Hannah's Blog

“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.

The I Derm Deep Skin Ionization Treatment

July 28, 2011 / 3:32 pm

The I Derm Deep Skin Ionization Facial, also known as the Iderm® Treatment, uses a direct galvanic current to introduce water soluble solutions into the skin, kill bacteria associated with acne and firm the skin. Dermaculture has utilized Ionization techniques for the treatment of skin for over 70 years. The Iderm® Treatment (a proprietary treatment technology owned by Dermaculture) introduced the concept of Ionization to the entire skin care industry. The photo above displays the galvanic mask (with the electrodes on the outside; the opposite of how it is used during treatment) for a feature in German Vogue.

What is an Iderm® Treatment?

The Iderm® treatment is the most comprehensive approach to treating the skin. This treatment uses a direct galvanic current which effectively introduces water soluble solutions into the skin by a process called iontophoresis. Skin naturally rejects whatever we put on it, so the only way we can truly affect the lower layers of the skin, is to draw vitamin rich solutions into the dermal tissue by means of electricity.

Is the Iderm® Treatment Safe?

The Iderm® treatment process uses a very low intensity current, a milliamper (1/1000th of an ampere) which is both safe and effective for application to the skin.

What Results Can I Expect?

You will notice how exceptionally clean and rejuvenated your skin looks and feels after the first treatment. A combination of treatments and proper use of skin care products will give your skin the appearance of a smoother, more youthful tone and texture.

In the San Francisco Bay Area, you can book your Iderm® Treatment with me; in Seattle, book with my good friend Jody at Dermaspace; and in Los Angeles or New York check out The Face Place.

Microdermabrasion

July 19, 2011 / 6:05 pm

In the 1950’s a treatment call dermabrasion used a wire brush to remove scars and wrinkles on the face. It was very invasive, required anesthesia and recovery took up to 2 weeks. Fast forward to 1985 and an Italian company introduced the first “micro” dermabrasion machine. By the mid-nineties our current style of microdermabrasion machine was imported to America and today most spas and skin care studios offer the treatment.

Microdermabrasion is a professional exfoliating treatment using crystals and suction to remove the top layer of dead skin which minimizes uneven texture, acne scars, large pores and fine lines. The treatment can be done alone or incorporated as the exfoliating step of a basic facial.

A single session will leave your skin looking smoother and refreshed, while a series of treatments will provide visible results for more stubborn concerns. A “series” is one treatment every 2 weeks for 12 weeks: a total of 6 treatments. Microdermabrasion is NOT recommended for clients with active acne: once the breakouts are under control, the treatment is effective to clear up any pigment or scarring.

There are a wide array of microdermabrasion machines on the market ranging from $200 home-use models to $14,000 machines made for use under a medical doctors supervision. The machine plays a significant part in the outcome of the treatment, the larger the motor, the more aggressive the treatment can be.

Technique does vary so you may see better results with one esthetician over another.

Microdermabrasion is an effective, affordable treatment that can help you achieve your skin care goals!

The Appeal of the Sun

July 4, 2011 / 5:48 pm

Last week I found myself in a yoga class of 40+ people and I was one of the handful of students without a tan…and yes, I mean intentional tans: dark, even, no tan lines. Living in San Francisco I can only surmise the majority of this color did not come from the sun.

Why are so many people still tanning with everything we know about sun exposure? And even worse, why are people using tanning beds???

Tanning beds are calibrated to emit mostly UVA radiation, the deep penetrating rays that are responsible for golden-brown skin color, not UVB radiation, which affect the surface layers of the skin and cause it to burn. In addition to premature aging, UVA rays are the cause of Melanoma, the most deadly form of skin cancer. Regular use of these beds can triple your risk of developing Melanoma.

The health benefits of sunshine, the role it plays in vitamin D synthesis, has been in the news a lot in recent years. UVB rays are responsible for this synthesis so spending time in a tanning bed will not help your vitamin D deficiency. Exposing your face and arms to 20 minutes of sunlight per day meets the requirements for most people to synthesize vitamin D.

The world of SPF can be confusing. I’m glad the FDA has decided to step in and simplify the labels as well as regulate protection from both UVA and UVB rays.

Confused by SPF? Take a number.

The bottom line: intentional tanning is never good, you are only damaging your skin. Find a sunscreen lotion that protects from both UVA and UVB rays: try several, the more you like the texture and smell, the more you will use it. When you know you will be in the sun for an extended period of time, wear a hat and long sleeved shirt in addition to SPF. And lastly, make sure you are using enough SPF lotion: a 4oz tube should only last 3 months if you are applying it to your face daily.

The Eyes are the Window to the Soul…

June 20, 2011 / 12:50 am

And how are you caring for your “window frames”?

The tissue around the eye area is delicate and has fewer oil glands than the rest of your face. A cream specifically formulated for the eye area is an important part of any skin care routine. And remember; eye cream does more to prevent than to correct the signs of aging!

I suggest my clients use an eye cream as part of their routine, both morning and evening, beginning as young as their mid twenties.

Darkness under the eyes is a common concern, lack of sleep and lack of hydration are the most widespread culprits. The structure of the eye socket makes the under eye area ideal for lymphatic fluid buildup, which causes darkness and puffiness under the eye. Drinking enough water (half your body weight in ounces every day) and using an eye cream with caffeine are the best ways to conquer this lymphatic fluid buildup.

Some dark circles are not caused by fluid buildup but by excess pigment (often called “hyper-pigmentation”), this is very common in darker skin tones. An eye cream with a lightening agent, like vitamin C or hydroquinone, will gradually brighten the eye area. Pair it with an exfoliating agent like retinol in the evening for better results. Make sure these ingredients are in a cream approved for use around the delicate eye area!

Fat loss in the face is common as we age and can lead to hollow looking eyes. A hyaluronic acid based filler like Juvaderm or Restylane will fill in the area. Hyaluronic acid is naturally present in the skin so these fillers are safe and have no risk of allergic reaction. Injectable fillers are very effective in the eye area and the results can last up to a year.
Fine lines, wrinkles and sagging all have the same root cause: break down of collagen in the tissue. This breakdown is caused by the aging process, sun exposure and dehydration (including dehydration caused by cigarette smoke and alcohol consumption).

The sooner the skin receives support from topical serums and creams, the better chance you have to delay this breakdown. Peptides mimic broken collagen molecules; when applied topically, your skin generates new collagen cells to repair itself. Choose an eye cream that contains peptides for firming and fighting wrinkles.

Deep wrinkles in the eye area, often called “crows feet” can be treated in several ways. Professional exfoliation using chemical peels or microdermbrasion will soften them and Botox or Dysport can be injected in the area to temporarily limit the muscle reaction. This process needs to be repeated every 3-4 months.

Neck Creams are the new black.

May 27, 2011 / 4:24 am

Have you noticed many skin care brands have introduced a “neck cream” ?

Skin care trends come and go. After many years in the industry, I see cycles similar to those in fashion: to quote Heidi Klum “One day your in, the next day you are out”. Neck creams seem to be the trend of 2011.

Are they necessary?

Well, yes and no.

As clients approach their late 20’s, I encourage them to add at least one anti-aging product to their routine. Vitamin C serum is my favorite since it works beautifully on combination skin, helping to combat blackheads while providing antioxidant protection and boosting collagen production. This type of serum is suitable for the neck and decollete as well, so there is no need for a separate “neck cream”.

As we age, oil production decreases and a heavier cream may be necessary. Most of the neck creams I have seen on the market claim to be “firming”: I don’t buy it. In order to noticeably firm the skin, the collagen must be activated with a heat source, like a laser, and the results are gradual. I have yet to see anything, applied topically, that actually firms the skin.

That being said, I love to see people paying attention to the neck and decollete area! Too often, our routine stops at the jawline. Use your night cream on your face, neck and decollete (it’s never to early to start: topical products do an amazing job at preventing aging but are far less effective at reversing it). Also, incorporate these areas into your daily sunscreen application.

The only products designed for the face I don’t recommend for the neck are retinoids and AHAs. The neck has fewer oil glands than the face and can be more easily irritated. Embrace this trend and start taking better care of your neck and decollete area!

All About Acne

May 20, 2011 / 3:31 am

Zits, pimples, spots, blemishes- call them what you want but we’ve all had to deal with them at one time or another!

There are many creams, lotions, and gels-both prescription and non- that claim to cure, prevent and treat acne but what really works and why?

Genetics, hormones, stress, and lifestyle all play a part in the condition of our skin. The two most common types of blemishes are cystic acne and comedones. Comedones can be open (commonly called blackheads) or closed ( commonly called whiteheads) but come from the same source, a build up of debris in the skin’s pores. Cystic acne blemishes are large, often painful bumps that start deep under the top layers of the skin.

Comedones are fairly easy to control while cystic blemishes are more severe and often need to be treated with prescription medication. Your esthetician can assess your skin and refer you to a dermatologist if necessary.

Comedones are a result of excess oil from overactive oil glands, dead skin, and external debris clogging the skin’s pores. During a deep cleansing facial the skin is exfoliated (often with a light glycolic peel), then steam is used to dilate the pores before the comedones are gently extracted. Once the skin is deep cleaned, the first step in preventing the build of of the comedones is to clean the face regularly

Begin by washing your face morning and night with a gentle cleanser. Often, it is necessary to wash the face a second time in the evening to ensure removal of makeup, sunscreen and surface debris. A toner is not necessary but an astringent can help control oil in extremely oily skin types.

Exfoliate your skin 2-3 times per week using an enzyme exfoliant. This will remove dead skin and surface debris before it has a chance to clog the pores. Additionally, if your skin produces excess oil, a clay mask can be helpful in absorbing the oil and keeping your skin clear. Apply the mask once a week and allow it to dry before removing it with a warm washcloth.

When dealing with acne, it is important to keep in mind the goal is to balance, not dry, the skin. Wash your face with  warm water and use a light moisturizer even if you are prone to breakouts.

Spot treatments are good for drying up existing breakouts and preventing new ones in acne prone areas. The two most effective ingredients are salicylic acid and benzoyl peroxide; try both and see what your skin responds to best.

Regular cleansing facials, light glycolic acid peels and proper home care will help most skin get clear and stay clear!

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