointment to see your dermatologist.

Skin care for the great outdoors

January 28, 2012 / 5:01 pm

Does your idea of a fun weekend include a Saturday morning ocean swim followed by a short hike and mountain biking on Sunday?

Outdoor activities require specific skin care considerations.

I cannot stress sun protection enough. And I mean thick, white, water-resistant sunscreen that you would never wear on a day to day basis. Yes, it may clog your pores but it will also help prevent a myriad of skin conditions ranging from unsightly Melasma to serious skin cancers. I like the Suntegrity Face Sunscreen for the face and Neutrogena SPF 70 for the body.

Both of these products utilize a physical sunscreen ingredient. A physical block (like titanium dioxide) contains particles that do exactly that, physically block the sun light. This also helps protect your skin from other elements like wind and cold.

Before you get dressed in the morning, apply SPF lotion to your face and entire body. This will ensure you don’t miss crucial areas on the edges of your active wear. Use a full 2 ounces to cover your body and a blob the size if a quarter for your face, neck and ears.

Re-apply often; immediately after an water-based activity or every 1-2 hours. I like spray sunscreens for re-applying on the body, it’s easier if you are wearing cycling gloves, have dirty hands etc. SPF sticks are helpful to for re-application to the face.

Wear a hat with sun protection, sun glasses with adequate coverage, long sleeves, and a high neckline when you can. If you have short hair, thin hair (or no hair!) don’t forget to apply sunscreen to your scalp.

After you activity, your first order of business is to clean your face. Keep facial cleansing cloths in your bag for a quick wipe before you head home.

Once you are able to give your face a good washing, use a gentle cleanser to cleanse twice. Lather, rinse, repeat. This will ensure your skin is clean without over drying.

Exfoliate on a regular basis. Use an enzyme peel 2-3 times a week and a gentle toner daily to keep dead skin to a minimum and pores clean.

Do skin care products really expire?

January 21, 2012 / 3:13 pm

The simple answer is yes.

However, there are many factors that can extend the shelf life of the fabulous products you work hard to be able to purchase!

Most skin care products have a symbol on the label that lets you know how long the product is good once it’s been opened: the most widely used icon is a jar with and open cap and a number on it. The number denotes how many months the product is guaranteed from the day you open it.

Most products are good for 6-24 months once they have been opened. Packaging plays a large roll in how this number is determined. An airless pump keeps a product fresh for much longer than a wide mouth jar. The less contamination (for the air or your fingers), the longer your product with stay fresh and stable.

If a product changes color or separates, chances are good that is has expired.

Vitamin C is difficult to keep stable and has a short shelf life. It oxidizes (turns brown) when it is no longer effective.

Most skin care products are sold in containers determined to be the amount an average person would consume, with regular use, in a 3-4 month period.

If you are worried about your products expiring before you use them up, stick with items sold in pumps and tubes instead of jars and store them in a dark, cool environment.

Is there a downside to using expired products?

Again, the simple answer is yes.

When a product is past the expiration date it is no longer effective. For something like a basic moisturizer, this isn’t a concern but for a product containing sunscreen or retinol it’s important to make sure the active ingredients aren’t past their prime.

How to wash your face.

January 11, 2012 / 4:52 pm

Many people have questions about this simple task!

Wash your face with lukewarm to cool water. Hot water will dry your skin as well as increase blood flow to the face which can exacerbate puffiness (especially around the eyes).

Splash your face with water, apply a dime size amount of cleanser to the palm of your hand, rub your palms together and apply the cleanser evenly to your face. Use a gentle, circular motion to work the cleanser on your skin for at least a minute. Rinse 2-3 times with clean water. Pat your face dry with a soft towel.

Use a gentle skin cleanser designed for the face.

Foaming cleansers will dry excess oil but I don’t recommend them unless you have extremely oily skin. For combination, normal and dry skin, use a cream base cleanser. If this doesn’t give you the squeaky clean feeling you crave, wash twice: lather, rinse, repeat.

Wash your face morning and night. Additionally, wash your face between work and working out (or any activity where you perspire).

Any questions?

Skin Care for Men

December 11, 2011 / 5:32 pm

Men need skin care too!

40% of my clients are male; they have thicker, oilier skin however many experience sensitivity, especially in the lower face and neck from shaving.

Here are some basic skin tips for men:

Shave as little as possible (many men can get away with shaving every other day, especially in San Francisco where “business casual” is the norm) or alternate your razor with an electric shaver. An electric shaver doesn’t give as close of a shave but is more gentle on the skin.

Shave after you shower. The steam from the shower relaxes the pores and the hair follicles making them more receptive to shaving.

Use a gentle shaving cream (Aveeno is good) or a face wash that doubles as a shaving lubricant (like IS Clinical Cleansing Complex).

Exfoliate your face 1-2 times a week. Use a gentle face scrub or an enzyme exfoliator. Exfoliation ensures dead skin cells are swept away before they have a chance to clog the pores which causes blackheads and exacerbates in-grown hairs.

Use a gentle lotion with SPF every day. No questions. Preventing sun damage is so much easier that reversing sun damage.

The same goes for eye cream; start using it before you think you need it, both morning and night.

Professional treatments help the texture and overall health of your skin. Cleansing Facials 4 times a year is a good place to start. Microdermabrasion is an option for men that want a more corrective treatment with little to no downtime.

Consistency is key: find a routine that fits your schedule and stick with it!

Why do I break out after I get a facial?

December 1, 2011 / 3:33 pm

One of the most common excuses for NOT getting regular facials is breaking out a few days after the treatment.
There are a few reasons why a facial can bring on an eruption of pimples.

Human skin is made up of 3 primary layers, sebum (oil) production occurs in the middle layer (the dermis) so the eruptions that surface after a facial originated long before the treatment occurred. Unfortunately, this is often part of the purging process associated with starting a new skin care regime.

That being said, there are many ways for an esthetician to minimize this risk.

Using a product or device to minimize bacteria during or after the extraction process is helpful. I incorporate the high frequency current into all of my treatments which treats existing breakouts and minimizes the chance of future eruptions.

If your skin is very “bumpy”, that indicates the presence of comedones or clogged pores. Smoothing out the texture of the skin is a process that includes regular professional treatments and consistent home care. You may have to deal with a few eruptions along the way, but the end result is worth it!

Quick Cold Weather Skin Treat!

November 8, 2011 / 6:11 pm

Carrot-E-Chop Facial Ingredients:
1 carrot
2 tablespoons honey
4 drops of vitamin E oil
1 teaspoon aloe vera gel
Oat flour

Supplies:
Medium-sized bowl
Large spoon

Step 1: In a medium-sized bowl, combine the carrot, cooked and mashed, with the honey, vitamin E oil and aloe vera gel.

Step 2: Mix ingredients with a large spoon, stopping when it forms a thick, orange paste. If the mixture appears too thin, add a small amount of oat flour, which acts as a thickening agent.

Step 3: Apply the mask in a thick coat evenly across the face, and let sit for approximately 30 minutes.

Step 4: Upon removing the mask, your skin should feel moisturized and rejuvenated. It will appear brighter, more toned and firmer—and ready to go for round two against Jack Frost.

I came accross this quick facial treatment in the current issue of Skin Inc magazine: I love the rejuvenating effects of carrots both inside and out!

How often do I need a facial?

November 2, 2011 / 5:32 pm

Do you wait until you get a gift certificate to think about skin care? If so, chances are you need facials more often!

Consistency is key. For general maintenance of healthy skin, I recommend a Cleansing Facial every 4-6 weeks. Having your pores cleaned on a regular basis allows them to shrink and become less noticeable.

New skin cells replace the old ones every 28-32 days, when treating a condition like acne scars, it is beneficial to have a professional treatment twice during this cycle. I recommend a series of 6 sessions of Microdermabrasion spaced 2 weeks apart for maximum results, then follow up treatments ever 3 months.

This same model works well with glycolic peels for acne prone skin.

If money or time is an issue, figure out a frequency that fits your budget and stick with it; even if it’s 2-4 times a year. Quarterly facials are more beneficial than four monthly sessions in a row then a large gap until your next treatment.

Find an esthetician that you like and stick with him or her! There is an added benefit to visits with someone who knows the history of your skin especially through hormonal changes like pregnancy and menopause. And it’s nice to have someone you know pamper you after a rough day!

Skin care from the neck down

October 23, 2011 / 9:37 pm

I share a lot of information about skin care for the face but what about the rest of your body? Here are few tips just in time for winter!

Use warm water when you bathe or shower. Hot water will dry your skin which causes flaking and itchiness. Skin on the body doesn’t have as many oil glands as the face so it becomes dry more easily.

Use soap or body wash only on the important areas, using too much of these products will dry you skin. If you have chronically dry skin, try a body wash that contains colloidal oatmeal which soothes the skin.

Use an unscented body lotion or cream every day. I like CeraVe Moisturizing Cream when my skin is dry. I specify unscented because most commercial scents contain alcohol which is drying. If you like a scented cream, add a few drops of an organic essential oil. Use a moisturizer with SPF on any areas that will be exposed to the sun during the day like arms, hand and chest.

For rough heels, knees and elbows, I alternate between Glycolix Elite 15 Percent Body Lotion to exfoliate the skin and a rich cream (like RAW Cocoa Butter) to moisturize. Glycolic lotion is also helpful when treating rough, bumpy patches on the upper arms (usually a result of dry skin).

Make sure you are drinking enough water during the winter months. Moisturizers work to seal in moisture so you need to hydrate from the inside out for the best results. And remember, any non-caffeinated beverage, fruit juice or soup counts towards your daily water intake!

“What do YOU use?”

October 10, 2011 / 4:25 pm

Several times a week, a client asks me “What do you use?”.

I have a closet full of products, most of them are given to me by product reps trying to get (or keep) my business; if I really like a product it goes in the “I’d pay retail for it!” category.

My recommendations vary depending on skin type, but here is a breakdown what I’m currently using:

Daily:

I wash my face during my morning shower with iS Clinical Cleansing Complex. I use a few drops of iS Clinical Pro Heal Serum Advance+ under my sunscreen. I’m a sunscreen junkie, I love Suntegrity Natural Moisturizing Face Sunscreen and Primer: I mix it with a bit of my foundation for a customized tinted moisturizer.

I wash my face when I get home from work (before I head to the gym or yoga). I use my Vitamin Therapy Fortifying Cleanser, the sulfate-free formula uses soy and avocado oils which dissolve dirt, oil and makeup. I’ve always been too lazy to use a proper makeup remover and this does the job! If my skin feels especially dirty, I wash twice: lather, rinse, repeat.

My nighttime routine varies. I always use my Firming Peptide Eye Therapy but I change it up between Nightly Therapy Retinol Complex and iS Clincal Youth Complex.

Every 8-12 weeks:

I like to have a cleansing facial every 8 weeks, I always need extractions!

I give myself a Jessners Peel or a South Beach Peel 3-4 times a year, covering my face, neck and decollete area. This keeps my melasma and fine lines under control and stimulates collagen production.

I’ve attempted to self-administer an Iderm treatment or Microdermabrasion and the results are comical! Some things are better left to the professionals.

Every 6-8 months:

I use Dysport on the vertical line on my forehead. The result is more subtle than Botox and only require maintenance every 6-8 months.

photo 2 copyIn 2008, I had an Affirm CO2 fractional laser treatment on my entire face, eyelids and neck. The doctor I worked with needed a test subject for his new laser; I don’t advocate an aggressive procedure like this for most people in their 30’s.

That being said, the results were amazing!

The laser eliminated all of my hyper-pigmentation, most of my residual acne scars and tightened my skin more than I was expecting. My face swollen and flaky for a week but considering the downtime versus the results, I will do it again in the future.

 

As I (rapidly) approach my 40th birthday, I try to keep my expectations reasonable. I do what I can to keep my skin healthy and youthful but I refuse to make it a full time job; balance is important. The routine listed above does a lot for my appearance but so does my healthy diet, regular Bikram Yoga practice, Zen meditation and general attitude towards life; don’t take it all so seriously!

The “Liquid Facelift”

September 21, 2011 / 4:40 pm

The combination of injectable fillers, neurotoxins and professional chemical peels is often referred too as a “Liquid Facelift”. When combined, these 3 procedures have a profound anti-aging effect that can replace or delay invasive surgery.

Neurotoxins like Botox and Dysport act to temporarily disable the nerve signals that cause muscle movement. Injections of neurotoxins are common in the forehead, the glabella (between the eyes; “the elevens”), and the outer edge of the eye, the “crows feet”. These injections can be performed by a dermatologist or a nurse.

Botox has been on the market for over 10 years and onset of action is about 1-2 weeks from treatment. Dysport was approved 2 years ago, has a smaller molecule size so onset of action is a little as 2-3 days and is priced slightly lower than Botox. The smaller molecule also causes the product to spread more which can result in a softer look.

Fillers like Restylene, Juvaderm, Perlane, and Radiesse temporarily fill in deep smile lines, add volume to lips, under eyes and cheeks. Each filler varies slightly; some are softer therefore better for use in the lips or other areas with a lot of movement, some are more dense so they work well in the cheeks or under the eyes. Most fillers last between 6-9 months depending on the filler and the area that was injected.

A medium or deep chemical peel will produce the most profound results. This procedure can be done the day before or the day after the injections but not the same day. Having injections during the same visit at a chemical peel, can cause scabbing at the injection site.

The “Liquid Facelift” is a great option for people who want a profound anti-aging effect without anesthesia and surgery.

Professional Hair Removal Treatments

August 31, 2011 / 7:17 pm

Unwanted hair can be frustrating! As we age, hormones fluctuate and women often have stray hairs popping up where they least expect. There are many options for hair removal, here is some basic information about the most popular methods.

Waxing:

Waxing is the most popular method of hair removal. Wax is heated until it melts then a thin layer is applied to the skin and quickly removed to pull out the hair.
Soft wax is most commonly used, a strip of muslin is applied on top of the hot wax to facilitate easy removal. Hard wax is less popular but better for more sensitive skin because it has a lower melting point. Hard wax it applied in the same fashion but no muslin is used, the wax hardens and is pulled off in one strip.

*Waxing is NOT recommended for anyone using any type of tretinoin (Retin A, Renova, Tazarac, Retin A Micro, Differin etc.) or Accutane. You should discontinue tretinion products for 3 weeks prior to waxing any area on your face.

Sugaring:

Sugaring is similar to waxing but uses melted sugar instead of wax. Distributors claim it decreases the amount of hair growth over time but I am skeptical of these claims.

Threading:

Threading is growing in popularity for facial hair removal. This method originated in India and uses special thread twisted in such a way that it grasps the hair and pulls it out at the root. It is recommended for anyone using topical tretinoin. The results last longer than waxing and it is more gentle on the skin.

Tweezing:

Tweezing is second to waxing in terms of popularity. It is the easiest method to remove stray facial hairs and maintain eyebrows in between appointments with your esthetician. The quality of tweezer makes a big difference in the result. Tweezerman are the best, you can even send them back to the company for sharpening when they become dull.

Laser Hair Removal:

Laser hair removal works best on brown or black hair, especially those with dark hair and pale skin. It removes about 80% of the hair in 6-8 treatments. Yearly touch-ups can be necessary, this method of hair removal can only be done by a doctor or a nurse working in a doctors office.

Questions? Feel free to ask them in the comments section below!

Professional Chemical Peels

August 7, 2011 / 5:56 pm

There are a wide range of professional chemical peels available. These treatments range from light glycolic acid peels that can be incorporated into cleansing facials to intense TCA peels that require 8-10 days of recovery time.

This is a comprehensive list of the most popular peels/peel ingredients in each category: light, medium and deep. New combinations of these ingredients are being used all the time (and often given new names) so don’t be afraid to ask what acids are in the peel you are about to receive.

Light Chemical Peels:

Glycolic acid is the most widely used chemical peel ranging in strength from 2%-70%. Glycolic acid exfoliates the top layer of the skin which minimizes surface pigment, fine lines and blackheads. It is safe to use during pregnancy and while breast feeding. The peel solution is applied to the face, left on for 2-5 minutes, then neutralized with water. This makes glycolic acid an ideal chemical peel to incorporate into a basic facial.

Salicylic acid is the most effective chemical peel for acne prone skin. Derived from white willow bark, it is chemically similar to aspirin which makes is unsafe to use during pregnancy and while breast feeding. Most professional salicylic acid peels are 20% strength: the solution is applied to skin after cleansing and degreasing with alcohol or acetone. 5-7 minutes after application, the heat and tingling subside and a cooling serum is applied; this is called a self-neutralizing peel. The solution must remain on the skin for at least 5 hours after the application but you may apply sunscreen and makeup during this time. Often, there is some light flaking of the skin 2-3 days after the peel is applied. This is normal and should subside with an application of moisturizer.

Lactic acid is the most gentle chemical peel available. It is derived from a milk enzyme and gently digests the dead skin cells. Lactic acid ranges in strength from 2%-70%, it ideal for sensitive skin types and is self-neutralizing.

Medium Chemical Peels:

The Jessners Peel is 14% lactic acid, 14% resorcinol (a phenol derivative), 14% salicylic acid and .3% retinoic acid. This specific combination of acids was pioneered over 30 years ago by Dr. Max Jessner as a way to reduce the harsh side effects of stronger acids yet provide significant results. There are a number of “modified Jessner’s” on the market and many of them have their own names: the Vitalize Peel from Skin Medica is a popular one. Jessners Peels are the most effective peel for lightening hyper-pigmentation and melasma. The formula is self-neutralizing and the depth can be controlled by the number of layers applied. The final layer is .3% retinoic acid which leaves a yellowish tint on the face. You may apply sunscreen and makeup but the solution needs to remain on the skin for at least 5 hours. Approximately, 36-48 hours after the application, the skin begins flaking. The amount of flaking depends on the amount of dead skin build up: if you exfoliate regularly the flaking may be light, if not it may be more intense. The flaking lasts for 3-5 days and you are left with smoother, more even toned skin.

The South Beach Peel is 7% TCA (tricholoracetic acid), 2% salicylic acid and .3% retinoic acid and was developed by a Miami-based doctor whose goal was to create a peel that wouldn’t leave his patients with increased sun sensitivity. This formula is self-neutralizing as well and the final layer is .3% retinoic acid which leaves a yellowish tint to the face. You may apply sunscreen and makeup but the solution needs to remain on the skin for at least 5 hours. Approximately, 36-48 hours after the application, the skin begins flaking. The flaking is usually more intense than the Jessners Peel and lasts for 4-7 days.

Deep Chemical Peels:

Tricholoracetic acid peel, commonly know as “TCA peel” is the most aggressive commonly used chemical peel. Lower strengths (5-7%) will provide a medium depth peel, while higher concentrations (10-30%) provide a deeper peel and require recovery time. There haven’t been conclusive studies about the effects of TCA and pregnancy so it is best to avoid while pregnant or breast feeding. The application process is similar to the Jessners Peel and The South Beach Peel; TCA is self neutralizing and needs to remain on the skin for at least 5 hours. The recovery period of peeling and redness can last from 8-10 days. TCA is the best option for large areas of the body, it minimizes sun damage and can even exfoliate surface cancer cells.

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