Specializing in the latest non-surgical treatments

Ask Deborah

Q: I would like your assessment on Dr. Perricone's products. I saw his TV show. How true are his view points? Thanks.

A: I just finished reading Dr. Perricone's book, The Wrinkle Cure. I believe how well you age is determined by genetics, as well as lifestyle. Dr. Perricone states that everything you do to nurture the inside of you body enhances your outward appearance. There are many factors involved here. For example he advocates an antiaging diet that includes frequent small meals, fish (especially salmon), omega 3, fruits and vegetables that maintain a stable blood sugar level and vitamin supplements, exercise stress reduction, sun protection a skin care routine that includes aha's, alpha lipoic acid and dmae. However, I would like to see before and after photos in his next book regarding his claims on patients who have tried his anti-aging program. If you are interested in his products, they are available at Nordstrom's and Sephora. Use them for 6-8 weeks and see if you notice an improvement in your skin. I hope this is helpful.

Q: I have rosacea on my nose and it is very hard to keep under control with overheating from walking and exercise. Do you know of any way to help prevent the worsening of the rash?

A: Rosacea can be difficult to control. It does exacerbate when exercising, drinking alcohol, eating spicy or hot foods, sun exposure and sometimes stress. Sun protection is very important i.e. hats, sun glasses, clothing and zinc oxide. The best treatment at this time is Metrogel. It is a topical treatment and available by prescription only. You may want to ask your doctor about it.

Q: What do you know about micro dermabrasion? How does it compare to CO2 lasering?

A: Microdermabrasion is a very superficial peel removing only the Stratum corneum, which is a layer of dead skin cells ready to slough off. There is no down time involved in this process and it's a nice superficial peel. Useful for fine lines, discoloration and acne. A series is usually necessary (6-10) for satisfactory results. Co2 laser resurfacing is considered a surgical procedure. It is a deeper peel, sometimes removing part of the dermis, which is the second layer of this skin. This is for moderate to deep wrinkles and severe sun damage. The down time involved can be as little as 2 weeks and redness can persist for months.

Q: The frown lines between my eyes bother me. People often ask me if I am angry or worried. I've heard about the treatment Botox, but I am concerned about its safety. How long do the effects last?

A: Botox is a safe and effective treatment for the wrinkles of the upper portion of the face, often caused by facial expressions. The treatment involves injecting a very diluted amount of the drug Botox into the muscle that causes the wrinkles to form. Botox has been used for over 20 years for its therapeutic value for those who suffer from uncontrollable facial movements, such as spasms around the eye. This non-surgical procedure temporarily blocks the nerve impulse to the muscle, thereby relaxing the muscle tension on the skin. The treatment is effective for the frown lines, as well as the horizontal forehead lines, and the crow's feet. In terms of its safety, Botox is safe in small doses, similar to aspirin. Aspirin can be taken to alleviate pain or fever, however, it is never advisable to take more than the recommended dose. The effects last approximately two to six months.

Q: My doctor gave me a prescription for Renova. I started using it at night, but my skin became pink and irritated. I would like to continue the use of Renova because my doctor said it may help get rid of the brown spots on my face. Do you have any suggestions to decrease the irritation?

A: Renova is a trade name for tretinoin (Vitamin A acid). Renova can be beneficial for improving the overall appearance of the facial skin, decreasing fine lines, and fading dark discoloration. The best way to acclimate your skin to the use of Renova is to begin on a gradual basis, i.e. two times a week., then every other night, and every night, as tolerated. It may take four to six weeks before you can tolerate it on a nightly basis. Use a regular moisturizer on the nights you don't use Renova. Most importantly, wear a sunscreen or sunblock daily, as Renova will increase the skin's sensitivity to the sun's rays.

Q: I like the look of a tan, but I am concerned about the skin damage the sun can cause. What is the best way to use a bronzer without looking like I have a fake tan?

A: You are wise to be concerned about the skin damage UVA and UVB can cause. 80% of skin damage is caused by the sun. The bronzers available today can create a very natural looking tan. Most contain the same basic ingredient called Dihydroxyacetone. The key to having a natural looking tan is to purchase the right color for your face. In other words, don't buy a bronzer for dark skin if you are fair -- it will look fake. Secondly, exfoliate your skin with a washcloth or loofa to remove dead skin cells and make the surface smooth. Apply evenly to your skin like you would a lotion. Do not put any clothes on for 20-30 minutes. This will ensure an even application, plus, some bronzers can discolor clothing. Here are some of my favorite bronzers you may like to try:

1. Go Bronze, by Este Lauder

2. Long's Drug Store generic self-tanner

3. Clinique Self-Sun Body Mist

Q: Is an SPF of 15 enough protection for the summer?

A: For daily sun protection, an SPF of 15 is enough, however, if you are going to be exposed to the sun's rays for several hours, an SPF of 30 or higher would be safer. The SPF should not be your only concern. It is very important to make sure the sunscreen or sunblock you use protects the skin from UVA and UVB. Most only provide protection from UVB and part of UVA. Check the label for full spectrum or broad spectrum protection. Two ingredients to look for are zinc oxide or parsol (avobenzone). Try Shade UVA Guard by Coppertone or Eucerine Moisturizer with an SPF of 25.

Deborah is a registered nurse with over 17 years of experience helping thousands of women and men look years younger through the use of non-surgical skin treatments including Botox Cosmetic, Dysport, Restylane, Perlane, Radiesse, and Fraxel laser. Deborah is well known in Walnut Creek and the San Francisco Bay Area both as an expert practitioner of her profession and as a teacher and guest speaker for various women's organizations.
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