I update my Blog after each appearance on KGO and periodically when there is interesting new information.

09/10/2011 06:46 PM

KGO Update

The Daily 3 + 2 Program Taking care of your skin to look your best is: • Easy • Fast • Affordable The following steps are basic guidelines to assist you in maintaining beautiful, healthy and youthful looking skin: Morning routine: Three steps 1.) Cleanse the skin with your favorite cleanser. I recommend Cetaphil or a creamy cleanser for normal to dry skin. If you have oily or acne prone skin, use a foaming cleanser. 2.) Apply an antioxidant in the morning before your sunscreen. Antioxidants are beneficial for neutralizing free radicals. Free radicals are unstable molecules that interfere with the normal reproduction and repair of skin cells. They include vitamin C, E, Coenzyme Q 10, idebenone, and green tea extract. 3.) Protect your skin everyday with a double-duty moisturizer that contains a broad spectrum sun block or sunscreen, with a minimum SPF of 15. The ingredients parsol (avobenzone), mexoryl, titanium dioxide or zinc oxide are recommended to protect the skin from the harmful effects of UVA/UVB rays. Evening routine: Two steps 1.) Cleanse every night: This is essential for the removal of sweat, oil, Make-up and Pollutants. Do not go to bed with your make-up on! Too tired? Try disposable cleansing towelettes. 2.) Exfoliate and repair to reveal fresh smooth skin and shed dead skin cells that clog pores, cause uneven skin tone, acne and poorly textured skin. Alpha hydroxy acids (AHA), beta hydroxy acids (BHA) and enzymes are beneficial for exfoliation. Vitamin A derivatives have proven to reverse some of the signs of photo damage caused by the sun. They include Retin-A, Tazorac, Rifissa, Avita, Renova & Retinols. WHAT ELSE WE DISCUSSED: 1.) What is new on the horizon Tria is a blue light devise for the treatment of acne. The blue light destroys bacteria that cause acne. This can be helpful for skin types that become overly dry or irritated with topical treatments for acne. The blue light device is glided across the face, after cleansing, five minutes per day. Company states results should be noted in two weeks. Cost $195.00 www.triabeauty.com Personal Microderm Microdermabration: This at home system uses the same aluminum oxide crystals that are used in the professional treatments. The treatment helps ‘sand’ the superficial layer creating smoother skin, and clear pores. It will also help your products to penetrate better and work more effectively. $179.00 www.dermadoctor.com Nu-Face: FDA cleared as a safe and effective for facial toning and stimulation devise. It works through the use of micro current technology- this is a gentle electrical stimulation. According to the companies clinical studies it delivers a micro impulse to the muscles and skin to increase collagen, circulation and better penetration of products. Optimal results are obtained with consistent use. $325.00 www.dermadoctor.com 2.) Five simple tips for looking your best: Sleep on your back The AAD cautions that sleeping in certain positions night after night may lead to ‘sleep lines’ Wrinkles that become etched into the surface of the skin and do not go away once you are up. Sleep on your back or try a pillow especially for side sleepers called “Save my Face.” Go to www.savemyface.com for information or purchase. Avoid squinting Constantly squinting will leave a permanent groove in the skin resulting in ‘crows feet.’ Wear proper reading glasses if you need them. Always wear sunglasses when out side. This may also help protect the eyes from macular degeneration and cataracts. Eat chocolate There is more evidence that cocoas, which contain flavonols help protect the skin from sun damage and affect hydration which makes the skin look smoother- Yes! Don’t over cleanse your face If you have oily skin this will increase the production of oil. If your skin is on the dryer side it will only strip the skin of natural barrier oils. Twice a day is adequate. Nighttime only is OK for those with dry skin. Don’t smoke Cigarettes rob the body of vitamin C. Smoking depletes the skin of oxygen. Twin study revealed that the twin who smoked looked ten years older than her sister. Wear broad-spectrum sunscreen daily If you have any concerns about brown spots, poor texture, wrinkles, uneven texture, and skin cancer, then by all means apply a moisturizer that does double duty. Apply a moisturizer that contains a broad-spectrum sunscreen. Look for the ingredients Zinc oxide, titanium dioxide, mexoryl or parsol. 3.) Are you noticing thinning eyebrows and lashes? Latisse is in clinical trials for enhancing the eyebrows. I know many patients who are using it on their brows with good results. Latisse is available by prescription. Revitalash is also worth a try and can be purchased in a salon or skin care clinic. 4.) Three of my favorite cosmetic picks: Neutrogena Ageless Restoratives 5 Minute Facial: $19.99/1.7oz. Aveeno Positively Radiant Cleanser-oil free soap free non-comedogenic: $7.49/6.7oz. Roc Multi-Correxion 4-zone Daily Moisturizer SPF 30: $25.99/1.7oz.

06/18/2011 10:00 AM

KGO Update

1.) The FDA finally standardizes new regulations for sunscreen. As of Tuesday June14, The FDA finalized new sunscreen regulations. There has been discussion to develop new guidelines and finalize regulations since 2007. The FDA has dragged its feet on standardizing sunscreens. Regulations have been long overdue, as many companies that manufacture sunscreen products have been very misleading in their unsubstantiated claims about the protection of sunscreen. Some examples include stating that sunscreens are waterproof, rub proof or sweat proof. High SPF’s of 50 and even 110 give people a false sense of security and is an exaggerated claim. It also implies that sunscreen is all that is needed for adequate protection. The new regulations will include the amount of UVA protection in the sunscreen. At this time there are standards measuring the amount of protection consumers can expect from UVB-which is the sun protection factor (SPF). UVA has no regulation at this time. The FDA states the publishing of new rules will take affect in one year. In the mean time look for ingredients, not just the SPF: Seek out products with zinc oxide, titanium dioxide, parsol, & mexoryl for broad-spectrum protection. Do wear protective clothing, sunglasses and hats. For children under 6 months, clothing, hats and shade are preferable and sunscreen is not recommended. You may see a rating system that originated in Asia and is used globally. Some companies that manufacture sunscreen have begun to utilize this system. There are three grades: PA+, PA++ & PA+++ PA +++ offers the most protection. PA stands for Protection grade of UVA. 2.) How chemotherapy affects the skin and tips on how to alleviate the typical skin problems: Some of the new therapies such as targeted therapies work on certain parts of the cancer cells to block the growth and spread of cancer cells. Targeted therapies are used with other drugs such as radiation or chemo to boost the effects of the main treatment. However helpful this kind of therapy can cause side effects such as rash and other skin changes. Chemotherapy can make it more difficult for the skin to retain moisture. Rash is the most common skin change is starts out with redness and swelling then progresses to extreme dryness. Itching can also accompany the rash, which makes it very difficult to cope. Report signs of skin irritation as a soon as they are noticed. It is easier to treat at the first sign of the symptom. Your doctor will prescribe medications topical and oral that will help alleviate the discomfort. In addition, the following are some tips to use at home: • Use as few skin care products as possible-keep it simple. • Use non-soap cleansers. • Take baths with colloidal oatmeal bath products to sooth the skin. • Avoid long ‘hot’ baths. • Moisturize right after bathing. • Moisturize at least twice a day. • Avoid skin products with alcohol, fragrance and color. • Do not use laundry detergents with fragrance. • Dermablend make-up can help cover the rash, especially on exposed areas without making it worse. • Wear daily sun protection such as sunscreens with zinc oxide or titanium oxide. Physical blocks are less likely to irritate the skin. Try Neutrogena for sensitive skin or Vanicream with zinc oxide. • www.cancer.org or www.lindiskin.com • Do clear the above skin care steps with you oncologist. 3.) Are there treatments for stretch marks? Stretch marks affect 90% of all women. Stretch marks typically occur during pregnancy, rapid weight gain and loss, growth spurts and even weight lifting. This rapid growth spurt leads to dermal tearing. If your mother had stretch marks you are more likely to develop them. Stretch marks go through various phases; in the beginning they can be red to reddish purple in color and then alter to a white or even silvery color as they age. Dermatologist Leslie Baumann suggests moisturizing the body three to four times per day: Apply creamy moisturizers such as cocoa butter so the skin becomes more pliant and well hydrated, which makes it better to stretch. Apply especially to hips, thighs, breasts and abdomen, as those are the most commonly affected areas. For the treatment of stretch marks it is better to treat them in the early stages for best results. In many cases topical creams may be helpful for rejuvenating the skin and helping to repair the damage: • Creams to try include antioxidants like vitamin C. • Retinoids have proved to repair damage caused by the skin stretching just as it has been used to repair photodamage for many years. Retinoids include Tazorac, Retin-A, Renova, Avita & Rifissa. Retinoids should not be used during pregnancy or breast-feeding. • Mederma Stretch Marks Therapy Advanced Cream Formula is worth a try. It is made of onion juice extract. For the red discoloration there are specific lasers for the redness since the redness is due to vascular lesions. V-beam and KTP are two lasers that target blood vessels. Skin rejuvenating Fractional lasers are beneficial for the poor texture and may help smooth the skin. According to studies this type of laser helps 30% of the stretch marks. Two of the fractional lasers include Fraxel re;store and Activ FX. An average of three treatments are necessary for optimal results. Of course there is the option of having an abdominoplasty (tummy tuck). If this is what you are seeking be sure to see a board certified plastic surgeon for a consultation. 4.) ePrime is one of the latest radio frequency treatments by Syneron. Syneron is a company that specializes in lasers and seems to be on the cutting edge of rejuvenating treatments of the skin. ePrime penetrates radio frequency (RF) energy into the deep dermis without affecting the epidermis (superficial level). A RF treatment stimulates volume and tone resulting in younger, plumper, & smoother looking skin. For more information see: www.syneron.com 5.) My hands look older than I do! Brown spots: brown spots are the most common problem and makes the hands appear old. The topical treatments used for the face can also be used for the hands. Look for products with hydroquinone, kojic acid, vitamin C, Co-Q 10, licorice extract, or albutrin. For stubborn spots there are lasers that specifically target brown spots such as the ND;Yag. Of course to maintain the even skin tone apply sunscreen everyday. Crepiness-Apply rejuvenating creams to your hands at night before bedtime, such as retinols, antioxidants or enzymes. During the day protect your hands with sunscreen. If you would like more dramatic results consider a laser treatment such as the skin rejuvenating lasers like the fractional & the Co2 or Thermage (radio frequency) treatments. Protruding veins and boney appearance: as we age we lose fat in areas where we want it such as the cheeks, temple and hands- this is very common. Loss of fat makes the hands and face appear older. You can either gain weight or have a treatment utilizing plumpers and fillers, including fat transfers to restore the lost volume. The most popular non-invasive ‘fillers’ are Restylane®, Perlane®, Juvederm® & Radiesse™. Fillers are ‘off label’ for the treatment of the hands. 6.) Velashape is a safe and effective non surgical treatments for cellulite This is a three in one treatment in that it delivers infrared light and radio frequency to tone and tighten the skin and reduce fat cells. During the treatment a roller massages the treatment site and smooths the skin. It feels like a deep tissue massage and lasts 20-60 minutes depending on how many area are treated. Typically six treatments are recommended with monthly maintenance treatments. Velashape is best for those who are within 10 pounds of their ideal weight and would like to tone the body. Of course exercise and a sensible diet are recommended in conjunction with Veleshape. 7.) Sandal weather is coming up- are you ready? The most valuable tip is to be consistent. • Apply lotion everyday after bathing to prevent dry skin and calluses. • Soak your feet at night or take a warm bath. After 10 minutes use a pumice stone (very inexpensive) to remove dry skin & calluses. Then apply lotion followed by socks before bed. • For tough calluses apply salicylic acid or glycolic acid at night followed by lotion. This will help loosen up the built up skin. Try Skin Juice Tough Buff foot serum-$33.00/1oz. • http://skinjuice.my.yahoo.comcom.au/ 8.) Three of my favorite cosmetic picks: • Avon for Goodness Face Antioxidant Skin Moisturizing Lotion SPF 30-$18.00/1.7oz. www.avon.com • Jurlique brightening cleanser with micro beads- 23.00/3.5oz. www.beauty.com • Alba Botanica Natural Even Sea Elements eye make-up remover- $8.00/4oz. Available at Whole Foods or www.albabotanica.com Congratulations to caller Sandy of Millbrae who answered the question: What are two of the treatments for stretch marks? Sandy won the Neova Smart Science Smart Sunscreen- $40.00/2.5oz. This is a great three in one product, which offers: Transparent zinc oxide, DNA repair Moisturizer with antioxidants www.neova.com

03/19/2011 08:15 PM

KGO Update

1.) Anti-aging skin care for men. No matter what your age or gender, taking care of your skin is an important component of your overall health care and ensuring the health of your skin goes beyond mere vanity. There has definitely been a dramatic increase in interest by men, as they are investing more time and money into their skin care routine. Skin products for men generated 33.5 million in 2009, which is an increase of 7.5%. There are new products ‘Just for Men’ including: Jack Black, Zirh & Neutrogena, Clinique and Nivea for Men. I also like Aveda and Murad. Of course any product line is fine if it suits your skin type. Generally men prefer light, fragrance free lotions as opposed to heavy scented creams. Keep it simple: Non-soap foaming cleansers such as Zia Natural Skincare HydraCleanse Face Wash fragrance free-10.99/5oz. Avoid deodorant soap, as it is too harsh. Take it a step further with the application of antioxidants- Apply every morning before a sunscreen. Studies indicate that anti oxidants and sunscreens have a synergistic affect on the skin by simultaneously protecting it from free radical damage and sun damage. Sunscreen-Clinque Skin Supplies for Men-Age Defense Hydrator SPF 15-30.00/1.7oz, Obagi Rosaclear-47.00/3oz, Anthelios Body Ultra Light sunscreen fluid-34.00/4.2oz or K2 Enderance Suncare 12.99/4oz. AHA or BHA’s are beneficial for smoother texture, decreasing brown spots and especially for men who are prone to razor burn. Try Murad Acne and Wrinkle Reducer-58.00/2oz. or Alpha Hydrox AHA Enhanced lotion-12.79/6oz. Avoid shaving creams with fragrance, such as citrus, peppermint and menthol-which are too irritating for the skin. Shave after a shower while the facial hair is pliable and soft. Men are also taking advantage of non-surgical cosmetic procedures. The top five most popular procedures for men: • Botox for the frown lines • Hair laser removal-especially for the back. • Mircro dermabrasion and chemical peels- for brown spots and to improve the skin’s texture. • Fillers for wrinkles-typically frown lines and naso-labial folds (smile lines). 2.) Fillers for the feet!? Yes, for the feet! If over the counter foot pads for the feet do not work for you, you may want to consider ‘fillers.’ Fillers such as Restylane, Perlane or Juvederm, which are popular treatments for wrinkle and scars, can benefit the feet by providing a pillow for the ball of the foot. This procedure alleviates pressure that occurs with wearing high heels. Patient’s report they can wear heels for hours without discomfort. May last up to one year. Two syringes are generally needed. The average cost is $1000.00. 3.) Freezing fat- a new FDA cleared treatment. Zeltiq is a cool sculpting device that freezes fat cells (cryolipolysis) causing the fat to crystallize-this destroys the fat cells which are reabsorbed into the body. It is a non-surgical treatment for areas or pockets of fat that do not dissipate with exercise or diet. It is not for those who need to lose a lot of weight. It is indicated for those areas such as the love handles, belly, back fatty tissues that just won’t go away no matter what you do. This is a common problem as we age. Zeltiq stimulates fat removal up to several months. 4.) Many would like a younger looking neck- Ultherapy is a new non-surgical therapy that may help. What is it? Ultherapy is a non-surgical treatment that utilizes ultrasound therapy to treat tissue that is losing laxity. It targets the underlying tissue to regenerate new growth of collagen. The protein that is the foundation of the skin and is also found in muscle and underlying support tissue. There is slight warmth conducted during the procedure and treatment takes approximately 30 minutes. Various areas can be treated such as the neck, forehead, and jowls or full face. The full effect may take up to several months. Occasionally more than one treatment may be necessary. It is not a replacement for surgery however may be a good option for those who are not ready for surgery or where surgery is not indicated. 5.) Fillers for hollow eyes. Jill, one of the KGO listeners, called in to ask a question about a treatment she had seen on Dr Oz’s TV show for the area under the eyes, which becomes hollow or sunken as we age. Losing fat under the eyes as well as the cheeks is common. Fortunately ‘fillers’ such as Restylane and Juvederm can be very good options to replace the fat that has been lost with time. To find out if you are a candidate for the procedure have a consultation with a physician or registered nurse experienced in this procedure. 6.) Three of my favorite cosmetic picks: Winter moisturizers should be thicker in the wintertime as the environment is arid often resulting in dry skin. Look for creams as opposed to lotions. • Carol’s Daughter sage and shea foot butter-$10.50/1.7 oz. www.carolsdaughter.com You will find many wonderful body moisturizers on the web site. • Topix Resurfix Ultra Gentle Cleanser-$13.00/8oz. www.skinstore.com Great for sensitive skin. • Clinque Skin Supplies for Men-Age Defense Hydrator SPF 15-$30.00/1.7oz. www.Sephora.com The product Neova DNA Total Repair was given to one of the KGO listeners: Neova was featured on the TV show The Doctors for the following benefits: Repairs previous sun damage. Aids the skin to prevent future damage. Diminishes brown spots and fine lines.

09/18/2010 08:38 PM

KGO Update

Test your skin care savvy! Fact or Fiction 1.) You can shrink your pores. Fiction- A pore is an opening that allows for the excretion of oil (sebum). Pores do not open and close. Warm water does not open pores nor does cold water close them. However, pores do appear larger when they are congested with oil and dead skin cells. Exfoliating the skin will make pores look healthier; prevent acne and make the skin look smoother. Constant sun damage can break down the collagen and supportive layers of the skin and lead to permanent dilation of the pores. 2.) Cocoa butter can help prevent stretch marks. Fiction- There is no proof that cocoa butter prevents stretch marks. Some people have a genetic predisposition and will develop stretch marks, either due to a growth spurt or excessive weight gain. Fortunately there are treatments for stretch marks once they do occur. Vitamin A has proven to reduce them as well as certain laser treatments such as the Faxel laser which can help restore the texture, or the lasers that treat veins and redness like the V Beam. 3.) Ultra violet rays penetrate through the clouds. Fact- Some people believe they do not need sunscreen in the winter or on cloudy days. 80% of UV rays penetrate through the clouds. That is why sunscreen should be worn rain or shine. 4.) Facial exercises tone facial muscles and prevent the skin from sagging. Fiction- For some reason this myth continues to prevail! Nothing could be further from the truth. We exercise our face everyday through talking and expressions. Doing facial exercises will only contribute to wrinkles. 5.) Products that contain vitamin A thin the skin. Fiction- There has been over 30 years of research and studies on products containing vitamin A. Vitamin A helps regenerate new healthy skin cells and actually makes the skin thicker. For those just starting to use vitamin A look for retinol creams such as ROC or SkinCeuticals. If you are ready for the big guns ask your doctor for a prescription for tretinoin, such as Retin-A, Renova, Afissa or Tazorac. For sensitive skin you may consider Micro Retin-A. Begin with application two to three times per week, then gradually increase use to prevent too much irritation of the skin. 6.) Use creams that contain collagen to help stave off wrinkles. Fiction- Applying facial creams do make the skin appear smoother by temporarily plumping up the skin and softening wrinkles. Collagen is a protein and the basic foundation of the skin, however collagen molecules in cosmetic products are too large to penetrate the skin surface. Creams that contain collagen are basic moisturizers. 7. Shaving facial hair will make it grow back thicker. Fiction- I cannot tell you how many women are afraid to shave off either dark hair or short blond hair from the face fearing that they will grow a beard! We are born with only so many hair follicles and shaving will not make you develop more of them. At first when the hair starts to grow back the tip is coarser so it may appear thicker, but becomes less coarse as it continues to grow out. 8.) Antioxidants help prevent sun damage. Fact- Antioxidants are beneficial in preventing free radical damage caused by factors such as too much sun, stress, smoking, pollution and poor diet. New studies are indicating that the application of an antioxidant prior to your sunscreen will give added protection against photo damage (sun damage). There are skin care products available that contain antioxidants with sunscreen. Some antioxidants to look for include: Coenzyme Q10, Green tea, copper peptides, idebenone, vitamins C & E. My favorite cosmetic picks: • Alba Botanica Very Emollient Sunblock Mineral Protection SPF 30-$9.95/4 ounces- www.albabotanica.com • Avon Foot Works Overnight Renewing Foot Cream-emollient cream for the feet-$6.00/3.4oz.- www.avon.com • KP Duty, by Dermadoctor-$36.00/4oz. Great for dry skin or those prone to keratosis pilaris aka ‘chicken bumps.’ Contains the AHA glycolic, the antioxidant green tea and urea for humectant qualities. See www.dermadoctor.com for great skin care articles as well as products.

06/19/2010 11:17 AM

KGO Update

1.) The art of Botox… Botox has been the number one non-surgical treatment of choice for frown lines and ‘expression’ wrinkles for many years. It softens existing wrinkles and prevents further break down of collagen. I personally am in awe of many of the results I have seen. I also like the results of the newly FDA cleared Dysport, which works like Botox. As with any procedure, the practitioner injecting the product is just as important as the product itself. In inexperienced hands Botox or Dysport can cause a droopy eyelid, lower the brows, even difficulty swallowing, and other side effects. Botox and fillers, lasers treatments and all non-surgical procedures require thorough training, practice and continuing education. Fortunately, new and very useful techniques are continually evolving. There is a new technique called “Baby Botox” where Botox is injected in tiny or dilute amounts so it is effective in softening wrinkles, yet allows for some movement and expression. This technique is very popular among those who are 30 something. 2.) Laser treatments for toe fungus-aka onychomycosis. There are laser clinics sprouting up all over the Bay area to treat Toenail fungus. The plus is that lasers are great alternatives to oral medications, which can have side effects and cause liver damage.Also, topical medications do not seem to work well. The first step is to have a proper diagnosis, as some infections or skin diseases may mimic nail fungus. Seek a treatment from a board certified dermatologist. Typically, only one treatment is necessary, but depending on the severity, more than one may be needed. Cost is $800-1000.00 for the first treatment. If a second treatment is necessary many clinics will give a discount. To prevent fungus infection from recurring: Remember, fungi likes warm moist environments and can also spread to others. Use fungal powders daily.- Keep feet as dry and free of sweat as much as possible. Wear open toed shoes. Air out athletic shoes. Use cotton breathable socks. Avoid walking barefoot around public gyms and pools 3.) Eight ‘must have’ healthy skin care essentials & tips for travel or weekend get-a-ways. • For quick and simple cleansing of the skin use cleansing wipes. Try Boots Expert sensitive cleansing & toning wipes-$4.49/30. • Use a hydrating mist for flights or whenever your skin needs to feel refreshed or rehydrated. I love the Juice Beauty Hydrating Mist-$22.00/6oz. Use it after cleansing or through out the day. • Apply daily sunscreen for face, neck chest & hands. Buy two-one for your purse/tote and one for the hotel. Olay Complete Ageless Skin Renewing Lotion SPF 20-$24.99/2.5oz. SPF for the body-Aveeno Continuous Protection spray SPF 50-$8.49/5oz. • A primer is applied prior to foundation to make the foundation go on smoother and it even helps diminish fine lines (albeit temporarily). I like the ones that contain a sunscreen also. Two great ones to try include: Victoria’s Secret Primer FX Face Primer w/ SPF 20-$14.00/ 2 oz., or Colorscience $45.00/1oz. • Mineral make-up for flawless looking skin-it is also easy to apply throughout the day when needed and contain sun protection. Colorscience $50.00/compact. • If you are going to be boating, snorkeling, swimming, etc. and can’t avoid sun exposure leave the retinols, beta & alpha hydroxy acids at home, as they make your skin more sensitive to the effects of the sun. Instead use a scrub when you need to exfoliate such as Garnier Nutri-Pure Microbead Cream Scrub -$6.49/5oz. • Rather than tanning your face, fake it with a bronzer like Neutrogena Healthy Skin Blends-$10.99/compact. • Look fabulous with fashionable hats, cover-ups and glasses by Shady Ladyproducts.com or athleta.com 4.) New implant for enhancing the lips. If you’re tired of having your lips plumped or fine lines around the mouth treated with ‘fillers’ and you’re looking for something more permanent consider the PermaLip implant. This is an in-office procedure, preferably performed by a board certified plastic surgeon. The implant comes in various sizes. You and your surgeon can choose the desired size. I recommend consulting with a plastic surgeon to discuss the procedure and viewing before and after photos. The cost is approximately $3000-5000.00 5.) The Vitamin D controversy never ends. When it comes to sun exposure should you or shouldn’t you? There is no question that there are pros and cons when discussing how to get your vitamin D. Everyone agrees it is essential as vitamin D is beneficial for the immune system & allows the body to absorb calcium for healthy bones. Low levels of vitamin D has been linked to depression. There are some health professionals who recommend 10-15 minutes of sun exposure 3 times per week. Many in the medical field believe that is risky and that it is best to get adequate vitamin D through food and supplements. The cons of sun exposure include increased risk of skin cancer, brown spots photodamage, and wrinkles, and other benign growths. In addition, some people suffer from polymorphous light eruption, which results in rash and bumps. Risk factors include skin tone, personal history or family history of skin cancer. Those with fair skin, light eyes & blond or red hair color are more prone to the risk of skin cancer. That is not to say those with darker skin should not wear sunscreen and practice safe sun as well. Some medications such as antibiotics and anti depressants increase the risk of sun sensitivity. Certain diseases, such as discoid lupus or HIV, also increase the skin’s sensitivity to the sun. The Nat’l Osteoporosis foundation recommends an RDA (recommended daily allowance) of 1000 IU of Vitamin D for adults over age 50. However, many doctors are recommending 2000-5000 IU. Of course the amount recommend is determined by a simple blood test. Normal levels range between 32-100. For a skin cancer self-exam lit go to: www.chooseskinhealth.com 6.) Best hair removal procedures for bikini season. • Shaving-If you are prone to razor burn, it is best to shave after bathing while the skin is moist. Apply AHA’s at night to exfoliate and prevent ingrown hair from forming. (Common areas for ingrown hair to occur are on the face, neck and bikini area). • Waxing-This is very effective means to achieve a smooth surface, however the hair needs to be approximately ¼ of an inch long for effective removal. • Laser hair removal-This is fantastic if you want to get rid of the hair for good. Keep in mind it does take more than one treatment and can be expensive-stating at $200.00 per treatment. Some offices have made it affordable by offering packages (multiple treatments) you can purchase at a discount. • Tip-avoid sunbathing several days after ant type of hair removal, as this can cause a dark skin discoloration of the treated area. 7.) Five most popular non-surgical procedures: • Botox • Hyaluronic fillers • Chemical peels • Laser hair removal • Microdermabration 8.) My favorite cosmetic picks. I have three fabulous picks under $25.00. • Yes To Carrots-hydrating body lotion w/SPF 30-$14.99/4.2oz. Drugstore.com. • Expert sensitive cleansing wipes, by Boots-$4.49/30 wipes. Drugstore.com, Walgreens & CVS. • Too Faced-Tanning bed in a tube-$22.50/6oz. Sephora.com Listeners may contact the office of Mark Isaacs, M.D. for complementary consultations @ #925-945-8656.

02/06/2010 08:51 PM

KGO Update

1.) Patients and consumers often write to me asking about the best cosmetic creams that will erase or diminish wrinkles. First of all it is important to understand the manifestation of a wrinkle, which is a result of many factors: from our individual genetic makeup to facial movement to how we take care of our skin. Cosmetic creams will work up to a point and are especially beneficial for fine lines, brown spots, and poor texture. However, there are other parts of the facial anatomy that contribute to winkles or sagging skin. The epidermis and the dermis lose collagen and elastin as we age. Collagen and elastin are proteins that form the basic foundation of the skin. In addition, there are multiple layers under the skin including the subcutaneous (fat) layer, muscle and bone. Did you know that the support layers under the skin also lose collagen and elastin? As we age, the loss of collagen and elastin as well as facial fat contribute to wrinkles. A cosmetic product can be great for the skin, at best penetrating into the epidermis; however, cosmetics cannot target the deeper layers under the skin or minimize sagging. This frustrates many, especially those who purchase product after product anticipating results. There are non-surgical options, such as peels, fillers, Botox, and lasers. When this isn’t enough, surgery may be the answer. 2.) There has been a lot of controversy about before and after photos in beauty/cosmetic advertisements. Consumers need to know what to look for and how to discern what is real and what is unrealistic. Most of us know by now that not all models in photos are realistically portrayed. With photoshopping, lighting and positioning of the face or body, the appearance of models can be enhanced. This creates two issues: 1) The unrealistic photos make many of us, especially impressionable young girls, feel inadequate: and 2) the misleading ads entice us to want to purchase useless products so that we can look like them. This is true for both cosmetic creams for wrinkles and for cellulite. Please be aware that most photos of models are photoshopped- this is a known fact in the industry. And I’m talking about models that are already fabulous looking. In ads for cosmetic creams, lighting can be altered to make the model look older or younger, depending on the angle. When the light is directed at the face this diminishes wrinkles. On the other hand when it is above or from the side the light will cast shadows making wrinkles appear more noticeable. Rather than deciding to purchase a cosmetic product based on the ‘before & after,’ do your own research on-line or ask a professional about its indications and efficacy. See the news story about how this topic affected young women in Seattle: http://www.examiner.com/x-1146-Seattle-Eastside-Parenting-Examiners~y2008m12d18-Truth-about-photoshopping-in-advertising--See-the-before-and-after-pictures 3.) The best of age defying cosmetics- when you want results, this is what you need. There are ingredients that can do wonders for the skin. Here is what to look for: Acne: If your concern is acne, look for the ingredients salicylic or benzoyl peroxide. Fine lines: Retinoids or vitamin A derivatives are the gold standard and have been proven to boost collagen. For the big guns ask your doctor for a prescription for tretinoin (Retin-A). Dark spots: Hydroquinone, licorice extract or vitamin C are known for their ability to lighten sun spots and brown discolorations. Hydroquinone 2% is found over-the-counter. Hydroquinone 4% is available by prescription if you find 2% ineffective. Redness: Azelaic acid is a good choice for those who suffer from rosacea. Azelaic acid is available in the form of a product called Finacea, which is also by prescription. (Lasers that target veins are also a good option for facial redness and rosacea.) Poor texture/sun damage: Glycolic acid and lactic acid are fabulous for helping the skin slough off that dull dead layer on the surface of the skin. Both acids loosen the ‘glue’ that hold the dead skin cells together making the skin appear smoother, refined and giving it a lovely glow. Dry skin: Shea butter and coco butter are the go to ingredients when you need a thicker moisturizer. If you find that none of the above works for you then it is time to seek out a professional esthetician, nurse or dermatologist. 4.) Five habits you should always avoid for healthy beautiful skin: 1) Don’t pick your pimples. The pimple usually ends up looking worse, as picking it either causes more redness or a dark spot from the trauma to the skin. I’ve seen many scars as a result of patients picking a pimple. Leave it to the professionals by visiting an esthetician. 2) Don’t go to bed without cleansing your face and especially with make-up! This is important for two reasons. You need to remove oil, sweat, pollution and make-up from your skin everyday. Secondly, bedtime is the best time to apply cosmetic/treatment creams and lotions. This allows better penetration of your products. Sleeping allows the body/skin to repair and rejuvenate. 3) Don’t over cleanse the face. Cleansing two times per day is adequate. Those who suffer from acne or have oily skin have a tendency to over cleanse, scrub & exfoliate. This usually exacerbates the problem, as over cleansing will make the oil glands produce even more oil. Instead try using oil blotting papers through out the day when necessary. Use translucent powders, and oil free moisturizers and make-up. At night use the appropriate treatment for the acne such as benzoyl peroxide salicylic acid, Retin-A or a prescription medication from your dermatologist. Try Free and Clear oil blotting papers and Neutrogena Sheer dry Touch sunscreen. 4) Don’t eat too much junk food. An occasional Snickers bar is OK, but for the health of your skin and body, don’t overdose on junk food. In the past, health experts thought diet didn’t affect the skin. Studies find not indulging too much in junk food and consuming a healthy diet is best for your skin as well as your weight. Foods high on the glycemic index, such as overly processed sugary foods do contribute to acne. High-glycemic foods trigger a chain of events in the body making blood sugar rise, which increases insulin thus stimulating oil-producing hormones. 5) Don’t skip the sunscreen because it is cloudy or its wintertime or because you “don’t spend much time in the sun.” The effects of the sun are cumulative. When you are exposed to 10 minutes walking the dog or 20 minutes driving to work, plus the many errands you do, it adds up. Apply a moisturizer that contains a sunscreen every morning as soon as you get out of the shower. 5.) The latest study about lead in lipsticks. The Campaign For Safe Cosmetics raised some concerns about the amount of lead found in lipsticks. This concern over the possible safety of lipstick was brought to the attention of the FDA. Using a highly sensitive detection method the FDA tested 20 shades of lipstick including 10 brands. The study revealed small amounts of lead in the lipstick. However, these amounts were considered trace amounts and not a safety concern in a product applied topically. The FDA limits lead in color additives to a maximum of 20 parts per million (ppm). The average amount found in the tested lipsticks was 1.07 ppm. If you still have concern about lead in your lipstick go to FDA.org or www.safecosmetics.org for the lipsticks tested and recommendations on lipsticks that have been found to have trace amounts. By the way, the amount allowed in candy is 0.1ppm. 6.) Silicone parties-people putting themselves at risk for beauty! The Associated press released a story this month about ‘pump-up’ parties. In spite of all the cautions there are still many who are participating in beauty/cosmetic parties often with someone administering the treatments without a medical license. A party is not an appropriate place to have a medical treatment. There have been reports that some of the silicone injected was not even medical grade. Large doses of silicone have been used to inject the buttocks and breasts. In lieu of silicone sometimes Paraffin and petroleum jelly were used for the treatments. Some treatments resulted in kidney failure, chronic pain where the treatment was administered and even death. A desperate need to look good makes some people go into unsafe territories. A medical office is the only place to have a cosmetic treatment 7.) My favorite cosmetic picks. Plus, Valentine gift giving ideas: There are Valentine weekend get-away packages for couples available from Napa to Monterey. Juice Beauty is offering a travel package- ‘Organics To Go.’ This travel kit is convenient for a romantic weekend away. It includes five travel size best selling products: 1. Cleansing milk, 2. Green Apple Peel, 3. Antioxidant serum, 4. Hydrating Mist, 5. Nutrient Moisturizer, 6. Organic Bamboo Washcloth. Available at www.beauty.com $29.00/6 piece set. Before an evening out with your Valentine, try one of the following masks for fresh, smooth, beautiful skin: Zia 15 minute Face Lift with plumping wheat proteins and seaweed extracts-$20.95 found at most health food stores or www.zianaturals.com Or Sephora Power Mask-Hydrogel Face Mask, with hydrating hyaluronic acid-$10.00 Found at Sephora or www.sephora.com For luscious lips- Murad Soothing Lip Therapy-$15.00/.5oz. Italian chocolates by Holy Orders. $25.00 includes one dark and light. Dark chocolate is rich in anti-oxidants, which is good for the skin. www.holyorders.biz Claremont Resort & Spa in Berkeley Valentines signature spa for two: $214.00 each. Special package available February 13 & 14. App: 510-549-8566. Listener questions posed this morning on Joanie Greggain’s show include concern over lack of vitamin D, ‘Save My Face Pillow,’ loss of facial volume, and non-surgical treatments:   An important part of a healthy lifestyle is getting the rest your body requires. Recent studies indicate sleep is important to decrease the stress in our lives. Sleep allows the body to repair and replenish itself. The average adult requires eight hours of sleep per night. To minimize 'sleep' wrinkles due to constant tugging and pressure on your face, try sleeping on your back. If this is difficult for you try the 'Save My Face Pillow’ which will help ease the constant friction and creasing of the face. I'm certain you will find it very comfortable: www.savemyface.com Turn back the hands of time with fillers, volumizers and plumpers.  Replacing facial fat loss is more popular than ever and often referred to as the “liquid face-lift.” There was a recent article in The New Yorker about how Madonna, Demi Moore and other fabulous looking actors are looking younger and fresher without appearing to have had surgery. The article alluded that they had had the liquid face-lift. There are many changes that occur to our faces and bodies that make us look older. One is the superficial layer of skin that becomes discolored, blotchy and less toned as we age. Underneath this superficial layer is the foundation of fat, muscle and bone. This is where the aging process really begins to manifest. Restoring the fatty layer helps create fullness, firmness and a more youthful looking face. Think of restoring or re-stuffing a pillow or upholstery. It is the same concept in that it makes you look new again! Combinations of products are used to restore facial volume, which include hyaluronic acids such as, Restylane®, Perlane®, Juvederm™, and Radiesse®, Sculptra® and fat transfers. Vitamin D: Are you getting enough of the sunshine vitamin? Vitamin D deficiency is becoming endemic. Over one million people will be diagnosed with skin cancer this year, so it is no surprise dermatologists are telling you to wear sunscreen to protect your skin from skin cancer, such as melanoma, which can be fatal. Confused?  Understandably. Many factors contribute to inadequate levels of Vitamin D: the amount of sun exposure, darker skin, how far north you live and age over sixty. There are foods that supply vitamin D such as salmon, mackerel, tuna, Sardines and egg yokes. While some foods are fortified such as milk, orange juice, cereals and some soy milks, it is difficult to get adequate vitamin D with food alone. A supplement may be necessary. The skin manufactures Vitamin D by being exposed to the sun (UVB). According to the Berkeley Wellness Letter-fifteen minutes of sun exposure two to three times per week may help the body produce enough of the sunshine vitamin.  Before taking supplements or sunbathing be sure to ask your doctor for the simple blood test that will determine whether or not your vitamin D is within normal limits. Many physicians are recommending 1000 units per day. If you do decide on a little sun exposure, put sunscreen on your face neck, chest and hands to help minimize sunspots and dark discolorations that commonly affect those areas. Additional products recommended on the show: • Olay Pro-X line with retinol • Olay Regenerist Microsculpting Cream

12/12/2009 10:17 PM

Gift Giving Ideas from Joanie Greggains’ Show

Joanie’s Annual Holiday Gift Giving Show for 2009 The following are a few fabulous gift giving ideas for those who love to pamper themselves: The Best of Bliss Set- $45.00- www.blissworld.com • Includes Lemon and Sage Body Butter • Lemon and Sage Soap • Triple Oxygen Energizing Mask • Foaming Face Wash • Best of Skintentions Packet The Winter Escape, by Philosophy- $25.00- Sephora or www.sephora.com • Peppermint cocoa shower gel, shampoo, or bubble bath • Melting Marshmallow body souffle' • Marshmallow Flavored Lip Shine Great Skin Home and Away, by Clinque- $59.00- Nordstroms or www.nordstrom.com Gift set includes both full size and travel size. • Liquid Facial Mild Soap • Clarifying Lotion • Dramatically Different Moisturizing Lotion Cherry Blossom Hugs and Kisses, by L'Occitane- $18.00- www.beauty.com • Lip gloss • Hand cream Herbal Works Eros 5-step natural skin care for men- $39.99- www.costco.com • Cleanser 8 oz - gentle formula that leaves the skin smooth and fresh. • Experience a smooth shave like no other; your face will be baby soft! • Skin Soother - mist your face, refresh the skin. • Body Moisturizer - moisturize your hands and body; all women love a soft touch! • Cologne Alcohol Free - spray your body with this manly, yet sporty and fresh. Gift certificates are a great gift and available at: • Skin care clinics • Salons • Dermatologist’s clinics and medical offices that offer cosmetic treatments Hemp Heroes, from The Body Shop-$24.00- www.thebodyshop-usa.com • Hemp Hand Protector • Hemp Body Butter • Hemp Lip Protector • Hemp Foot protector Sugar Wish, by Fresh-$28.00($55.00 value)- www.sephora.com • Sugar Lip Treatment • Brown Sugar Body Cream Clarisonic Skin Care System, $195.00 www.blissworld.com Device that cleanses gently, yet thoroughly. Proper cleansing allows your products to penetrate better. Includes: • Clarisonic skin care brush • Replacement brush • Charger • Trial size cleanser

10/24/2009 05:16 PM

KGO Update

1.) At-home anti-aging devices-- Do they work? Cost ranges from $150-$800. Are they worth the cost? Recently there has been a host of at-home light generated therapy available for the treatment of wrinkles, dark spots, poor texture, and even acne. The technology is LED-phototherapy. These treatments are similar to the ones offered in a doctor’s office. Of course they are not as powerful as the professional devices, however studies indicate they do prove to be effective. It will take diligence on your part if you want to see results. Follow the instructions and use it consistently, as more treatments will be necessary to obtain the desired results, compared to a professional device. The following is a list of available LED therapy units: • Omnilux New-U-$225.00 • Baby Quasar-$379.00 • Ansr-$195.00 • Tanda Regenerate-$275.00/starter kit. Light therapy for the treatment of acne. Certain wavelengths effectively destroy P. Acne bacteria, which are responsible for the cause of acne. Four to consider are: • Omnilux Clear-U-$225.00 • Quasar Light Therapy Baby Blue-$279.00 • Tanda Clear- $250.00/starter kit • Ansr: $195.00 treats both fine lines & acne. For purchase go www.skincarerx.com or www.blissworld.com Tip: If you wear a daily sunscreen and apply Retinoids (Vitamin A. tretinoin, retinol) before bedtime the results will be even more dramatic. Retinoids have proved to regenerate collagen and daily sun protection helps stave off the signs of premature aging in the first place. 2.) Healthy foods for healthy skin. Many years ago chocolate, fries, sodas, and certain foods were thought to be the cause of acne. Then to the relief of some this belief was dispelled. However, new studies are proving that wasn’t such far-out thinking. Processed foods, too much sugar, high glycemic index and junk foods are likely contributing factors for acne, poor texture and even wrinkles. I’m sure you have heard by now that the ant- inflammatory diet has been touted to reduce risk of disease and promote health. There are many books on the subject-The Zone and The Mediterranean Diet are considered anti-inflammatory diets. Choose a diet that is good for your heart it will be good for your skin. Think low trans fats, lean meat, fish, tofu, fruits and veggies and a rainbow of colors. Consider foods low on the glycemic index such as whole grains, multi grains, brown rice, rolled oats, barley, beans, broccoli, cabbage, grapefruit, apples and peaches. For Antioxidants-consume plenty of fruits and vegetables. They are rich in polyphenols, which are healing antioxidants. There isn’t one that is best- chose a variety of fruits and veggies. Foods rich in Omega 3-such as walnuts, flax seeds, fish oil. (Buy whole flax seeds in bulk and grind them in a coffee grinder-add a tbs. to your cereal in the morning). Other good fats include walnut oil, olive oil & safflower oil for essential fatty acids are good for skin hydration. Application of quality skin care products, as well as sunscreen is beneficial for the skin. However a nutritious diet is not only good for your skin, but also essential for your general health. For more information check out: ‘The anti-Inflammation Zone: Reversing The Silent Epidemic That’s Destroying Our Health,’ By Barry Sears. 3.) ‘Identical twin study’ New study comparing twins and how their individual lifestyles made their age gap appear 10-15 years apart. New research published recently in Plastic and Reconstructive Surgery, by Dr. Bahman Guyuron, proved how lifestyle affects our appearance and more importantly our general health. Our lifestyle has more of an influence on us than we realize. The following are factors found in his study that influence our appearance: Excess Weight: Weight on women over 40 made them appear younger by softening wrinkle and folds, whereas extra pounds made women under forty appear older by obscuring a smooth jaw line. Estrogen: The study revealed that women on estrogen-either birth control pills or HRT- appeared younger. Estrogen improves the skin’s elasticity. Estrogen has its benefits as well as health risks and is contraindicated for some, especially those with breast cancer or a family history of breast cancer. Intake of alcohol: Drinking in moderation does not prove to be harmful. Some studies have shown that resveratrol (found in red wine) may even delay aging. However, excessive amounts of alcohol can damage blood vessels in the skin. Too much alcohol damages the liver, which plays a major role in the quantity and quality of collagen production. Sun exposure: Twins who sunbathed appears up to ten years older than their sisters. Over exposure to the sun caused, mottled skin, wrinkles, poor texture, loss of elasticity, and redness due to breakdown of the blood vessel wall. Smoking: No surprise here! Smoking deprives the skin of oxygen, depletes the body of vitamin C, not to mention the constant pursing of the lips resulting in smokers lines. 4.) Latisse for eyelash enhancement is getting rave reviews! Latisse is a topical product applied directly to the base of the lash line to help grow longer, thicker and even darker lashes. Latisse is the result of a side affect from a medication called Lumigan, which is for the treatment of glaucoma. Results start to manifest within 8 weeks and then peak at 16 weeks. After the desired results are achieved then application is only 3 times per week to maintain results. 5. ) Be aware of the ‘30-day free trial’ scam. I’m not saying it is not convenient to shop on line or that it is not an occasionally good deal if you are careful. The company will have your credit card information and you will be charged if you don’t cancel within a prescribed time. Oftentimes it is NOT convenient or easy to reach a company to cancel. Many companies use this technique of ‘free trial’ not only to introduce consumers to their product, but because they expect a certain number of people will forget or get lazy about canceling, until they see their credit card bill after the fact, perhaps two shipments later. Me? Knowing myself, I would not take the chance. My favorite cosmetic picks (under $30): • Trader Joe’s Face and Body sunscreen with zinc oxide- 30-6oz./$5.99 • Kinerase Hydrating Mist- 6.6oz. /$35.00 www.kinerase.com • Juice Beauty Green Apple Sunscreen/Moisturizer for the body-10oz/$29.00 • Available at www.Sephora.com • Juice Beauty Oil Free Facial Moisturizer-2oz/$28.00 Listeners may call the office of Mark Isaacs, M.D. at 925-945-8656 for a complimentary skin care consultation. Vein Specialists of Northern California 1981 North Broadway, Site 427 Walnut Creek, Ca. 94596

08/01/2009 08:51 PM

KGO Update

Test Yourself: Myth or Truth? 1.) Self-tanners provide protection from the sun. 2.) UV rays emitted from indoor beds tanning are safer than outdoor sunbathing. 3.) Avoid skin care products with alcohol. 4.) The higher the SPF the better the protection. 5.) Facial exercises tone facial muscles making you appear younger. 6.) Skin cancer is the most prevalent of all cancers in the U.S. 7.) Shaving facial hair will make it grow back thicker. 8.) It is not necessary to use a toner after cleansing. 9.) Vitamin A thins the skin. 10.) Natural chemical free products are best for healthy skin. For Answers click here Skin Cancer: 1 in 5 Americans will develop skin cancer in a lifetime. Fortunately, when detected early most cases can be successfully treated. Melanoma is an uncontrolled growth of pigment producing cells and is the most serious form of skin cancer. Melanoma may appear suddenly or appear on an existing mole. Sign and symptoms to look for include: Asymmetry: One half is unlike the other half Boarder: irregular, scalloped or poorly defined boarder. Color: Color is varied from one area to another: shades of tan, brown, black, red blue or white. Diameter: typically, 6mm or larger (the size of a pencil eraser), however they can be smaller. Evolving: Change in appearance of any skin growth or mole. Free skin cancer screenings go to: http://www.skincancer.org/tour/tourbystate.php On August 23 between 10am-4pm at Justin Herman Plaza (1 Market Street-San Francisco) Natural vs Synthetic: Consumer are more concerned then ever about what they put in and on their bodies. Keep in mind, natural isn’t always good and chemical or synthetic isn’t always bad. Some natural ingredients, such as those found in essential oils, can be irritating to the skin. They include bergamot, peppermint, grapefruit, and cinnamon. According to the Safe Cosmetics Campaign the following should be avoided when possible: parabens, sodium laureth/sodium laurel sulfate, petroleum, phthalates, and formaldehyde. You will have to judge for yourself. Lets take them one at a time: Parabens, which include methyl, ethyl, propyl and butyl, are used as preservatives. These ingredients are very effective in preventing the growth of bacteria, fungus and mold. At this time it is used in a majority of skin care products (and even in food items) due to its stability and efficacy. *Cosmetic products without preservatives should be refrigerated. With all products, use a spatula, not your fingers, when dipping into a jar or container to prevent bacterial growth and contamination. Sodium laureth/laurel sulfates are commonly used in cleaners and can cause skin irritation. Most people do not have difficulty with these ingredients, but if you have sensitive skin, rosacea or are prone to acne you can find adequate cleansers made with plant oils. Products with petroleum such as Vaseline have been around for many years and are even used in hospitals to treat wounds and for basic skin care. If you are uncomfortable with this there are many moisturizing alternatives to try such as glycerin, beeswax, or natural plant oils. Consumer concern about the safety of Phthalates, which include, diethyl, dibutyl and dimethyl phthalates continues to grow. Phthalates are plasticizers and are commonly used in nail polish, hairsprays and fragrances. Animal studies with phthalates caused birth defects, liver disease, reproductive impairment among males, and a list of other adverse symptoms. At this time scientists don’t know what effect small amounts of phthalates have on humans, but small amounts have been found in urine. Some companies have voluntarily removed phthalates from their products in response to consumer concerns. They include OPI, Sally Hansen, Avon, Cover Girl, Estee Lauder, Max Factor, Orly and Revlon among others. Formaldehyde is a preservative and is not used as much as in the past due to its reaction with other chemicals called amines. This combination can form nitrosamines, which are carcinogenic. Products without formaldehyde are common and easy to find. For a complete list see www.safecosmetics.org My favorite cosmetic picks: Jergens Natural Glow Foaming Daily Moisturizer-$6.79/5OZ. www.drugstore.com, CVS or Walgreens. Holy Orders Shea Butter Lotion, Lavender scented-$12.75/4OZ. www.holyorders.biz Neutrogena Sensitive Skin Sunblock with SPF 60-$9.99/3OZ. CVS or Walgreens. Target Oil Free Eye Make-up Remover-$4.55/4OZ. Target or target.com Please, contact the office of mark Isaacs, M.D. @ 925-945-8656 for a complementary consultation with Deborah. www.RN4beautifulskin.com

04/11/2009 09:15 PM

KGO Update

1.) Varicose Veins: Have you noticed aching, throbbing, heaviness, itching, pressure or fatigue of the legs? These symptoms, including restless leg syndrome, may be signs of varicose veins. Varicose veins occur when the one-way valves that prevent back-flow of blood traveling to the lungs become faulty and weak. As pressure builds the veins become enlarged, weak and ropy in their appearance. Fortunately, the days of stripping the veins through surgery are rarely used. Diagnosis with ultrasound is the first step so the physician can get a clear picture of the vein. After the diagnosis, one of the two out patient procedures may be performed: Foam sclerotherapy in which the vein is injected with a foaming agent called sodium tetradecyl sulfate (STS), this agent irritates the vein to make it collapse. Or Endovenous laser treatment, EVLT® uses laser energy delivered in a thin fiber optic probe to treat the underlying cause of the varicose vein. Either treatment is performed in less than an hour. On the other hand if your concerns are small superficial spider veins, which are more common in women, as female hormones may cause relaxation of vein walls, the treatment involves injections with a tiny needle and the sclerosing agent STS. Some contributing factors include genetics, age, standing for long periods of time and pregnancy. Some preventative measures that may help include: Exercise, Weight control, Leg elevation, Avoidance of long periods of sitting or standing, wear compress stockings when taking a long airplane trip or car rides. Mark Isaacs, M.D. was chosen as one of the top ten phlebologists in the U.S., by his peers. For more information please go to misaacs@veinspec.com or call 1- 800-200-VEIN 2.) Laser treatments for wrinkles: When CO2 ablative lasers for the treatment of wrinkles were first introduced to plastic surgeons and dermatologists in the early 1990’s everyone was very excited. Fine to medium wrinkles could be eradicated and deep ones softened in addition to toning the face and repairing sun damage. However, the downside was that in many patients the healing took a lot longer than anticipated and redness persisted up to three to six months. In the mid nineties non-ablative lasers became popular-the only problem was that more than one treatment was necessary and the results were not very impressive, as a result, they were not worth the cost. The latest generation of lasers, called the fractional lasers, is proving to deliver what they promise. The laser light is the same technology as the CO2 laser of the early nineties, however the laser beam is delivered in micro columns of light (think pixilated dots on an LCD television) leaving healthy tissue in between the affected areas, which allows for faster healing. The fractional lasers have also been cleared for the treatment of hyperpigmentation. Ask your dermatologist or plastic surgeon about Fraxel Repair, UltraPulse Active FX or SmartXide DOT. 3.) Cellulite: In the past we discussed radiofrequency treatments for wrinkles and toning the face, such as the Thermage. That same technology is now being used to smooth cellulite on the thighs and other problem areas. Of course exercise and diet will help. Even when patients are within their normal weight, the dimply texture may be noticeable. There is a genetic predisposition. Other light treatments include VelaShape and VelaSmooth. Even liposuction may not smooth cellulite entirely. I read that on the horizon scientists are studying Viagra for cellulite to presumably burn the fat underlying cellulite and improve circulation- Go figure! 4.) Cost effective tips for beautiful skin: Save your money for the products that treat the skin and make a difference such as AHAs, Retin-A, peptides and antioxidants. Purchase cleansers, sunscreen and moisturizers at drug stores like Long’s and Walgreen’s. Instead of using Renova (up to $170.00/tube) try mixing tretinoin (Retin-A) with a plain moisturizer: Blend half and half and apply at night. OTC sunscreens that contain zinc or titanium can be mixed with liquid foundation to decrease the whitish tint. Try Neutrogena for sensitive skin, with zinc oxide. Mix your favorite facial mineral powder with moisturizer for a liquid foundation and better coverage. Apply masks at home: see www.about.com and go to ‘beauty’ then type in home made masks. Have a facial at a school for estheticians. To exfoliate the body, use a loofa or back brush prior to bathing or showering while skin is still dry. Brush arms and legs in an upward motion, using small strokes, starting at the feet and then hands moving towards the heart. It’s true what they say about beauty sleep- when you are well rested and get adequate sleep it manifests in the color, texture and glow of your skin-try it! 5.) Vitamin D: Are you getting enough of the sunshine vitamin? Vitamin D deficiency is becoming endemic. Over one million people will be diagnosed with skin cancer this year, so it is no surprise dermatologists are telling you to wear sunscreen to protect your skin from skin cancer, such as melanoma, which can be fatal. Confused? Understandably. Many factors contribute to inadequate levels of Vitamin D: the amount of sun exposure, darker skin, how far north you live and age over sixty. There are foods that supply vitamin D such as salmon, mackerel, tuna, Sardines and egg yokes. While some foods are fortified such as milk, orange juice, cereals and some soy milks, it is difficult to get adequate vitamin D with food alone. A supplement may be necessary. The skin manufactures Vitamin D by being exposed to the sun (UVB). According to the Berkeley Wellness Letter-fifteen minutes of sun exposure two to three times per week may help the body produce enough of the sunshine vitamin. Before taking supplements or sunbathing be sure to ask your doctor for the simple blood test that will determine whether or not your vitamin D is within normal limits. Many physicians are recommending 1000 units per day. If you do decide on a little sun exposure, put sunscreen on your face neck, chest and hands to help minimize sunspots and dark discolorations that commonly affect those areas. 6.) Reloxin (Medicis) may be FDA approved within the year for the treatment of frown lines. Reloxin is the first to rival Botox® Cosmetic. According to the latest in cosmetic/medical news, it won’t be the last, as several more ‘muscle relaxers’ are expected with in a year or two. Originally, Botox was FDA approved for the treatment of strabismus (crossed eyes) and blepharospasms (eye spasms). Botox cosmetic has had a corner on the market since its approval for frown lines in 2002. Both Reloxin and Botox Cosmetic are derived from botulinum toxin type A. However according to Medicis, manufacturer of Reloxin, the onset is faster and lasts just as long. *Botox Cosmetic is also approved for the treatment of profuse sweating (hyperhidrosis) and on average lasts up to 6-8 months for hyperhidrosis. For wrinkles the average result is 4-6 months. 7.) Is there a difference between skin care products sold in a doctors office versus over-the-counter? I would place skin care products in three separate categories: OTC: over the counter products are great when your want to purchase moisturizers, sunscreens and cleansers. There are some OTO products that contain peptides, alpha hydroxy and beta hydroxy acids as well as retinols. These less potent products are a great place to start if you are new to treatment products or have sensitive skin. Skin care clinic /salon: If you want to see dramatic results then purchase your products in a licensed facility, such as salon or skin care clinic. You get the assistance of a professional who has knowledge and has been educated about the products. Many professional products can be purchased at Sephora or on line. However, it may be difficult to determine which products are best for your skin type and the products indication without the assistance of a professional. Medical office: There are many products, such as the Obagi skin care system, which are only available in a medical office. Some of the products are formulated with prescription strength ingredients. Companies, like Obagi or SkinCeuticals prefer the exclusivity of a physician’s office. This ensures the patient receives proper instruction on the use of the product and there is less risk of the product being misused. 8.) Four favorite cosmetic picks: • Aveda Intensive Hydrating Mask for dry skin: $20/5oz.- Aveda specialty stores through out the bay area or www.aveda.com *Tip-use it on your hands while giving yourself a manicure. • Safeway Cleansing & Make-up Remover Towelettes: $3.49/30-Safeway • Neutrogena Moisture Shine Lipstick SPF 20: $9.49/tube- Longs or Walgreens. • Coolibar Shadz; Sunglasses for children: $12.95-www.coolibar.com

01/10/2009 06:47 AM

KGO Update

1.) I’m very excited about this newly FDA approved eyelash conditioner: Latisse. Latisse is a product produced by Allergan (manufacturers of Botox Cosmetic). This conditioning eyelash product actually makes lashes thicker and longer. It is derived from a seven-year-old glaucoma drug. One of the side effects, that was reported by patients and noted by physicians, is enhanced eyelashes. Latisse is applied to the base of the upper lashes one time per day. Allergan indicates results will be seen within eight weeks. Reports of itching and redness occurred in 4% of the clinical trial participants. If Latisse is discontinued, lashes will go back to baseline. Allergan will investigate other uses for this product such as eyebrow growth and baldness. Latisse will be launched in February. Estimate cost will be $120.00 for a one-month supply. 2.) ‘Liposuction’ vs. ‘liposculpture’: Oftentimes the two words are used interchangeably. Both procedures involve the surgical removal of unwanted fat deposits that are difficult to lose through diet and exercise. Liposuction was developed in the late seventies and involved a larger canula, thus bigger incisions and prolonged healing time. In addition liposuction was primarily used for larger areas such as thighs, abdomen and buttocks. Liposculture is a vernacular defining a more refined technique: a smaller canula and tiny incisions to remove fat thereby sculpting and shaping the body such as a double chin and smaller pockets of fat as well as thighs, abs and buttocks. 3.) It’s January and by now everyone is feeling the effects of a dryer climate from indoor heating, fireplaces, lack of humidity. These wintry conditions result in dry, chapped, flakey skin, which can even be painful. Dry heat also affects the scalp. Perhaps its time to change to your winter routine: • Switch to cream cleansers for the face: try Cetaphil or Neutrogena Sensitive Skin Solutions Cream Cleanser. $9.00/5oz • Upgrade the thickness of your moisturizer, i.e. if you use a lotion switch to a cream • For the body, avoid soap (especially deodorant soap) and use moisturizing cleansers such as those made by Aveeno, Dove, or Olay. • Apply moisturizer while skin is damp to lock in moisture. Try Curel Ultra Healing • Lotion $7.00/13oz. You still need sun protection in the wintertime. • Dual Defense Moisturizer by www.DHCcare.com has a good moisturizer with sunscreen. $27.00/3.5oz. Sometimes the corners of the mouth become cracked. Apply lip balm to the corners. Take care not to apply AHA or retinols to the corners of the mouth. If redness is persistent at the corners that may be an indication of a fungal infection-see your dermatologist for topical treatment creams. A humidifier may be a good investment to add moisture to your home. This one is a tough one for me!1 It is best to avoid long hot baths and showers as this saps moisture for the skin and scalp. It is helpful to exfoliate the skin either with a loofa or body scrubs. This helps your moisturizer to penetrate better. Try Kiehl’s Cream de Corps Soymilk & Honey Body Polish-- fabulous scent! Use olive oil on elbows, knees, and hands. For the scalp use your moisturizer or tea tree oil on your scalp the night before you plan to wash your hair. 4.) Many women begin to notice gradual changes in the skin starting around age forty. Perhaps dark spots, a ruddy complexion, and wrinkles start to become apparent. However, somewhere around age fifty changes seem to happen overnight! Deeper lines, darker spots, rough texture and more… Of course, lifestyle plays a role, but hormonal shifts seem to be one of the main culprits. As estrogen begins to decline so does collagen and the elasticity of the skin causing less tone and more wrinkles. Some women turn to HRT and claim it helps restore youthful looking skin. HRT is not for everyone and that is a personal choice you should make after discussing the options with a good gynecologist. I recommend a base line estrogen at age forty for comparison in later years. If you notice an increase in acne breakout this may be due to a declining estrogen, which can make testosterone more dominant thereby increasing acne breakouts. Taking the time to find the best skin care routine during perimenopause and menopause is the best way to help stave off some of the skin problems and restore smoother, even toned, younger looking skin. • It is still vital to wear a daily sunscreen to prevent further skin damage such as uneven skin tone, dilated spider veins and wrinkles • Continue to use AHA or BHA in an emollient creamy base. • Consider using Renova. Renova is Retin-A (tretinoin) in a cream base. • Kinerase, (N6-furfuryladenine), is a plant based extract which reduces uneven skin tone and fine lines. I like the fact that Kinerase does not cause sun sensitivity • Have regular facials (every 6-8 weeks), light chemical peels or microdermabrasion for exfoliation and for a skin assessment. Sometimes our skin goes through disconcerting changes, i.e. dryness, acne, (Yes, at fifty something!) or redness. A professional will give you the advice necessary, as this is their area of expertise. • If you’re having problems with very thin skin, bruising easily and irritation then avoid AHA, BHA, and retinols since your skin may be too fragile for these products. Instead keep it simple with moisturizers or moisturizers with antioxidants in conjunction with a daily sunscreen. 5.) Can topical creams really get rid of dark circles? I would like to preface this by saying it can be frustrating for those of us who specialize in skin care to hear the half truths and exaggerated claims made by some cosmetic companies advertising their products. Typically, one topical cream can’t do it all, as there isn’t just one reason for the dark circles in the first place. There are a number of reasons people get dark circles under the eyes. From genetics to the aging process. As we age, the delicate skin around the eyes becomes thinner making superficial spider veins more apparent thus creating a red discoloration. In addition the accumulation of skin or wrinkles around the eyes makes the area appear darker. Loss of fat can make the eyes slightly recede, which will cast shadows or a protrusion of the fat pads will also cast shadows. Lastly, some people are genetically predisposed to under eye discoloration. The reason for the discoloration needs to be determined first, and then an appropriate treatment can be implemented. There are color specific lasers that can target spider veins or pigment (melanin) under the skin. Topical lightening treatments, such as kojic acid, hydroquinone and vitamin C may be helpful. For excess skin, lasers such as the Co2, Active FX, Fraxel are options. Lastly, for severe fat pads, wrinkles and loss of tone surgery may be the only option. See a board certified Plastic surgeon for a consultation. 6.) Antioxidants, peptides, niacin, & growth factors? Confused about which products are best for you? The beauty industry is a billion dollar industry. It is no wonder that there are many fabulous products available on the market today. As you know by now, expensive isn’t always better and cheap isn’t always inferior. There are good and bad products in all price ranges. The best step is to keep it simple and start with two products: 1) A good cleanser 2) A daily moisturizer with a sunscreen for your skin type. Then begin by adding treatment-oriented products, such as one of the following: • Olay Regenerist with peptides: Chain of amino acids that instruct cells to increase collagen production. • MD Formulations with glycolic acid or Vitamin A: To exfoliate and repair sun damage • SkinCeuticals C, E & Ferulic with anti oxidants: Neutralize free radicals. FR’s damage cells and prevent normal cell repair and reproduction. • NIA with niacinamides (B3): Repairs sun damage. There are studies B3 may possibly prevent skin cancer, per The National Cancer Institute. • TNS Complex: believed to help the performance of cell renewing growth factors for the production of collagen. Do a little research and read the labels to determine the right product for you. Are you looking to repair sun damage or lighten discolorations? If you need advise, see an esthetician, nurse or dermatologist. Be sure to use the product for 4-6 weeks to determine if that product improves the condition of your skin. See my article on ‘Basic Skin Care’ for step-by-step suggestions. 7.) Quick fix beauty tips: There are times when we are in need of a quick fix. Below are a few tips that may be just what you need in the event of a beauty emergency: • For under eye puffiness or facial edema: Lie with your head elevated (approx. 3 pillows) Place two tea bags, that have been seeped and cooled in the refrigerator, over each eye for 15-20 minutes. Water and parsley are natural diuretics. • A temporary fix or fine lines: Hold a steamy wash cloth over your face for 60 seconds, then apply a rich hydrator to help the skin retain the moisturizer. This will last for an evening out. • Chapped lips: Gently scrub with washcloth or exfoliating scrub than apply lip balm. Always apply lip balm or Aquaphor before bedtime. • For wintry, pale skin: You can use a self tanner in the wintertime too. Use one that adds a little color, but don’ go over board as it may look too unnatural. • Or try a make-up with an apricot tone to liven up the face such as Q10 Moist Color Base with SPF 30 by www.DHCcare.com. $17.00/1oz. • For olive complexions mix bronzer with your moisturizer and apply. • Liven up a dull and dry complexion: Try St. Ives Elements Microdermabrasion. Follow directions than apply a moisturizer. $7.99/4oz. From longs or Walgreens. • To freshen up the skin before an evening out: Apply a mask. For oily skin and to create a slight “lift” try egg whites: beat egg white only, then apply to face for 20 minutes, rinse and apply moisturizer appropriate for your skin type. • For acne prone skin, apply Milk of Magnesia to face for 20 minutes then rinse and apply an oil free moisturizer. • For dry skin apply a tbs. of honey mixed with 1/4 mashed avocado to face rinse and apply moisturizer. • If au natural does not sound good to you: • For oily skin-use a mask with the ingredient kaolin, such as The Body Shop 3 in 1 Honey and oat scrub mask: $16.50/3.6oz. • For dry skin try a hydrating mask such as Estee Lauder Resillience Lift Extreme Ultra Firming Mask: $40.00/2.5oz. • Feel an acne lesion forming: Ice it for 30 seconds then apply BPO 5%. Cover with Maybelline Shine Free Blemish Control Concealer. $15.00 • Visine can also help get the red out of a zit-try it. • If it is a cystic lesion and you can’t wait 1-2 weeks for it to heal, see a dermatologist for a cortisone injection. • Lastly-don’t forget to distress. Stress can take its toll on your appearance by making you feel and look frazzled. Relax, deep breath, turn down the lights and listen to soft music in a tub with bath salts such as Ahava Dead Sea bath salts-$18.00/32oz. 8.) My favorite cosmetic picks include: • Yu-Be Moisturizing Skin cream-Find it at www.yu-be.com $15.00/1.25oz.This is a great hand cream. • Azure Naturally Tearless Moisturizer & anti-aging cream, SPF 30: Find it at www.azurskin.com or 1-800-698-3275 $30.00/1.7oz. • Kirkland Signature by Borghese Mineral loose powder SPF 15 $26.99/compact. Available at Costco. • Frownies Rose Water Hydrator Spray. $10.99/2oz-www.drugstore.com I am happy to see listeners for a complementary consultation at the office of: Dr. Isaacs, founder of The Vein Specialists of Northern California, in Walnut Creek. Phone number #925-945-8656.

10/18/2008 06:10 PM

KGO Update

1.) Turn back the hands of time with fillers, volumizers and plumpers. Replacing facial fat loss is more popular than ever and often referred to as the liquid face-lift. There was a recent article in The New Yorker about how Madonna, Demi Moore and other fabulous looking actors are looking younger and fresher without appearing to have had surgery. The article alluded that they had had the liquid face-lift. There are many changes that occur to our faces and bodies that make us look older. One is the superficial layer of skin that becomes discolored, blotchy and less toned as we age. Underneath this superficial layer is the foundation of fat, muscle and bone. This is where the aging process really begins to manifest. Restoring the fatty layer helps create fullness, firmness and a more youthful looking face. Think of restoring or re-stuffing a pillow or upholstery. It is the same concept in that it makes you look new again! Combinations of products are used to restore facial volume, which include hyaluronic acids such as, Restylane®, Perlane®, Juvederm™, and Radiesse®, Sculptra® and fat transfers. 2.) Concerned about the cost of non-surgical beauty treatments, but want to look your best? Cost effective chemical peels are a viable, safe and great option. Yet peels are misunderstood as too invasive-not true! Chemical peels can decrease brown spots, wrinkles, treat acne, tone the skin and give it a lovely smooth appearance. There are many different types of chemical peels ranging from light to deep. Of course the deeper the peel the more the down time. I recommend the light to light-medium peel for optimal results and little down time. A light peel has no down time, whereas a light-medium peel has typically 3-7 days of down time. A peel is definitely one of the best ways to get more bang for your hard earned buck! See an esthetician for lighter peels and a nurse specialist or dermatologist for medium peels. See a dermatologist for a deep peel to address moderate wrinkles, severe photo damage and scars. Cost for light to medium starts at $120.00 up to $600.00 on average. 3.) The autoimmune disorder Lupus and issues relating to sun sensitivity. Nine out of ten people with lupus are women and of childbearing age-14-45. There are two types of lupus: systemic erythematosus and discoid lupus. Sun sensitivity occur in both types, however the effects of discoid lupus are restricted to the skin 95% of the time, so sun sensitivity is more prevalent in this type of lupus. When someone is sun sensitive or photosensitive they are abnormally sensitive to the sun and require constant protection from the sun. It is also common that medications taken for lupus can increase the sensitivity to the sun. By being aware of the necessary steps to take to protect your self, as well as your family you can prevent further complications. The following steps are recommended by www.coolibar.com: Avoid unprotected exposure at any time, but especially between the hours of 10am and 4pm. Wear sun protective clothing, including long sleeved shirt, hat and sunglasses. Apply broad-spectrum sunscreen with SPF 30 20 minutes prior to exposure and every two hours during exposure. Routinely check skin for changes and report suspicious changes to health care provider. Educate others about the need for sun protection. 4.) I find that many patients are still confused about the difference between Botox® cosmetic and Fillers and often use the two interchangeably. The confusion is that both are very popular non-surgical treatments for wrinkles. However the way in which they treat wrinkles are very different. A Botox treatment temporarily relaxes the muscle that is responsible for causing wrinkles through movement, i.e. constant frowning will cause the body’s natural collagen to break down resulting in a loss of support, which will eventually create a frown line. Botox goes to the source of the problem by preventing the line from forming in the first place or by softening an existing line. Fillers, on the other hand, fill in the wrinkles by replacing the collagen that has been lost due to movement, time and the aging process. Typical fillers include Restylane®, Perlane®, Juvederm™, Radiesse®, Artefill®, Cosmoplast®, and Collagen®. Botox® cosmetic plus a filler are often used in conjunction with one another for optimal results. 5.) Good news for caffeine lovers! I would like to site two studies about the positive effects of caffeine: The first one is how caffeine and exercise has a positive affect on the body. A recent study showed how the combination of regular exercise and caffeine appears to help destroy precancerous cells damaged by the sun’s ultraviolet-B. The study compared the effects of exercise and caffeine alone, but found that the two together proved to be more valuable. The underlying mechanism is unknown at this time and further studies are indicated. Of course this is not an excuse to leave the sunscreen at home, which is still highly recommended for preventing skin cancer. The second study sites how too much caffeine can have a negative affect on the body causing dehydration, increase stress, acid reflux and sleep disturbances, however in moderation caffeine may be beneficial as an antioxidant and for reducing inflammation. Caffeine is now found in many topical creams due to its anti-inflammatory benefits and its antioxidant protection, which neutralizes free radicals. This may be especially useful as an eye cream to help reduce puffiness around the eye by constricting blood vessels. Find the ingredient caffeine in Topix Replenix cream, Murads Essential-C Eye cream, or Zuhr Restore eye cream. 6.) One of the most common questions I am asked towards the end of summer is how to repair the skin after too much sun exposure. The skin appears red and blotchy, dry, and you may notice more fine lines, especially around the eyes from squinting, as well as brown spots. Steps to repair the skin include: • Hopefully you left the alpha hydroxy acids and retinols at home when you were playing in the sun, as the application of such products in conjunction with too much sun would cause more harm than good. • Treat the skin very gingerly with mild cleansers and moisturizers including a moisturizer with sunscreen everyday. Moisture helps the skin to heal and repair itself. • Apply antioxidants everyday such as vitamin C, and E, Idebenone, Co Q10, and green tea • After a week or two start using alpha hydroxy acids or retinols. Begin using them on a gradual basis such as twice a week then build up gradually. • If you notices brown spots a lightening agent such a kojic acid or hydroquinone 2% or 4% (4% by prescription only) applied two times per day may help even your skin tone. • After 4-6 weeks consider a light chemical peel to remove dead skin cells, brown spots and refresh the skin. • If you notice a new skin growth, change in a mole or anything you think looks suspicious see a dermatologist pronto. 7.) My favorite cosmetic picks: Zuhr Restore eye cream (with caffeine)- $28.00/1oz.- available at Sephora. Aveeno Positively Ageless Lifting and Firming Eye Cream- $20.00/.5oz- available at Drug stores or drugstore.com Almay Oil Free Make-up Remover Towelettes- $6.00/25- available Drug stores or drugstore.com I am happy to see listeners for a complementary consultation at the office of: Dr. Isaacs, founder of The Vein Clinic of Northern California, in Walnut Creek. Phone number #925-945-8656.