Skin Care

By Andrea Toochin

During my stint as skin care editor, I’ve experienced many different ailments. When you live and breathe beauty you begin to see flaws that don’t exist simply because you know there are solutions. When you anticipate an important event like a wedding, you begin to scrutinize every imperfection. No matter whom you’re marrying or where the ceremony will take place you want radiant skin. To celebrate all the future brides we’ve developed a simple yet comprehensive guide to skin care, with realistic attitudes and expert advice.

The doctors we spoke to represent opinions from each end of the spectrum, but they all agree everyone should visit a dermatologist before taking action and preparation should begin at least two months before the wedding. If you’re one of the many New Yorkers who crosses the street carefully because you’ve no health insurance, fear not. The Medi-Spa phenomenon ensures that anyone with credit or disposable cash can turn their skin around; Instead of visiting an internist and waiting for a referral, you can visit a dermatologist at a spa just by making an appointment.

Eliminating and Preventing Acne
People experience acne in cycles but a common mistake is treating acne like weight management; we often react rather than acting to prevent outbreaks. At a recent meeting, Jan Marini touted Benzoyl Peroxide as one of the best anti-bacterial substances created to date. Since it functions by killing bacteria, she informed that it can be applied over other products to prevent acne.

The skin care community has been advocating the use of lasers for acne and scar treatment but many over-the-counter (OTC) chemicals treat and prevent acne when used regularly. For mild acne, try the Neutrogena Advanced Solutions Complete Acne Therapy System, a three-part system that involves a cleanser with .5 percent Salicylic Acid and Glycolic Acid; an overnight lotion with 2.5 percent Benzoyl Peroxide, and an oil-free, glycerin-based moisturizer with physical and chemical sunscreen and cinnamon extract, a natural anti-inflammatory and anti-bacterial. For effective but mild exfoliation, opt for treatments that utilize fruit-derived acids like Face Focus’ papaya and pumpkin peel. Face Focus offers a variety of facials that exfoliate and promote cell regeneration but their Blueberry Smoothie peel lured us immediately. Raluca Minea, one of Face Focus’ licensed aestheticians, often performs the exfoliating acne treatment, which utilizes physical exfoliants like beads as well as blueberry extract and chemical exfoliants like Lactic Acid.

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For medium acne, I’d recommend a glycolic-based regimen. Dr. Francesca Fusco, a Manhattan-based dermatologist and a member of the AAD and the American Chemical Society is “a big advocate of chemical exfoliation – both in the office and at home. “Though it’s difficult to pinpoint which products are successful she goes with the tried and true ingredients and well respected brands when asked to recommend a regimen for clear smooth skin, “If I had to generalize, a product with AHA (glycolic and lactic are both AHAs) or retinol could be a good choice as these exfoliate and diminish fine lines.” In addition, Fusco also instructs patients to look for non-comedogenic products because oil-free products aren’t necessarily safe for acne-prone skin.

Fusco conducts seasonal chemical peels on most patients and recommends maintenance at home with products like the Patricia Wexler Glyco-Peel System, a treatment that uses a pad soaked in 10 percent glycolic acid solution. A lesser-known drugstore brand, Aqua Glycolic, makes a shampoo/body cleanser with 14 percent glycolic acid at a pH of 4.4 to keep the scalp healthy and the body smooth. All products have at least 10 percent glycolic acid. The face cream also has hyaluronic acid; it lessens sun damages and helps promote cell turnover and collagen production. Fusco herself keeps it simple; she uses Suave Natural Oatmeal Moisturizer on her face because she has sensitive skin. To keep the rest of your body soft and clear, she recommends keeping a bottle of Suave body lotion by the shower and slathering it on while the skin is still damp. “For smooth body skin, look for ingredients like glycerin (Suave increased the percentage in most of their moisturizers), lanolin, and dimethicone.”

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Those with severe acne should have a dermatologist they trust on speed dial and a multi-step treatment that’s strong enough to combat overactive sebaceous glands and easy to maintain for the long term. Jan Marini has treated countless teenagers and adults through a multi step system that often involves her glycolic cleanser and her wonder item, Bioclear Lotion. Since Bioclear contains Salicylic Acid, Glycolic Acid, and Azelaic Acid, it destroys bacteria, breaks down acne lesions, and resurfaces skin thereby easing hyper-pigmentation.

Clearing and Tightening Skin
Women that don’t have acne often complain their skin is dull and sensitive or that gravity has taken its toll. To achieve a dewy complexion and taut skin, moisturizing and collagen-producing treatments are imperative. Sephora’s new line Cosmedicine is a reasonably priced line that offers everything from serums and healing cream to tinted moisturizer and body cream. Consultants from Johns Hopkins affirmed clinical studies that showed the MegaDose serum offered 63 percent protection from free radicals. For young brides, the prep stops here. Dr. Steve Fallek, a board certified Plastic and Reconstructive Surgeon cautions women in their 20s from going overboard. However, older brides can benefit from many non-surgical procedures that fix imperfections like “fine lines, drooping lids, or brown spots.” “The key is achieving the optimal result without significant downtime. Full laser treatments, chemical peels, or dermabrasion may lead to prolonged redness,” says Fallek. “My aestheticians and I use IPL (intense pulse light) treatments, microdermabrasion, light peels, Botox, and fillers such as Restylane.”

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Every doctor has a different approach. Fallek and Fusco both agree brides with more damage should begin treatments two to three months before the wedding but Dr. Fusco prefers to treat droopy skin with Thermage. “For dull droopy skin I recommend Thermage (Thermacool). Radiowave frequency energy heats the collagen and tightens it. Results are not immediate, and take up to three months. There is minimal redness, swelling, and no crusting or scabbing. One can actually go back to work the same day.” Thermage falls in the same category as a newer technology, one exhibited through the Cutera Titan, a machine that emits infrared light and causes collagen contractions. Though many machines are created for facial treatments, the Titan can be used all over the body, even on the stomach.

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You may not think the current laser treatments are worth the price of a Fendi bag, but there’s a new machine in town that might just lure you. Rhytec’s Portrait Plasma treatment is a non-invasive way to treat sun damage and boost collagen production with little downtime. Dr. Paul J. Frank, a board certified dermatologist and dermatologic surgeon, was the first in Manhattan to get this machine. Used primarily to treat sun spots, fine lines and scars, Dr. Frank believes this is the best resurfacing treatment available today because it provides the benefits of laser treatments with a more localized delivery and less down time.

“This is activated nitrogen – in layman’s terms it’s electrocuted nitrogen,” says Frank. “It’s a form of skin resurfacing which gets rid of pigmentation, fine lines and scars. The machine delivers heat, takes away all the skin with wrinkles, and reveals new skin. Damaged skin sits there until a new under layer is grown.” A number of doctors across the country conducted studies using the Portrait Plasma treatment and yielded positive results, as noted in a clinical roundtable printed in the Aesthetic Buyers Guide (www.miinews.com). Most noted that within a few weeks a new layer of skin resurfaced, removing brown spots and decreasing the depth of lines and wrinkles; the treatment also stimulates a healing process which some say explains why collagen and elastin production ensues without a level of heat that caused charring with other treatments.

The process requires just one treatment at optimum power but if you can’t handle one week with pseudo sunburn, you can opt for three treatments. Dr. Frank has so much confidence in technology-driven treatments and the skin’s ability to heal that he seems to shun anti-aging products and quinones, sometimes referred to as bleaching agents. If you can handle looking sun burnt for a week and you can come up with $3500, this may be the best gift a mother of the bride could ever receive. Not only does this produce results on the face but doctors have recently begun using it on hands and décolleté as well.

If you’re wary machines, it’s time to invest in a cult skin care brand. Obagi will likely reach the fame in coming years that brands like La Prairie and La Mer did in the past. Created by Dr. Obagi, a board-certified member of the American Board of Dermatology and American Academy of Dermatology, the line’s claim to fame is the combination of vitamin C and prescription-strength hydroquinone, four percent (the FDA OTC limit is two percent). The Obagi-C? Rx System is a five-product regimen with vitamins E and C, and four percent hydroquinone. They also offer four vitamin C serums in increments of five percent up to 20. The Obagi Nu-Derm? System offers products with four percent hydroquinone and tretinoin (05 and .1 percent), a retinoid.

Dr Fallek advocates the usage of hydroquinone but recommends starting with a two percent solution. Dr. Fusco also supports the usage of hydroquinone and laser treatments to diminish liver spots, “Depending on how dark the spots are a prescription strength hydroquinone (4 percent) or a new product, Solage, can be highly effective for those who don’t want laser. But, laser or chemical peels could absolutely be done three months before the wedding but as always, go to a dermatologist.”

Removing Unwanted Hair and Calming Excessive Sweating
Everyone is always talking about laser hair removal (LHR); some say it’s permanent, others say it’s semi-permanent. Whatever your belief, it’ll take at least three sessions to remove a significant amount of hair, which is why this requires planning at least three months ahead of time.

Everyone agrees fair skinned patients with dark hair have it easy because there are many lasers that work. Dr. Fallek uses IPL for ideal LHR candidates but cautions that few lasers can perform well on darker skin or blond hair, without side effects. “Darker skin points need a different laser to prevent scattering and scarring.” Dr. William Greenberg of Skin TheraP Medi-Spa claims to have the technology to perform LHR on all skin and hair hues, even blondes, historically the toughest patient. He uses a machine equipped with ELOS (electro-optical-synergy) that detects hair via texture not color.

If you don’t have the capital or the time to get LHR opt for threading. Threading offers more control over shape than waxing and with all the Indian neighborhoods in Manhattan and Queens you’re sure to get a good deal. Praba is Spanish Harlem even offers back threading for men starting around $40.

For most brides we’ve covered all the important topics but there’s one group we’ve left out. For this group, even men’s deodorant won’t suffice and their dreaded moment is finding out how much it’ll cost to remove the yellow sweat stains from their silk organza dress! Well, Dr. Fallek assures us that in the confines of his office, he treats just as many brides with Botox for excessive sweating than he does for wrinkles, and he’s getting rave reviews from satisfied clients. “Botox should be a one time treatment for both underarms. It takes about 10-12 injections per side and I use an acupuncture needle and topical Lidocaine to minimize any pain. I tell patients treatment is about twice a year.”

Now that we know everything there is to know about wedding skin care solutions, there’s no reason to complain or worry about your appearance. We are lucky enough to live in an area with a huge concentration of experienced doctors, all of who can alleviate one big pre-wedding stressor. Just remember, the goal of every bride should be to look like you at your best. Keep in mind you should be as comfortable with your dermatologist as you are with your hairdresser, your OBGYN or your shrink. This holds true especially if you are contemplating surgery, in which case professionals like Dr. Fallek are happy to advice on cosmetic surgery at least six to nine months before the big day. When you start to get jitters keep in mind an America without Hollywood would probably show a better success rate. In an ideal world, marriage should always be about a union of minds, not just a fusion of bank accounts, apartments, and black books. Age and looks should be minor issues, but we appreciate that having clear skin can drastically change one’s self esteem. If a little zapping is what it takes to ensure a weekend and hopefully the start of a lifetime of happiness we’re all for it.

Obagi is available at www.skintherap.com and http://www.dermacareusa.com/loc-brooklynheights.html

Dr. Fallek practices in New York and New Jersey. http://www.fallekplasticsurgery.com/
Face Focus is located in Englewood, NJ. They offer a variety of treatments including reasonably priced laser (IPL) packages and they sell excellent skin care lines, including PRESCRIBEDsolutions, SkinCeuticals, and CosMedix. http://www.face-focus.com/

Dr. Frank’s created a skin care line specifically for sensitive skin, available at his office, Fifth Avenue Dermatology Surgery and Laser Center, 212.327.2919 and online http://www.pfrankmd.com/

Prana Salon offers threading and facials 212.966.1740 http://www.indiantreasures.us/

Cosmedicine is available at www.sephora.com

Aqua Glycolic is available at CVS and Walgreens, www.aquaglycolic.com
Suave products are available at drugstores and at http://www.suave.com
Information about Solage is available at www.solage.com

Originally published May 2006
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