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!



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.



Niacinamide is an ingredient receiving some well earned attention lately in skin care.  Studies have been conclusive that niacinamide has numerous skin benefits.  If your skin care does not include a product with niacinamide, you might consider adding one.

Niacinamide, vitamin B3, can be applied topically (ideally at least a 5% concentration) to skin once or twice a day for the following benefits:

  • Decrease moisture loss by increasing barrier function
  • Improve cellular communication
  • Fade hyperpigmentation
  • Increase Collagen
  • Increase skins elasticity
  • Decrease acne
  • Decrease inflammation
  • Fade the skin discoloration acne blemishes can leave behind
  • Decrease redness associated with Rosacea
  • Decrease oxidative damage (similar to an anti-oxidant)
  • Increase cellular turnover

A house favorite here at TOC Medical Spa is Skinceuticals® Metacell Renewal B3.  This daily corrective moisturizer has 5% niacinamide, 2.5% tri-peptide concentrate and 15% glycerin.  I can safely say that every staff member here is using this at least once a day if not twice a day.  Most of us are on our 3rd and 4th bottles.  It is emollient without being heavy feeling at all and works well under makeup during the day.

You will likely see niacinamide popping up more and more in skin care products, and hopefully this review will help you understand why 🙂


As the cooler weather arrives and we have to turn on the heat many people are prone to dry and itchy skin.  This can be minor for some people and more of a disaster for others who struggle with dry skin to start with.  It can lead to flare ups of atopic dermatitis (eczema) and create cracks in the skin (creating a break in the barrier and possibly leading to infection).   There are numerous approaches to minimizing and alleviating the problem.

You may need to alter your skin care routine from the warmer months to the cooler months.  Using a milder cleanser and avoiding toners with alcohol is a good start.  If you are a fan of exfoliating, a more gentle approach may be helpful.  Finding a cleanser that is moisturizing for both your face and body is also helpful.

As tempting as it is to take a long steaming hot shower or bath when you are chilled to the bone, it will only make your skin drier by breaking down your skins lipid barrier.  It is recommended to minimize the amount of time bathing and to avoid temperature extremes.  Additionally, putting a moisturizer on immediately after bathing when the skin is still slightly damp can help to trap in the moisture.

Ingredients to look for in moisturizers include:

  •  Glycerin
  • Sorbitol
  • AHA
  • Petroleum/Petrolatum
  • Urea
  • Lactic Acid
  • Olive Oil
  • Jojoba Oil
  • Shea butter
  • Hyaluronic Acid/Sodium Hyaluronidase
  • Dimethicone
  • Lanolin
  • Aloe Barbadensis
  • Tocopherol (Vitamin E)
  • Mineral Oil

It is also helpful to avoid heavily fragranced products.

A few face/neck/décolleté creams we love and recommend here at Toccare/TOC Medical Spa include:

There are products that are specific to body areas.  For instance, hand creams tend to be heavier than face creams.  Our hands (and feet!) have fewer oil glands so require more moisture replacement.  Make a habit of moisturizing at bedtime as this allows the skin to absorb the moisture during your sleeping hours.

Lips can be a particularly irritating area when they loose moisture.  Sealing in moisture and always maintaining a barrier is the best way to treat lips.  We tend to lick our lips more as they become irritated.  This actually makes matters worse by breaking down the barrier even more.  Keeping a lip balm on your person is the best defense.  I love Lip Drink™ by Jane Iredale.  It is moisturizing, has an SPF from titanium dioxide and tastes like lemonade!

Diet is part of the solution as well.  Eating foods rich in Omega-3 fats can help your skin maintain a lipid barrier.  Avocados, fish, nuts, olive oil, flax seed/flax seed oil and sardines are all sources of Omega-3 fats.    Additionally, drinking plenty of fluid is helpful.

If an area becomes particularly dry and irritated it may be time to try over the counter hydrocortisone cream.  This usually manages minor irritation and eczema.  If irritation persists, it is advisable to seek the care of a dermatologist.