Category Archives: Professional Treatments

How to Prepare for a Chemical Peel

1. Schedule a consultation with your skin care professional to determine the best chemical peel for your skin type and the results you want to achieve.

2.Schedule the peel when you have enough downtime to allow for any flaking and peeling that may occur in the days following the treatment.

2. Follow the pre-peel skin care routine prescribed to you. This usually includes retinol creams, Retin A or Hydroquinone products to start the renewal process and increase the benefits of the chemical peel.

3. Stay out of the sun! Wear at least an SPF 30 every day.

4. Stop all exfoliating products 3 days prior to your chemical peel appointment.

Do I need a chemical peel?

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?

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!

How do I care for my skin after a chemical peel?

Professional Chemical Peels are a great way to improve many skin issues with very little downtime.

When having a medium depth, self neutralizing chemical peel (like a Jessners Peel or a light TCA peel) the skin barrier is compromised. How you care for your skin during the week after the treatment can greatly affect the results.

Immediately after the treatment, your skin may be red and feel tight. Make sure your skin care therapist applies sunscreen before you leave the studio and reapply sunscreen as necessary throughout the day. Most peels need to be left on the skin for 5 hours or longer after the application so don’t wash your face or do any activity that makes you sweat.

The flaking generally begins 36-48 hours after the application of the peel. Be very gentle with you skin during this time. Use a gentle cleanser followed by a rich moisturizer and lots of sunscreen.

The flaking generally lasts 3-5 days depending on the depth of the peel and the condition of your skin. Most importantly, DO NOT pick at the flaking skin! When washing your face, use a gentle circular motion with your hands (no washcloth or face brush) to help the dead skin slough.

If you have a lot of clogged pores, you may experience a breakout during the flaking process. Do not use any products designed to dry the skin: salicylic acid, glycolic acid etc. Treat your skin very gently, the breakouts should clear up quickly as the skin cells turn over.

Do not use any products containing Retin A, retinol, AHA, benzoyl peroxide, glycolic acid or any other acid during the healing phase. Reintroduce these products when you feel your skin has fully healed, everyone is different but two weeks post-peel is a good guideline.

Plan to have your chemical peel 2-4 weeks prior to a major event to allow your skin to fully heal. I recommend medium depth chemical peels 2-4 times a year for most of my clients concerned with acne and anti-aging.

All About Brows

The eyes are the window to the soul…and the eyebrows are the window dressing!

A well groomed eyebrow can make all the difference in your appearance but can be difficult to achieve.

Q: I plucked my eyebrows too thin when I was younger and they haven’t grown back. Help!

A: This is a common problem. The hair follicles of the eyebrows are easily damaged and aggressive plucking can cause growth to slow or even stop.

The first order of business is to STOP plucking! Let your brows grow for 2-3 weeks (longer if you can stand it), then go for a professional shaping. During this time, use a product like Latisse or Rogaine to encourage lazy follicles.

Have your brows professionally tinted with a vegetable based dye to cover any grey or white hairs and create a bolder look.

In between appointments with your brow professional, put away your magnifying mirror and lay off the tweezers. It’s OK to grab a stray hair now and again but daily obsessing will only get you in trouble.

If your brows don’t respond, you may have caused too much damage for them to recover. If this is the case, you can have them filled in with tattoo ink. Do your research when choosing a tattoo artist, ask for references and before/after photos. Brows tattooed by hand (versus a machine) look more natural but need to be touched up more often.


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

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 and we can discuss your options. If you ready to book, go here!

What to expect when getting your first massage

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  ::

What to expect when getting your first facial

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?

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

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.

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

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

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.

Ethnic Skin Care

Everyone’s skin tone is unique, from light to dark and everywhere in between, we are a blend of our biological parents. Of course, these differences affect our choice of makeup, but should they influence our choice of skin care?

In 1975  Dr. Thomas Fitzpatrick, a dermatologist at Harvard Medical School,  developed a scale to classify a person’s complexion based on tolerance to sunlight. Dr. Fitzpatrick studied skin pigmentation and did pioneering work in treatments of many skin ailments. Today, we use the Fitzpatrick Scale to determine whether or not a patient is suited for various professional treatments.

The Fitzpatrick Scale uses the skin’s reaction to 10 to 45 minutes of sun exposure to classify skin type.

  • Type 1 burns easily and never tans
  • Type 2 burns easily and tans minimally
  • Type 3 burns moderately and tans gradually
  • Type 4 burns minimally and tans easily
  • Type 5 rarely burns and tans easily
  • Type 6 deeply pigmented skin that never burns

The Fitzpatrick scale is a widely used system of classification and is crucial when performing treatments like chemical peels and microdermabrasion. Darker skin is more likely to experience post inflammatory hyper-pigmentation if treated too aggressively without proper preparation.

Once we classify the skin type on the Fitzpatrick scale, we look at other factors like skin density (thickness), oil production and laxity.

As a general rule, Melanin increases skin density and thicker skin tends to be more prone to oiliness yet I have found many of my darkest skinned clients sensitive to aggressive exfoliation.

I recommend a gentle cleanser without sulfates for my Asian and African American clients. The goal is to clean the skin without stripping healthy oils. Gentle exfoliation is also important, weekly use of a white clay mask will help remove dead skin cells while calming reactive skin.

A broad spectrum SPF is very important, even for the darkest of skin tones. UVA rays are present from sunup to sundown, 365 days a year, all around the globe; these rays are the primary cause of premature aging.

Many of my darker skinned clients are concerned with dark patches, increased melanin makes the skin prone to dark spot or hyper-pigmentation. These dark spots are a direct result of inflammation caused by acne or sun exposure and commonly occur during pregnancy or in women that use hormonal birth control.

Prevention is key. Daily use of a broad spectrum sunscreen will help prevent new spots from forming and existing spots from getting darker. Add a Vitamin C Serum under your SPF to boost it’s effectiveness as well as provide a gentle brightening action.

Nightly use of a Retinol or prescription Retin A will remove mild pigmentation. The combination of Vitamin C Serum during the day and Retinol Serum at night is effective for most mild cases of pigmentation.

If your pigment spots are more severe, you can employ a regimen of professional chemical peels and hydroquinone based products to even your skin tone. Consult with a professional before your start a more aggressive regimen, some lighteners can actually have the opposite effect when not used properly on darker skin tones.

Pregnancy and Skin Care

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

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

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?

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!