Category Archives: Professional Treatments

Do I need a chemical peel?

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Most people can benefit from some type of chemical peel.

Chemical peels are the preferred treatment to address many skin conditions like acne, fine lines, wrinkles, scars, hyperpigmentation and melasma.

There are many types of chemicals peels to choose from, the trick is finding the right one for your skin and your concerns.

When it comes to chemical peels the more results you want to see, the more downtime you will have after the treatment! There is no magic solution that will erase years of damage without a period of redness and flaking after the application. Sometimes a series of lighter chemical peels will achieve similar results to one more aggressive peel, this may be a better option for sensitive skin types.

Schedule a consultation with your skin care professional to determine what is the best option for you.

What’s the difference between crystal and diamond Microdermabrasion?

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Traditional Crystal Microdermabrasion uses a wand to spray crystals and gently sand the skin to eliminate imperfections. Since the early 2000’s the Diamond Tip method of Microdermabrasion has been gaining popularity. What is the difference?

Diamond Tip Microdermabrasion uses a hand piece with rough tip that gently resurfaces the skin. The different tips have different levels of grit, like sandpaper, to be used on different areas of the face. The treatment is often paired with a light chemical peel during the same session to achieve better results.

Crystal Microdermabrasion uses a disposable tip but the level of suction and amount of crystals used can be adjusted. The treatment is generally done alone or paired with a soothing mask since is it more aggressive than the diamond tip version.  Crystal Microdermbrasion is more effective at elimination acne scars and fine lines. It does leave behind crystals, (or “sparkles” as one of my clients calls them!) so it requires a bit more clean up.

The two types of machines vary greatly in price, Diamond Tip machines are less than half as expensive as their Crystal cousins which may explain their growing popularity. Don’t hesitate to ask what machine an esthetician or spa uses for their treatment before you book a session!

Exfoliation

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Take a stroll down the skin care aisle at any major retailer and you will get a sense that exfoliating your skin is important.

Why has exfoliation become such an important part of our skin care routine? And what is the best method for your skin type?

The skin is comprised of four layers, the top layer includes dead and dying skin cells. In young, healthy skin, these dead cells flake off in a normal cycle of about 28 days.

As we age, or our skin becomes damaged by exposure to the elements, this normal cycle begins to slow. If these dead skin cells are allowed to remain on the face for a longer period of time, the skin begins to appear rough and dull. This excess skin can also clog pores and cause blackheads.

There are many exfoliation products on the market, most fall into one of these categories:

Physical: Anything that uses particles to removes dead skin cells. Scrubs, face brushes and microdermabrasion treatments are all physical exfoliators.

Enzyme: These products use an enzyme, usually derived from fruit, to dissolve the bonds that trap dead skin cells and slow the natural skin cell turn over. An enzyme exfoliator, usually in the form of a gel or cream, is left on the skin for a short period of time to allow it to penetrate.

Chemical: Anything that uses an acid to remove dead skin cells is a chemical exfoliator. Glycolic and salicylic are two of the most popular acids used in this manner. Professional chemical peels also fall into this category.

My favorite method of exfoliating at home on a regular basis (1-2 times per week) is an enzyme mask. Enzymes are more effective and predictable than scrubs and carry less of a chance of reaction than chemicals.

For best results, professional exfoliating treatments like chemical peels and microdermabrasion should be incorporated into your routine.

Consult a professional to determine the best course of treatment for your skin type. Many of my clients with combination skin and fear of aging have a session of microdermabrasion every 4-6 weeks and a light chemical peel 3-4 times a year.

New treatment: A Match Made in Heaven

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Every so often I look at my treatment menu and think “What more can I offer?”, then I recruit a friend to be my guinea pig and, most times, a new treatment is born!

My most recent “discovery” is the amazing combination of Dermaglow Microdermabrasion and Deep Skin Ionization. It’s the total package: resurfacing, anti-acne, anti-aging, firming and clarifying.

This combination of treatments is aggressive, I wouldn’t recommend it for sensitive skin types or immediately before a big event. It’s perfect for more resilient skin types who want to kick start a new skin care routine or need a pick me up after a busy summer. The Before and After photo above shows the results of a series of 6 treatments, spaced 2 weeks apart and paired with a home care routine. If you want to determine whether this treatment is good for you, drop me an email hannahsowd@hannahsowd.com and we can discuss your options. If you ready to book, go here!

What to expect when getting your first massage

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Getting your first professional massage can be daunting!

Tell your massage therapist if you’ve never had a professional massage so they can answer all your questions before the session begins.

Massage is generally booked by the length of the session. A one hour (or longer) session will allow time to cover the entire body whereas a shorter session (30 or 45 minutes) will only allow time to focus on a few specific areas.

Most spas will ask if you prefer a male or female massage therapist. This is the time to speak up, you will not hurt anyone’s feelings with your preference!

You make take off as much or as little clothing as you like, many clients keep their underwear on during the session. You will be fully covered with a sheet during the entire session and female clients will be offered a breast drape if work is done on the stomach area.

This is YOUR treatment! If something feels uncomfortable, speak up. Massage therapists are well trained to read body cues but they cannot read your mind! Feedback during the session is welcome and encouraged.

Common requests include more or less pressure, avoiding specific areas of the body like the face or the stomach, a cooler or warmer table or treatment room and louder or softer music in the treatment room.

You may talk to your therapist during the session but don’t feel obliged to keep up a conversation. This is your time and do what makes you comfortable.

The most important thing is to relax and enjoy your treatment!

Photo by Matt Lehman  :: www.mattlehmanphoto.com

What to expect when getting your first facial

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I seem to have an abundance of first timers showing up at my studio this year!

Most everyone is curious about what happens during a facial, here are some pointers to help you get the most of your experience.

For your first treatment, book a basic facial. Glycolic peels and microdermabrasion are amazing but it’s best to get a professional opinion about what is best for your skin before scheduling a more aggressive treatment. Most estheticians (myself included) will offer a complimentary 15 minute consultation either over the phone or in person if you have questions.

Before your appointment, take note of the products you are currently using on your skin. If they contain active ingredients like alpha hydroxy acids, salicylic acid, glycolic acid, benzoyl peroxide or retinol make sure you let you esthetician know. If you are unsure, don’t hesitate to bring your products with you (or take a photo of the label).

Also, take a moment to think about what bothers you about your complexion. Do you suffer from acne breakouts? How frequently? Do you have dark spots or wrinkles you would like to minimize?

If you have an idea of what you would like to work on, your esthetician will be able to give you a tailored treatment and customize the appropriate treatment plan for you.

Be up front and honest about your time and budget constraints.

A basic, one hour facial will most likely include the following:

Cleansing: This step includes removal of makeup and cleansing the skin. Show up for your appointment wearing minimal makeup so time isn’t wasted removing it.

Exfoliation: Exfoliation can be done with a chemical like glycolic acid, an enzyme or a scrub and the goal is to prepare your skin for extractions.

Steam: Often steam is applied while the exfoliating mask in on the skin. Steam helps the pores to relax and hydrates the skin to make extractions easier.

Extractions: Most full length facials include extractions which is the removal of blackheads and whiteheads. This step is often skipped in shorter, “express” facials so if it’s important to you, don’t hesitate to ask.

Massage: Dry skin will benefit from facial massage but oilier skin types may react poorly. Your esthetician will determine what is right for your skin type.

Mask: A facial mask will help soothe the skin after extractions or hydrate dry skin. Often, the esthetician will massage the decollete and the hands while the mask is on. They also may leave the room for a few moments to get fresh water or any other supplies they may need.

The final step will be an application of lotion containing an SPF. Don’t hesitate to ask any questions you have either during or after the treatment. Estheticians are well trained to assess your skin but feedback from you is important.

Make sure you get the most out of your treatment!

Diamonds, gold…and skin care?

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Do expensive ingredients really mean better skin?

The past ten years have seen an increase in luxury items being added to skin care and spa treatments with the promise of a better complexion. Caviar cream, 24 carat gold body wraps and most recently, black diamond skin serum.

Many of these ingredients provide a temporary benefit. I’ve worked with a line of caviar products that do a wonderful job of plumping the skin before a major event, great for a “red carpet facial”.  Likewise, diamond particles fill in fine lines and wrinkles as well as reflect light which gives the skin a youthful glow when the product is applied.

However, there are no long term studies that suggest these type of ingredients penetrate the outer layers of the skin or do much for the long term health of the skin.

If you have a special occasion or feel like indulging, go for it! If you’d like more bang for your buck, use proven ingredients like antioxidants, peptides and retinols.

Laser Tattoo Removal

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Tattoos are often considered permanent, it is possible to remove them, sometimes fully, but often there is a shadow of ink or a scar left behind. Tattoos gained popularity in the 90’s, tattoo removal gained popularity in the 00’s!

Early forms of tattoo removal included the injection or application of wine, lime, garlic or pigeon excrement. Tattoo removal by laser was performed with continuous-wave lasers initially, and later with Q-switch lasers, which became commercially available in the early 1990s. Today, “laser tattoo removal” usually refers to the non-invasive removal of tattoo pigments using Q-switched lasers.

Tattoo removal lasers break down the ink in the tattoo then the broken-down ink is absorbed by the body, mimicking the natural fading that time or sun exposure would create. A tattoo laser must be capable of emitting adequate energy within the given absorption spectrum of the pigment to provide an effective treatment. Certain tattoo pigments, like yellows and greens are more challenging to treat than darker blacks and blues, because they have absorption spectra that fall outside or on the edge of the emission spectra available in the tattoo removal laser.

photo_37
A 19 year old, black tattoo on my ankle after 17 laser treatments.

Tattoo removal sessions vary in intensity, largely depending on the practitioner and the laser device. Laser tattoo removal must be performed by a doctor, or in some states, a registered nurse. It is not uncommon to have some blistering and swelling at the treatment site after a laser treatment. This actually speeds the breakdown of the ink.

On average, it can take 12-15 treatments to completely remove a tattoo. Depending on the size of the tattoo, each session can cost $125-$300 and
even higher.

Tattoo “removal” is a very popular service, however, be aware it may not be as easy as it sounds!

Bridal Skin Care

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Why am I writing about Bridal Skin Care in December when wedding season isn’t until June?

Pre-wedding skin care prep can take 3-4 months and the goal is to be ready at least a month before the big day. You want to look your best for all the events!

If you aren’t getting professional treatments regularly, schedule a consult with several skin care specialists in your area. Ask around for recommendations or consult review sites like Yelp or Genbook. Be upfront with your concerns about your skin, your time and your finances. Make sure to ask about home care products you will be expected to purchase for optimal results.

When you decide on a specialist, consider booking all your appointments up front. Your schedule will get busy and skin care treatments work best when you stick to regime. Ask about a discount if you pay for all the treatments in advance.

I usually recommend a series of 6 sessions of microdermabrasion spaced 2-3 weeks apart and a home care routine using retinol, vitamin C and a lightening product if pigmentation is a concern. One or two chemical peels may be added if the goal is to get rid of dark pigment patches. These peels can have 4-6 days of downtime so they need to be scheduled accordingly.

Pre-wedding nerves can bring on a breakout even if you aren’t prone to them. Now is a good time to build a relationship with a dermatologist. A week of preventative antibiotics and a just-in-case appointment for a last minute cortisone injection can save you from waking up with a giant pimple on your big day. You also may be able to get a prescription for Retin A or other topical creams that will help get your skin under control. Be sure to let your esthetician know about any prescription skin care creams you are using.

If you are considering injectables, give them a trial run 6 months before your big day and get a touch up at least 4 weeks before. Botox takes 2 weeks to set and fillers can cause bruising or swelling (even if you haven’t had these reactions in the past).

And above all, relax and have fun on your big day; happiness brings it’s own natural glow!

Fabulous Lashes

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Eye lashes are a major focus in the cosmetic industry and this trend shows no sign of  going away. There are many ways to enhance the lash line, following are some of the popular options.

Eyelash Enhancing Serums:
The active ingredient in most of these products is prostaglandin which extends the growth phase of the eye lash resulting in longer, thicker lashes. Latisse uses a higher concentration which is why it is classified as a prescription, many over the counter products (like my current fav LiLash) use the same ingredient in non-prescription strength doses. These products require daily use for the first 3-4 months to see maximum results, then you can taper off to 3-4 times per week to keep your fabulous lashes. Latisse claims to darken lashes as well but I used it for over a year and noticed no darkening. These products can also be used to enhance eye brow growth.

Semi-permanent mascara:
Semi-permanent mascara is a professionally applied mascara designed to last 10-14 days. The application process takes about 30 minutes and can be tailored to your specifications regarding length, thickness etc. The mascara is waterproof which makes it an excellent choice for vacations and special events.

Eyelash tinting:
Tinting or dying the eyelashes is a great option for people with light colored eyelashes. The process takes about 20 minutes and lasts for 2-3 weeks. Tinting enhances the color of the lashes but doesn’t affect length or thickness.

Eye lash extensions:
(pictured above, compliments of my fabulous friend Akiko)
Lash extensions are semi-permanent false eyelashes. An extension is added to each individual lash to create a customized look. The process can take up to 2 hours for a full set, less for touch-ups or partial sets. With proper care, they can last up to 3 weeks before a touch up session is needed.

Pregnancy and Skin Care

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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.

Skin care for the great outdoors

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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.

Skin Care for Men

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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?

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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!

How often do I need a facial?

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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!

Professional Chemical Peels

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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

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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.