MENOPAUSE AND YOUR SKIN 101

MENOPAUSE

Menopause can take a toll on us.  The hormonal shifts have both emotional and physical effects.  Some of it is out of our control, but a lot of it can be managed.

As our estrogen levels drop we notice changes such as hot flashes, changes in our skin and hair, difficulty sleeping, fatigue, irritability and decreased sex drive.  (to name just a few)  As an aesthetic nurse I am frequently asked what can be done to help with some of the skin changes.

Obviously, it goes without saying, that having a healthcare provider to help you manage the medical aspects of “the change” is in your best interest.  HRT (hormone replacement therapy) is a viable option for many of us, but not everyone.  Some individuals may have contraindications for HRT.  If it is an option, estrogen replacement can help alleviate many of the symptoms of menopause.  Each individual has to look at their own medical history and determine what is the best approach for them.

ESTROGEN AND OUR SKIN

As our ovarian function declines,  we lose estrogen production.  A side effect of this is the loss of collagen.  Estrogen helps the body with the production of Collagen I and III.  Additionally, estrogen supports oil gland activity, elastin and subcutaneous fat.  We notice this as we discover our skin thinning, new wrinkles, sagging, dry skin and less volume.  We can provide support to our skin as it experiences menopause related changes.  Here are a few ideas….

  • Eat a healthy diet full of antioxidants. (eat lots of colors!)
  • Try to incorporate soy into your diet.  The isoflavonoids in soy mimic estrogen.
  • Drink plenty of water/stay hydrated.
  • Try to sleep 8 hours a night.  (easier said than done, I know)
  • Wear sunscreen every day, rain or shine!  UV rays break down our collagen.
  • Use a topical antioxidant prior to your sunscreen every day.
  • Utilize a retinol/retinoid (Vit A) product topically at night.  Studies show this helps stimulate new collagen.
  • Utilize peptides in your skin care.  It is proven that various peptides help support the production of collagen and elastin.
  • Use a gentle non-stripping cleanser.
  • Exfoliate your skin.  A physical exfoliant or lighter chemical peel exfoliant.
  • Look for hyaluronic acid in your skin care.
  • Utilize fillers/fat transfers to replace lost volume.
  • If dryness is an issue, make sure your moisturizer is replacing enough moisture so your skin feels comfortable.

There are other issues I hear complaints of related to menopause.  Facial hair growth is a common complaint.  (as estrogen levels drop and our androgen hormones become more dominant)  If there is pigment in the facial hair, laser hair removal is a fantastic option.  If the hair is light or has no pigment, electrolysis is a better option.  There are  also prescription creams that can decrease facial hair growth.

Acne can be a problem that resurfaces at this point.  Again, due to the dominance of androgen hormones our skin can have thicker sebum production.  Retinoids/retinols can be helpful.  For more serious issues your health care provider can help you decide if Spironolactone (a prescription) is an option for you.  The Spironolactone helps suppress the androgen hormones, helping both with hair growth and acne.

Estrogen also helps control our melanocytes.  As we lose the estrogen, hyperpigmentation can become more of a problem.  So, this brings us back to sunscreen and topical antioxidants to protect from UVA/UVB.

For those wanting to go the extra steps to help with collagen production and repair prior damage, there are numerous laser modalities available that make a considerable improvement and difference.  I am currently a fan of  HALO™, IPL’s and Ultherapy®.

I read that we spend 1/3 of our lives in menopause based on the average life expectancy in the developed world.  We can make it feel good and look good ladies!

I’ll finish with a current list of favorites.

SUNSCREENS

The entire line of Elta MD® sunscreens are excellent sunscreen options.

c-e-ferulic

The Skinceuticals line has excellent antioxidants.  Both CE Ferulic® (for drier skin) and Phloretin CF® are great options.

alastin retinol

Alastin® Retinol at night is effective, yet gentle.

Alastin Restorative Skin

The Alastin® Restorative Skin Complex has numerous peptides and antioxidants.  This stimulates collagen and elastin.

Both SkinMedica® and SkinCeuticals offer hyaluronic acid products that effectively boost hyaluronic acid in the skin.

triple lipid restore

SkinCeuticals Triple Lipid Restore is an excellent hydrating cream for those with drier skin.

All of the mentioned products are available at TOC Medical Spa.

We have a sale this month too!

10% off one product

15% off two products

20% off three products

Hope this is a little informative 🙂

 

 

 

 

SKIN CANCER AWARENESS MONTH

SUNSCREENSMay is Skin Cancer awareness month, so I thought I would do a quick blog on sun protection and skin care in regards to sun exposure.

Approximately 1 in 5 Americans will have some type of skin cancer in their lifetime.  Skin cancers are the most common type of cancer in the United States of America.  Protection from damaging UVA/UVB rays can help improve ones odds significantly.

Some basic tips include avoiding sun exposure between 10-4, wearing broad spectrum sunscreen, wearing protective sunglasses, wearing broad rimmed hats and seeking shade whenever possible.  But when you find yourself in the sun, your choice of sunscreen protection is important.

When purchasing sunscreen look for broad spectrum, meaning, protects against UVA and UVB radiation.   Broadly, UVB rays burn our skin and UVA rays go deeper and damage the skins structure. Both increase cancer risk.  Both contribute to premature aging of the skin.

In the sunscreen market there are chemical sunscreens that are referred to as absorbers.  They absorb the UV rays and convert them to heat.  There are a long list of these chemical agents and some cover either UVA, UVB and some absorb  both.  There are approximately 20 FDA approved agents.  These chemical agents have a maximum amount of absorption and then loose their effectiveness unless reapplied.  Physical agents, such as zinc dioxide and titanium dioxide, reflect the UVA/UVB rays.  I always discourage patients from focusing too much on the SPF factor because an SPF of 15 filters 93% of the UV rays while SPF of 30 filters 97%.  Going to an SPF of 50, 70, 80 or 100 does not significantly improve your protection factor.  Reapplying, however, does.

I am a big fan of physical agents as they are the least likely to cause irritation, work immediately upon application and offer broad spectrum UVA/UVB protection.  When applying make sure not to miss the eye area, ears, backs of legs, feet, lips, and if you are bald or have thinning hair, the scalp.  Sunscreens with zinc and titanium are not the thick greasy kind we remember from our childhood.  They are now micronized and have a cosmetically elegant feel.  Do not under utilize your sunscreen.  When applying to your whole body you should use several tablespoons of sunscreen.

There are increasingly sunscreen garments that can add protection.  Rash guards are increasingly popular and fashionable.  When purchasing sun protection wear make sure it has a UVP rating on the label.  Do not rely solely on this as a means to protect your skin.

Finally, I wanted to review protecting eyes.  Repeated and cumulative UVB/UVA exposure to the eyes can contribute to cataracts and macular degeneration.  Eyelids (upper and lower) are one of the most common sites for non melanoma skin cancers.  The lower lids are more effected than the upper lids.  Sunscreen and sunglasses with UVA/UVB protection are vital.  Skin cancers on the eyelids do not always present the same way as elsewhere on the face.  These types of cancers tend to infiltrate and can effect ocular structures, thus putting site at risk.  Those with light colored eyes and skin are more at risk.   Ideally your eyelid skin is evaluated by your dermatologist yearly.

That brings me to the importance of yearly skin checks.   A yearly skin check should be part of your routine medical evaluation.  Depending on your risk factors a physician may determine if this should be done more or less frequently.  There are also physicians who will skin map you if you are at higher risk.  (take photos to reference back to,  helping to  evaluate changes over time)  I had mine mapped as I am a fair red head who spent part of her childhood in the South Pacific with year round sun exposure and am covered in acquired nevus (brown skin lesions/freckles).   If you feel you have too many spots to keep track of skin mapping may be a good option.

I am a huge fan of the Elta MD® line of sunscreens (thus the photo) and encourage everyone to find their favorite sunscreen.  If you love it you will use it!

Happy Memorial Day weekend!  Protect yourself while having fun out there  🙂

HOW TO COMMIT TO A SKIN CARE REGIME

routine products

We all have the best intentions whether it be related to our diet, exercise program or other goals.  This is about committing to a solid skin care regime.  Just like all other ‘habits’ it can take practice for a new skin care program to become the new normal.   I believe the research shows that it takes 21 days for a new practice to become a habit.  So, how can we make that easier and help insure we will commit?

The easier we can make it for ourselves, the more likely we are to experience success.

First off, decide what your day time skin care should look like for you and what you are trying to target.  Ideally, everyone includes an antioxidant and a sunscreen with zinc every morning.  A night time routine should include a retinol/retinoid and plenty of moisture.  Once you have established which skin care items are going to suite your skin care needs make sure the products are accessible.  It can be easy to want to skip any part of the routine when we are in a rush to get out in the morning or we are exhausted at night.

Have all your must use products easily accessible.  I keep a tray with my current products on the bathroom counter next to my sink.  I am always able to commit in the morning, it is at night, sometimes, when I am exhausted, that I might be less committed.  But once I brush my teeth my products are right there so I rarely skip.

I am a true believer in topical skin care.  I came in to medical aesthetics with pretty sun damaged skin and can honestly say that I turned my skin around.  I once thought tanner was better.  I even used tanning beds back in the day.  Being a pale red head, this was just a bad idea on so many levels.    I believe that what we use topically is a big piece of the “pie” and is worth the money and time.

I tell patients to, at the very least,  commit to an antioxidant, sunscreen and retinol/retinoid.  I am a huge fan of products with multiple peptides these days as well.

Maybe this well help you get on board with a topical skin care routine.

Happy Monday!

 

 

 

FAVORITES OF 2016

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.

c-e-ferulic

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-spf-40-daily

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.

metacell-renewal-b3

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.

voluma

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.

voluma-2

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

dysport

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!

vi-peel-2

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!

LAST MINUTE GIFT IDEAS

xmas-tree

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!

elta-lip

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.

ji-gloss

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.

awake

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®!

mia

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

DO YOU STRUGGLE WITH REDNESS?

flushing

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

anti-redness-products

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.

COLD SORES

cold sore

They are mean, nasty, painful and unsightly.  If you are a fellow sufferer you know exactly what I am talking about!

They can be predictable.  For instance, after too much sun or wind, a fever, stress or anything taxing on your system.  But they can also be unpredictable, coming on out of no where for no apparent reason,  leaving your lips looking swollen, sore and uninviting.

Cold sores (or fever blisters) are  caused by HSV (herpes simplex virus)  type I.  Genital sores are generally caused by HSV type II.  However, both can occur in either location.  Transmission is through intimate contact, such as kissing or oral sex.  An oral lesion can be transmitted to the genitals and vice versa.  A lesion is contagious until it completely crusts over or heals.  Once infected, outbreaks are  frequently associated with stress, certain foods or a womans menstrual cycle.  Between outbreaks the virus lays dormant in the nerve cells until it is activated.  Most individuals report feeling  itching or sensitivity right before an outbreak.  Ideally, this is when treatment is initiated  in order to reduce the severity of an outbreak.  The sooner anti-virals are introduced the better.

There are numerous anti-virals to treat HSV I or II.  Acyclovir (Zovirax), Penciclovir (Denavir) and Valacyclovir (Valtrex) are commonly prescribed.  Abreva® (docosanol) can also be applied topically to help to reduce the severity of an outbreak by preventing the virus from replicating.  Ideally, if you suffer from cold sores frequently enough, you have a supply of your medication of choice available at all times.

Orajel

I find these single dose ampules very helpful as well.  They are a combination of an numbing agent and alcohol.  If a cold sore gets to the blistering stage these really dry it out and reduce the healing time in addition to numbing the area slightly.  I find having a small bag with a dose of Valtrex,(my medication of choice) an ampule of Orajel™ and Abreva® in my purse to be the most proactive way to deal with cold sores.

In my line of work we frequently put patients with a history of cold sores on antivirals prior to treatments that can induce an outbreak.  For instance, IPL’s, laser treatments, chemical peels or lip injections. Prevention or prophylactic treatment seems to be the best approach.

Also, sunscreen can be very helpful in the prevention of UVA/UVB induced outbreaks.  I love elta MD® UV lip balm.  It has transparent zinc oxide, is water resistant and has a nice minty taste.

Elta Lip

There are other dietary supplements that can be helpful, for instance the amino acid Lysine.  Although it is not well studied and in high doses over time can create complications, such as kidney problems.

Ultimately, each individual learns there own triggers and can plan accordingly.  Some people have an initial outbreak and then never have a reoccurrence.  (lucky ones)

Hopefully this quick synopsis helps my fellow sufferers!