fine lines

In ALL, PREENING by Stephanie Klein45 Comments

Unless you’re going to have your body checked for squamous and basal cells, the key to going to the dermatologist is to be at your absolute ugliest. Visually, you need to be screaming for help. It’s the only way you’ll really be taken seriously. When the sensitive skin around my eye looked as though it was puckering up for a kiss, I was urgently treated, even if I was treated like a troll. Had I applied a coat of mascara and brushed on some bronzer, it wouldn’t have seemed as dire.

I’m going today, barefaced, just a thin coat of spf. Red blemishes, untouched. "Fix me," I’ll say to the technician–yeah, that’s right, to see an actual M.D. at Westlake Dermatology, you need a standing appointment made months in advance. It’s a medical spa, offering everything from chemical peels and microdermabrasion to skin lightening systems and PhotoFacials. Who doesn’t like the idea of "skin resurfacing" and treatments designed to stimulate collagen growth? They offer mesotherapy (where your fat is injected and subsequently "melts away") and VelaSmooth (basically they vacuum your skin hoping to break up the fat and diminish cellulite). While all this sounds like something I should maybe weigh, all I can really think is, that’s for skinny people with problem areas. It’s not for the fatties who really need it. I mean, one can only melt away (or even reach) so much fat. And what good is it if I’m going to continue to eat and live as I do: like a normal person who loves food? Problem areas. As if.

I don’t want Botox–not that I’m against it, at all, I just don’t love the idea of temporary, of having to rush back for another dose in a few months, what’s the point?–but I am hoping the technician takes one look at me and says, "You know what will make a world of difference?" I think we’re all looking for that, for someone to instantly know what to do, someone confident and masterful, someone who’ll get it right.  We rarely believe that someone is us. And when we do, when we trust ourselves and believe we have to know ourselves better than the doctors and technicians with names like Fig, Piper, and London, we’re proved otherwise, that we couldn’t have been more wrong. Previously, with a different practice, when I went in with the puckered eye and was told it was contact dermatitis, that I was allergic to something, I glossed over all the doctor’s warnings about my shampoo, soap, laundry detergent, and body and facial creams. It couldn’t be any of that. I’d been using the same brands for years. Yeah, yeah, people can develop allergies later in life. Please, I thought, I’m no ninny, now let’s roll up our sleeves and get down to it. I rolled off my shirt and succumbed to a "patch test," where my skin was exposed to chiclet-sized ingredients found in everyday products, from essential oils and fragrances to dyes. Everything came back negative. In the end, they couldn’t find a cure. I eventually found the culprit. I’m terribly allergic to Tide. Now, I feel dumb and fragrance-free.

Still, I’m looking to make a fresh start today at the medical spa, looking forward to all their products (see any worth recommending?) promising to diminish this and smooth that. To plump, lighten, and correct all without the use of a laser, knife, or needle. Which reminds me, I think one of my readers a while back sent me a link to her blog, where she showed before and after pictures of her face and how lasers ruined her. Light therapy maybe. Pieces of living tissue had to be surgically transplanted onto her face, and grafts later, she was no closer to the beauty she’d imagined for herself, wishing she’d never been so discontent. There’s a fine line between upkeep and keeping up (as evidenced by Ugly Rivers). And it’s sometimes hard to know when to throw a reception for your fine lines and appreciate your genetics just as they are.

*In the coming days I’ll let you know what was "prescribed" and give my immediate reviews

Comments

  1. Retin-A and sunscreen. Seriously. That is all you need (that and eye cream for daytime). Email me and I will tell you exactly the regimen my dermatologist told me. I have heard very good things about Skinceuticals, especially for those with sensitive skin. Aren't redheads supposed to be be more sensitive to dyes and perfumes? NOw, as for going to a cosmetic surgery place, I think I would draw the line at micro-dermabrasion.

  2. Be careful. If they reccmmend a treatment ask what the "down" time is. A few years ago I was getting microdermabrasion treatments (which I loved) and the esthetician followed up a session with a chemical peel. I could tell it was different from the sting when she applied it. Well – two days later I looked like a burn victim. When I called her to let her know what I looked like I was told that's normal – once the skin is done peeling you face will look awesome. You know what? She was right. My skin never looked better. Have I done it again? No. WOULD I do it again? Yes, but I would block off a week to stay out of public.

  3. I'm all for a little 'upkeep' at the dermatologist, after waiting months to get in. I've had a few little marks zapped from face with laser. It hurts for a few seconds but it worked. Have you ever tried a body lotion by Hugo? the fragrance I love is called sweet orange vanilla. It smells like a creamsicle and you will want to eat it! (It's organic from a health food store)Good luck with your appointment. Ordered your new book the other day, can't wait!

  4. My sister is a dermatologist and she thinks that most of what you pay for in expensive creams and serums is pretty packaging. She recommends drugstore moisturizers for the day and night (Aveno, Olay, Cetaphil, Cerave), a gentle cleanser (again Cetaphil), Retin-A or Renova for problem (wrinkles, acne) skin, and a 2% salicylic acid spot treatment for pimples. She doesn't think eye creams do anything particularly special either (she says they are just heavier moisturizer).

  5. I always consider getting a facial, but have never broken down and done it. I guess I feel like if I can't be bothered to drink lots of water and eat healthy, I can't expect my skin to repay the favor. Luckily, with my red hair I've stayed out of the sun most of my life, and my face is so glad. I love when people ask if my tanning queen younger sister is older than me- and once, someone asked if she was my MOM! (Patting myself on the back…)

  6. ahhh girl! so glad you asked. I'm 29 years old and have been doing such treatments at a medical spa since the age of 26. I'm pale (like you) and it has made a HUGE difference. I've always had nice, smooth skin but when i turned 26 I started to notice my skin looked dull and i had fine lines around my mouth/forehead, etc. Here's a list of the products/treatments I've done over 3 years. It should be noted all of these treatments were administered by a NURSE.

    Prevage- Daily antioxidant face cream. Allure mentions it in an article in the current issue. Fantastic product. Evens out skin tone/fine lines.

    Photofacials- My favorite next to botox. After I completed my first series of treatments I had strangers coming up to me asking what I used on my skin.

    Botox- Love it. It took me 2 years to try it (I was scared and thought it was unnatural). I now use it in my forehead and around my eyes. I can still move my eyebrows just without the funky lines. It is temporary in that it wears off, but it weakens the muscle so even when it does wear off you lines aren't as pronounced.

    Restalyn- For the lines around my mouth only. Don't use it in your lips. It looks weird. But it's great for around your mouth.

    LED laser- for after my photofacials, it boosts collagen and speeds up healing

    Scleratherapy- for spider veins

    Creme De la Mer- Not a medical spa treatment, but nice nonetheless. Great for dry skin.

    Oil of Olay Regenerist Serum- If you can't afford Creme de la Mer try this. It's great. NY times recently had an article about how it is more effective than some very pricey creams.

  7. ahhh girl! so glad you asked. I'm 29 years old and have been doing such treatments at a medical spa since the age of 26. I'm pale (like you) and it has made a HUGE difference. I've always had nice, smooth skin but when i turned 26 I started to notice my skin looked dull and i had fine lines around my mouth/forehead, etc. Here's a list of the products/treatments I've done over 3 years. It should be noted all of these treatments were administered by a NURSE.

    Prevage- Daily antioxidant face cream. Allure mentions it in an article in the current issue. Fantastic product. Evens out skin tone/fine lines.

    Photofacials- My favorite next to botox. After I completed my first series of treatments I had strangers coming up to me asking what I used on my skin.

    Botox- Love it. It took me 2 years to try it (I was scared and thought it was unnatural). I now use it in my forehead and around my eyes. I can still move my eyebrows just without the funky lines. It is temporary in that it wears off, but it weakens the muscle so even when it does wear off you lines aren't as pronounced.

    Restalyn- For the lines around my mouth only. Don't use it in your lips. It looks weird. But it's great for around your mouth.

    LED laser- for after my photofacials, it boosts collagen and speeds up healing

    Scleratherapy- for spider veins

    Creme De la Mer- Not a medical spa treatment, but nice nonetheless. Great for dry skin.

    Oil of Olay Regenerist Serum- If you can't afford Creme de la Mer try this. It's great. NY times recently had an article about how it is more effective than some very pricey creams.

  8. Okay, for all you experts: what can be done about puffy undereye circles? They make me look tired even though I'm not. I've pretty much given up on creams / lotions to solve this problem. Anything more invasive that works?

  9. I took a look at their products and they carry the BEST product in the world – SkinCeuticals CE Ferulic. It is incredible. I have been using it for a year and it has changed my skin's life!

  10. I'm 34 and I have no lines at all. I think some of it is genetic but I've always been careful about using sunscreen daily. SkinCeuticals Hydrating B5 Gel is great everyday too. The stuff is amazing.
    I just started adding microderm every 4-6 weeks. My skin feels so good now.

  11. Oh, I want to throw my hat in for Retin-A and sunscreen. I've been using it for years, I'm 38, and have almost no lines on my face (with the exception of a few, very fine undereye lines). Of course, having dark skin and good genes helps, but I am a believer in Retin-A.

  12. I work at a high end medical spa, much like the one you go to and the products you are going to get in drugstores may have been sitting on the shelves for years, they have little or no active ingredients, which is what you need to see results.

    Skinceuticals CEF ( vitamin c, e, and ferulic acid) is an amazing prodcuts. It firms the skin and protects against free radicals…

    Retin-A is much too strong for someone with fair skin, however Retinoids (sometimes called retinol) are much milder versions of retin-A and will change your skin in an amazing way. They are the only thing that the FDA approves as actually anti-aging and every single person should be using it. In conjuction with the CEF, it works even better.

    Monthly facials can also do wonders for your skin. Be careful of cetaphil, it is very clogging to the pores. A lot of other cleaners can be drying because of the lathering agents, so try and get a "foaming cleanser" on that is a liquid and foams up when you pump it out. Good luck, SkinScienceRB.com is our website, and you can email me and I can get you samples of some pretty awesome products (ours are all pharmaceutical grade and very fresh and active)

  13. I look forward to your review; my appt with said piper is next week. I could have waited a few more weeks for a Dr (I scheduled last week) but I'm too impatient. Mine is a standard check-in only.

  14. Puffy undereyes-

    Have you tried cold teabags or spoons out of the freezer on your eyes? Both work very well!

    J

  15. I'm desperate to do something for my skin. I never had serious problems with it, a zit here or there, but nothing serious, and then right after my wedding last year I started breaking out. I guess I'm chalking it up to stress from grad school, wedding planning, etc., and it's pretty much stopped now, but it did some serious (I'm afraid permanent) damage to my skin.

    I really want to try that new cream from Clinique that's supposed to spot treat these little marks… anybody tried it? They make a point of saying that sunscreen is a MUST if you use it, so it scares me a little. I use a moisturizer with SPF 15 every day, and I have medium-fair skin, is that not enough?

  16. Skinobsessed, I can't help but think that this "nurse" must've seen you coming about a mile away. It seems impossible that someone still in their 20s could need Botox, Restylane, lasers, etc. already. I'm nearly ten years older than you and my derm (regarded as one of the best in Manhattan) still won't do Botox or other fillers on me because it's "too early." Save your money!

  17. I just have to tell you that I love the Jane Iredale make-up line. That is definitely worth checking out.

  18. I just have to tell you that I love the Jane Iredale make-up line. It is definitely worth checking out.

  19. Did you notice that the TNS Illuminating Eye Cream has an ingredient called "human fibroblast conditioned media" ? I thought, what is that? So I googled it.

    Um… neonatal foreskins, anyone? Here's a link that explains what's in that eye cream. Just sayin'. Tea bags don't have that in 'em. :)

    URL REMOVED

  20. I've been getting facials regularly for the last 5 years. They keep my skin smooth, although they can't do miracles for my acne (that's where proper diet, nutritional supplements, and exercise come in).
    I have recently started learning about all the harmful chemicals that go into our bodies through skincare and am switching to this brand for everything, starting with baby products for my son:

  21. Love the comments on this one. Re: Beth- Wearing spf 15 is not enough. It needs to be SPF 30 (according to my derm)to be effective.
    Sunscreen- daily- has already been mentioned. Even running an errand for 15 minutes without it can create enough sun damage over a short period of time. Diet is of huge significance- avoid processed foods it truly ages you. And water, drink lots. I also stay away from the caffeine and booze too and my skin looks much better. Sugar also contributes to accelerated aging- this is something I did not know until recently. This doesn't include natural sugars found in fruits, though.

    Skin cancer runs in the family so I called Westlake Dermatology a few months ago when I saw a mole that looked funky. I got a few odd ones during my pregnancy I guess happens but I was concerned with a few I found. The wait was ridiculously long and I mentioned I was making an appointment with Dr. Lisa Rhodes based on a referral from my doctor and got in sooner. The deal is this: expensive cosmetic procedures make more money so they see them sooner. They were pretty nice but I must admit it was unnerving being in an office where I could not even begin to guess how old anyone was. Even the probably twenty something girls looked pulled so tight I couldn't see any expressions on their faces. I guess they get free procedures? Dr. Rhodes did a skin check and also zapped a cluster of broken capillaries on my cheek and were very efficient. Beautiful office too.

    I'm all for someone improving themselves and feeling better via cosmetic procedures if they can afford it. It's just scary to see so many young people jumping in on this.
    Stephanie, you're 31, right? I don't think you have any worries for a bit.

  22. Seconding (or Thirding) the Skinceuticals line. Especially the Antioxidant Lip Repair. Because your babes deserve the softest kisses.

  23. I recommend commiting to Renova (tretinoin cream) which is (if I understand correctly) a synthetic derivative of vitamin A – I believe it is of the same category as Retin-A and/or possibly Differen Gel, which are synthetic retinoids as well. I've read that Renova has soothing emolients and is more moisturizing than products like Retin-A and Differen Gel.

    I say committing to it only because when I first started using it (three years ago), my skin did become somewhat irritated and peeled a little, so I used Aquafor on certain parts of my face for a few months. The difference in my skin is absoutely incredible. I suffered from mild adult acne and also was a sunscreenless sun worshiper until I was in my mid-twenties and started noticing fine lines by the dozens at twenty-seven or so and just had a general ashy, dull complexion that no foundation could help.

    I started with Differen, which also takes a commitment because at first it made my skin crap, but then a year or two later started Renova just before I turned thirty and have used it ever since. I will be thirty-three in May and my skin has never looked better. It looks better now than it did when I was twenty-five. Seriously. Sometimes I can't believe how nice it is compared to what it was. It also seemed to help with the minor acne scarring (the ones that I didn't mess as much). The ones I picked at are permanent (although not very noticable)pocked scars.

    Renova costs about $120.00 and a tube of it lasts me an entire year. I compare that to what I used to spend on Estee Lauder products and have figured that it is less expensive than even some drugstore creams over the course of a year.

    I should also mention that when using a tretinoin or retinol that you must also commit to sunscreen. I tend to have hyperpigentation along my upper lip if I spend time in the sun. It's like an unwaxable, unbleachable mustache. Attractive. So on my upper lip, in the summertime (I live in the North Pole), I use a clear zinc – kind of like what lifeguards use on their noses, but they now make a clear version so you don't have to walk around with white, pink, or blue ointment on your face.

    So to condense my suggestion: Renova and sunscreen. Clear zinc for hyperpigmentation. I also remove my makeup at night with simple baby wipes (I use baby oil for eye-makeup). I also recommend a sugar exfoliation every month or so. I use the Oil of Olay Microdermabrasion/Peel that you can buy anywhere. It's a sugar exfoliation followed by a mild AHA peel. But do not use this until your skin is accustomed to whatever tretinoin or retinol treatment you choose to use (if you choose it).

    Good luck

  24. Okay, follow up question on the SPF…

    I use at least 30 when I'm out in the sun, but just a moisturizer with 15 on a normal day when I'm buried in my office w/o even a window's worth of sunlight.

    My question: Are people really using a sunscreen in ADDITION to their moisturizer, or all-in-one moisturizer with SPF? I think I read somewhere that even if your moisturizer has SPF, most people don't use enough moisturizer for the SPF to actually be effective, but I kind of chose to ignore it because I'm afraid to put multiple layers of lotions on my face all the time. Also I need all oil free stuff.

  25. Omigosh, this post (and many of the comments I read) made me ill. You sound like a dream to the marketers out there. You don't need all that crap! You are young and gorgeous, with gorgeous skin. Just because something is given to you by a medical professional, that doesn't mean you need it! (And just because someone is a doctor or nurse doesn't mean they should automatically be trusted either.) Women are persuaded they need all this useless, expensive, (often harmful) stuff (and procedures) for their skin. What do you really need besides sunscreen, a gentle cleanser and moisturizer?
    Don't perpetuate it!

  26. Your skin is gorgeous. Make sure you sunscreen & moisturize every day and instead of going to the medical spa, buy yourself that insanely expensive bag you were coveting a few months ago.

    If women in their 20's & 30's are having surgical & non-surgical skin procedures now, there's going to be a plague of Jocelyn Wildenstein clones upon the land in about 30 years.

  27. Ah, skincare. As a lifelong acne sufferer, I could/should write a book. But there's already a good one out there, Your Best Face Without Plastic Surgery, by Dr. Branith Irwin. I love this book and also, "Breaking Out" by Lydia Preston, but that one is more spefically geared toward acne.

    I second the comments about Retin-A and sunscreen. I also agree that your skin will take time to acclimate to Retin-A. I have used all formulations and find I'm happiest with Retin-A Micro, which has "microspheres" that sort of time-release the retinoid. Retin-A will over time give you the exfoliation effect women are seeking through peels, scrubs, and dermabrasion. I also makes your pores "behave" and not stockpile sebum as blackheads leading to breakouts.

    Contrary to popular opinion/sales techniques, OTC "retinoids" are not the same as Retin-A, so if you want results, you have to go the prescription route.

    If you have blemishes all the time you should probably use Retin-A at night, and a benzoyl peroxide cream, only in your breakout areas, during the day. Most OTC BP creams are too strong, starting at 5%. I have had luck with a prescription combo BP/clindamycin gel called Duac, that has I think only 2.5% BP. I use that on my chin only every day.

    What's been difficult for me is finding a good facial sunscreen that doesn't irritate my acne.

    And I am an advocate of Botox, but am a decade older than you. You have time!

  28. I will also vote for sunscreen and Retin-A.

    I am also a long time acne sufferer. I’ve been on Accutane (3 times) starting in high school (39 yrs old now) and on Retin-A since college. My skin looks great and I attribute it mostly to the sunscreen. My family has a huge history of skin cancer and I am extremely fair (alas, paste-y?) with red hair. The best advise I’ve ever received is that if you can see your hand in front of your face while outside- you should be wearing sunscreen.

    I had always thought of Retin-A as an acne treatment….until I hit my 30’s and women would stop me in airports asking what I did for my skin.

    I’ve been seeing dermatologists every 6 months since 11 yrs of age…..the sum of that experience is this: Cetaphil cleanser, Neutrogena moisturizer in the morning, and the same at night with the addition of Retin-A. That’s really all you need.

    The only facial sunscreen I’ve found that works for me is Clinique CityBlock SPF 40. It’s tinted and I use it daily instead of foundation.

  29. While I know this comment isn't applicable to this particular post, I couldn't help but let you know how much I l-o-v-e-d your Bob Dylan ad for Moose. Not only do I appreciate that you utilized Mr. Dylan (the quiet poet of my soul,) but the ad also made me want to preorder the book even more than I already did (done, and done.)

    May is now such a wonderful month to look forward to–both the release of Moose and the Sex and the City movie. Two of my favorite Manhattan girls are back on the block.

  30. So many women read these comments that I just feel it's necessary to tell a bit of my story to save at least someone from going through the nightmare I did.

    I went to a "medi-spa" type place, got a facial, then they suggested a IPL just to zap some sunspots. She did my entire face. Soon after I felt a deep burning, like a sunburn on a cellular level. Within 3 weeks the fat cells in my face were gone, destroyed. I lost my cheeks, chin, temples, nose, around my lips. This is serious. The IPL was a Palomar Starlux, apparently set too high by a faulty technician. I have had 3 full face fat grafting surgeries, and will need more as time progresses. The amount of money and suffering that one little trip to a spa caused has been soul destroying. Please be cautious.

    Love your skin and treat it gently. That's my advice.

  31. Stephanie
    This is unrelated to you latest post, sorry.
    In NY Magazine (this week) they mention a new Jewish cookbook (Authentic Jewish Cooking) and the article mentions an essay titled "Why Jews like chinese food"
    Thought you might want to check it out?

  32. Since a few people have commented on how great Skinceuticals is, I'm curious about it, but I'm also concerned b/c I break out from EVERYTHING. Has anyone had this problem w/ the skinceuticals? My skin has finally been clear for several months now, and I'm afraid to try something new, yet I do need something to fight the little lines at the corners of my eyes, and to maybe/hopefully undo the damage I already caused as a teenager, when my friends and I would literally bake in the sun soaked in baby oil w/ our homemade sun reflectors – an album cover wrapped in tin foil. OMG!

  33. I am so looking forward to the product review. After a bad experience with a facial two years ago (turns out I'm severely allergic to enzyme peels), my skin is still not right. It is extremely sensitive and has all kinds of problems that it never had before. I'm always looking for new information on good products for sensitive skin. I can't wait to hear what you have to say.

  34. Stephanie –
    I visit your site to get away from work for a minute…I was surprised to find my work on your page this afternoon:) I provide physicians with lasers, IPL systems, microdermabrasion systems, skin care, etc. My suggestion is to start small!!! I would recommend that you try microdermabrasion first and see how that works for you. Microdermabrasion provides significant results without being too aggressive. The treatments will leave you with a really nice glow and over time (usually 6-8 treatments) they will help any fine lines or small scars.
    I’ve been using the skin care line Derma MD for the last 7 years and I love it! The products are perfect for sensitive skin and it’s a smaller line- which is nice because as the industry changes, the product line can easily change. I especially love their moisturizer with SPF.
    You also mentioned mesotherapy which can produce extremely nice results…but it can be very painful, cause bruising and occasionally pigmentation changes occur. There is a system available, Mattioli's Transderm Ionto, that allows physicians to deliver the same drugs targeting cellulite, fat, etc. without needles so you don't have any of the pain or side-effects. Hope this helps!

  35. To add to the sunscreen discussion: I've been using Bare Escentuals for nearly ten years and I can seriously attest to its sunscreen and skin-healing powers. I don't sell it nor am I involved in the company or anything like that; I just seriously love it and would encourage anyone to try it, preferably at a boutique where they can show you how to use it correctly.

  36. One of my dear friends once said to me – and it is truer and truer….

    "God can't be a woman if you can have pimples and wrinkles at the same time".

    Damn.

  37. Two questions for everyone here: Have any of you had (or know someone that's had) laser/light treatments for rosacea? I've been thinking about doing this, but I'm a little spooked if something goes wrong. Second, I've been looking for a great cream to get rid of sun spots / dark spots on my face and hands. Any recommendations? The marketing out there is dizzying and it's hard to just "pick something" when everything is like $80 – $150.

  38. Hi Gals,

    I love this blog!

    I completely surprised to hear that no one has mentioned Arbonne. They are a Swiss health and wellness company with patent pending anti aging technology, the best eye cream I've ever used and the safest products you can find. Above that…they are products that show you the results you are promised without lasers etc…
    If anyone is interested in more information or FREE samples. Please let me know. I would be more than willing to share with you. I'm not trying to sell anyone stuff that doesn't work. I just love to see people get on healthier products that work!
    They also have the best line of sunscreen out there!
    -Farrah

  39. Hi jpg, I don't know if you'll ever see my response. I have had 4 laser treatments for redness on my upper chest and have seen improvement. I go to a laser center run by a dermatologist, and it's not a medi spa. They only do laser there. I think hair removal is their bread and butter, but the nurse who runs the laser is really good at the redness thing (which is a different laser.) I looked into so-called "photo facials" but they were just as expensive and not as deep as what I'm having done.

    As for brown spots, get something with hydroquinone. That's the only effective treatment other than laser.

Leave a Comment