What are peptides and why do we want them in our skin care products?

A peptide consists of 2 or more amino acids and are the building blocks of proteins.   There are hundreds of peptides. There is growing research in skin care proving that certain peptides have the ability to assist the skin cells to perform specific functions.  In skin care, the peptides are  used to help trigger the growth of new collagen and elastin.  Although, there are also neuropeptides that have the ability to relax the muscles slightly as well.  (think a very weak version of Botox) There are also certain peptides which researchers are discovering assist in the support of adipose tissue.  (fat, which gives our face fullness that we loose over time)

There is enough proof that incorporating peptides in your skincare regime has worthwhile benefits.  Peptides are best when used in conjunction with other skin supportive ingredients, such as antioxidants.  These ingredients can work synergistically with one another.

When looking at an ingredient deck look for hexapeptides, tripeptides, dipeptides and tetrapeptides.  Think of the peptides as part of a healthy diet for your skin.  Just as you would eat a well balanced, nutritious diet to support the functions of your body.

As always, always have a quality sunscreen with zinc or titanium as a part of your morning routine!

Products I am currently utilizing myself and recommending to clients with peptides include:

Alastin Restorative Skin

Alastin™ Skincare Restorative Complex

Alastin Eye

Alastin™ Skincare Restorative Eye Complex


NeoCutis Microfirm Neck and Décolleté Rejuvenating Complex

As always, the mentioned products are available at TOC Medical Spa here in Austin!


I thought I would share an honest account of the process of having an IPL or photofacial followed by a peel.

*please pardon the mug shots 🙂


This is a before photo the day I did my IPL

I was bothered by hyperpigmentation which was increasing over the last 6 months



The two above photos are the day after the IPL and the pigmented lesions have “peppered” and now appear darker.  This is GOOD!  That is what I was targeting!

After allowing my skin to calm down for 1-2 weeks, I applied a VI Peel® on day 10.  By day 4 I was experiencing peeling that lifted my stratum corneum (the top layer) and any remaining peppering that was hanging on.


The peeling starts around the mouth and spreads out the cheeks over the course of 1-2 days.  This period is itchy and a bit irritated, but the VI Peel® comes with hydrocortisone cream in an emollient base that helps sooth the skin.  I flaked until yesterday which was day 9.

Today is 10 days since  I applied my peel and I now have clear, smooth and rejuvenated skin.  My pores appear smaller, the pigment is significantly improved and any fine lines have been minimized.  Makeup applies very smoothly after recovering from these procedures.


Here is todays mug shot!

(without makeup on face as evidence by my uncamouflaged breakout! just eye makeup)

I wish I had a picture from 12 years ago before I started taking care of my skin. Once upon a time I was a red head who wanted a tan!  I was covered in freckles and “age spots”.  I try very hard to protect my skin these days.  However, even with my efforts, I end up with some sun from long walks with my dog or hiking with friends.

Anyway, I am a huge fan of these modalities for skin rejuvenation and thought I would share these photos as an example of what one can expect!  I try to do this 3-4 times per year.



There are a few stand-out products from 2016!

Alastin Restorative Skin

The Alastin Restorative Skin Complex® has become a part of my daily routine.  I have found an improvement in the texture and tone of my skin using this product regularly.  The skin around my eyes (especially under my eyes) has firmed and there are fewer fine lines.  This product has peptides that help your skin grow collagen and elastin.  Restorative Skin Complex has been written up in numerous publications and has been recommended by multiple dermatologists and plastic surgeons.   It is worth every penny.


Skinceuticals C E Ferulic rotates in and out of my regime, and has for years.  There is unequivocal evidence that this product, loaded with antioxidants, helps neutralize UV and free radicals.  Used with sunscreen, your protection is improved significantly.  90 % of visible premature aging is caused by environmental free radicals.  Sunscreen alone is not enough.  Adding an antioxidant such as C E Ferulic or Phloretin CF gives the skin significantly improved protection.


Elta MD® UV Daily Broad-Spectrum SPF 40 is always on my bathroom counter, in my purse and in my car.  With 9 % zinc oxide, the sun protection is superior to any chemical sunscreen.  The formula is not at all heavy, and with  hyaluronic acid , it is hydrating.   I love this sunscreen.


Skinceuticals Metacell Renewal B3 is also always in my rotation.  This product helps with hyperpigmentation and, with niacinamide, redness as well.  It has a smooth and hydrating feel without feeling heavy or greasy.  Great product.


Allergan Juvederm Voluma™ has become one of my favorite dermal fillers.  It is FDA approved for filling the midface, although I use if off-label in temples, tear troughs and lower face.  This filler is wonderful at restoring lost volume while looking very soft and natural.


And, as always, the tried and true merits of Botox® and Dysport® can not be disputed.   The preventative and corrective effects of both of these botulin products are proven in terms of efficacy and safety.  They are here to stay, and when in the right hands, can create a rested appearance.  We have all seen a “Botoxed” face, but that is not how it has to be.  There can be movement and expression  when the muscle activity is minimized rather than frozen.  A rested appearance is the ideal outcome.

Botox cropped


One more product I have enjoyed this year, and in previous years, The Vi Peel.  In a perfect scenario we would all have a peel every 3-4 months.  Peels help to lift damaged and dull skin, stimulates collagen, fades hyperpigmentation and clears stubborn breakouts.  I love my skin 10 days after the peel is applied.  The Vi Peel is strong enough to see a difference ,but not so strong that there are weeks of downtime.    Great glow!


All products and services mentioned are available here at TOC Medical Spa in Austin!

I hope your 2017 is off to a great start!  Here is to your health and happiness!



Looking for a last minute gift idea for under the tree, or a stocking stuffer?

Here are a  few suggestions (which won’t break the bank, mostly:-) ) from TOC Medical Spa.

A product that would work for any recipient is Elta MD® UV Lip Balm Broad Spectrum SPF 31.  ($10)  This lip moisturizer tastes good (minty) and gives lips the protection they need.  This is a great product to have in your pocket when you’re skiing!


Another idea  is a Jane Iredale® Puregloss lip gloss ($24) in a universal tint.  Both Tangerine and Snow Berry look beautiful on their own or as a gloss over lip color.


The Jane Iredale® line also has a universal blush that I have yet to find a person it does not look beautiful on.  Awake Purepressed Blush ($27) literally makes you look like you have had a quick walk or a kiss under the mistletoe.


A more indulgent gift could be a Clarisonic® Mia facial cleansing brush ($129).  This facial cleansing brush thoroughly cleanses the face using sonic technology.  I have yet to meet an adult or teenager who does not love their Clarisonic®!


Just a few last minute suggestions!  Happy Holidays Y’all!!!!



Facial swelling or puffiness due to fluid retention can be a chronic issue for some people.  Swelling around the eyes, in particular, is a common complaint from patients.

There are numerous culprits (salty food, crying, lack of sleep, allergies and drinking too much, to name a few).  Swelling is frequently  worse in the morning upon arising, because  we sleep with our heads more dependent, allowing fluid to accumulate in facial tissues.  Frequently what looks awful in the morning can be significantly improved by mid day, simply by having our heads elevated, allowing fluid to drain.  But, what else can help besides gravity?

Sleeping with your head slightly elevated can prevent fluid from accumulating, or at least minimize it.  But when you have swelling and want a fix, here are a few suggestions.

  • cool compresses (old school, but it works)
  • an eye cream with caffeine (Neocutis Lumiere)
  • drinking fluid and flushing out that accumulated fluid
  • drinking or eating something to help with diuresis to help your system release the fluid, such as coffee or tea or certain fruits and vegetables.
  • Avoid high sodium foods as the sodium will encourage your system to hold on to the fluid.

Taking care of the thin skin around the eyes can, over time, help to minimize puffiness.  If the skin is in good shape, the puffiness is less evident.  When the tissues are cared for and collagen and elastin are being supported ,the skin is tighter and less likely to show bulging or swelling. We frequently recommend SkinMedica™ TNS Eye Repair or Alastin Restorative Eye Treatment™.

Ultimately, one day, you may find the puffiness never truly goes away.  This can be the result of the orbital fat pads herniating through the muscles and thin eye tissues.  At this point it may be time to see an oculoplastic surgeon to address the issue.  The fat pads can be removed or repositioned to improve the appearance of the eye area.  (it is called a lower blepharoplasty)  The doctors at TOC Eye and Face are experts in oculoplastic surgery.  They all specialize in both cosmetic and functional eye surgery.






Redness, or flushing, is a common skin complaint.  The two skin tone issues that I hear the most complaints about are hyperpigmentation (dark spots) and redness.

Redness is the result of superficial blood vessels dilating.  It can be a minor problem that remits and exacerbates, or it can become more and more of an issue over time.  Over time the small vessels can dilate and appear larger and more numerous.  The cheeks, nasal area and chin are common sites of this redness, although it can occur anywhere.

Culprits that contribute to redness include sun exposure, temperature extremes (cold and hot), consumption of alcohol and/or spicy foods.  Of course, there is a genetic component to facial flushing as well.

What to do to prevent or improve it?  For starters, use a good sunscreen, preferably with zinc (7-10%). Adding a quality sunscreen to your routine every day will protect your skin, and the blood vessels in it, from UVA/UVB rays   A topical antioxidant, along with the sunscreen will give you further UVA/UVB protection as well as strengthen the capillary walls.  Find a  product with niacinamide, as this has been proven to help.  Other ingredients that may help include licorice, chamomile and feverfew.

Products I frequently recommend include:

  • SkinCeuticals® Metacell Renewal B3 (niacinamide)
  • Alastin Skin Nectar™
  • Sunscreen, such as Elta MD® SPF 46 (has 5% niacinamide!)
  • Antioxidants such as SkinCeuticals CE Ferulic® or Phloretin CF®
  • ALL of these products are available at TOC Medical Spa


Obviously avoiding triggers such as hot/cold temperature fluctuations, spicy foods and alcohol can help.

If the vessels are broken, or noticeably enlarged, you need to remove them.   Lasers are your best option.  Pulse dyed lasers, such as the V-Beam, are meant for this specific purpose.  Yag and IPL devices are also helpful.  Your skin care provider can help you choose your most appropriate treatment plan.

There is a condition called Rosacea that can make your skin red and angry appearing and seeking the expert care of a dermatologist is recommended.  Rosacea can be treated with a combination of topical and oral medications.


There are several programs offered by the aesthetic pharmaceutical companies that are meant to drive patients back in for additional treatments.  They are effective for the companies AND they save the patient money.

I think it is worth utilizing these programs if you are a consumer as it does save you $ on something you were probably going to do anyway.


Allergan, the makers of Juvederm®, Botox®, Kybella™, SkinMedica® products and Latisse®, has a program called Brilliant Distinctions®.  You accrue points by receiving treatments with your provider, purchasing skin care, and in the case of Latisse®, filling a prescription at your pharmacy.  You simply sign up at  When you receive an aesthetic treatment with an Allergan product remind your provider to issue you points at check out.  When purchasing SkinMedica® products also ask the person checking you out to issue points on your skin care purchases.   Check your account before your treatments to see how many points you have accrued and create a coupon.  The coupon are worth anywhere from $10-$80 depending on what you have accrued.  (I have seen patients have more than $80 in their banks)  Points do expire after 9 months so keep an eye on them.  Brilliant Distinctions® also has an on line mall where purchases from participating retailers can also create dollars in your account.  The list of retailers is extensive and includes many commonly shopped businesses.  Maybe your holiday shopping is going to pay for your next Botox® treatment!


Another program, from Galderma, the makers of Restylane® products, Sculptra® Aesthetic and Dysport®, is called Aspire.  Once again, you accrue points as you receive treatments.  Go to to sign up.  You are also able to accrue points in Aspire by taking monthly quizzes, participating in surveys and referring friends.  The Aspire program points last longer than Brilliant Distinctions® points,  although they do eventually expire.

Both programs have smart phone apps that make it that much easier to access and utilize.

If you are a fan of medical aesthetic treatments check these out.  It can only save you money!