Skin Care

Facial Skin Condition Treatments

Adult Acne
Broken Capillaries
Dark Circles
Deep Wrinkles
Dry Skin
Fine Lines
Hyperpigmentation
Open Pores
Puffy Eyes
Rosacea
Sagging Skin

Body Skin Condition Treatments

Aging Hands
Breast Firming
Cellulite
Hands
Keratosis Pilaris
Lips
Scalp Acne
Stretch Marks

Skin Care Ingredients

Clinical Procedures and Topics

Four Fundamentals
Absurd Skin Care
Aging Skin
Antioxidants
Botox
Enzyme Exfoliation
Free Radical Damage
French Skin Care
Glycolic Acid
Idebenone
Irrational Fears
Klein Becker
Oxidative Stress
Paula Begoun
Perricone
Restylane
Skin Structure
Stem Cells
Healthy Skin Barrier Function
Smoking
Sun Protection
Topical Vitamin C/Firming
Choices and Needs
Strivectin
Additional clinical skincare topics.

La Roche-Posay Kerium is unavailable in the US and Australia. We recommend ProCyte Tricomin as an alternative.

Neova Creme De La Copper and SkinMedica TNS Recovery Complex are excellent options for sagging extremely sensitive and sensitive skin.

Vitamin C serums can stimulate collagen production which may help reduce the appearance of stretch marks, however high concentration, low pH glycolic acid and retinoic acid are likely more effective topical options. Therefore you would only use a Vitamin C serum in addition to these options.

Because stretch marks occur in the dermis, the deepest portion of your skin, you will need the deepest-penetrating Vitamin C to get the most optimal effect, should you wish to try this. A low concentration Vitamin C serum is most likely to be an expensive waste of time.

The most potent Vitamin C serums are Obagi C-Clarifying Serum, IS Clinical Pro-Heal Serum Advance+ and Obagi Professional C Serum 20%, the former being available on prescription only.

Obagi Professional C Serum 20% contains zinc chloride, which helps break down damaged collagen, and other ingredients which drive Vitamin C in further, factors absent from Skinceuticals CE Ferulic. The concentration of Vitamin C is also 5% higher and the product is more stable.

Alyria Exfoliating Cream Level 3 (30% glycolic acid) and Glytone Body Lotion (17.5% glycolic acid) are glycolic acid options.

If you notice stretch marks, begin treatment at home immediately and schedule a visit with a laser dermatologist — once the stretch marks have changed colour from red/purple/pink to white, there is far less which can be done.

You may prefer to use the SkinMedica TNS Lip Plump System, which contains the same major active ingredient (human fibroblast conditioned media) as SkinMedica TNS Recovery Complex, in addition to niacin, which increases blood flow with the effect of increasing lip fullness, however yes — it is safe to use the facial product on the lips. The product leaves no residue.

For further information and a video about the ingredients in SkinMedica TNS, refer Human Fibroblast Conditioned Media.

Remember to use a Lip Sunscreen, as the lips are the most vulnerable to photodamage and skin cancer.

No, studies show that under typical conditions, the sunscreen in makeup yields an SPF of less than 4 (due to the relatively small amount applied) and wears away within a few hours to leave your skin fundamentally unprotected.

Use a dedicated sunscreen product as a moisturizer and forget the notion that SPF in makeup is photoprotective under real-world conditions — it can only provide a small amount of benefit supplementary to sunscreen only.

Yes, combinations of Vitamin C and E as you find in Skinceuticals CE Ferulic and IS Clinical C&E Serum Advance+ improve melasma, however not as quickly or as effectively as the hydroquinone you find in products such as Biomedic Conditioning Gel, La Roche-Posay Mela-D or DCL AHA Lightening Gel.

If you are prone to melasma, a product such as Skinceuticals CE Ferulic or IS Clinical C&E Serum Advance+ underneath sunscreen helps prevent recurrence better than sunscreen alone.

I recommend IS Clinical Firming Complex, Skinceuticals Skin Firming Cream and La Roche-Posay Redermic.

Unfortunately this is just an expensive moisturizer (containing only glycerin, natto gum, panthenol). It would provide no bona-fide biological firming effect. I do not have a problem with products being expensive if they function as described, however nothing in this product is actually firming. To achieve actual firming your skin (rather than a superficial "tensor" effect on its surface) use products containing retinol, ascorbic acid and centella asiatica — all these are among the options which are vastly less expensive and are actually effective.

Effective retinol options include Biomedic Retinol and Skinceuticals Retinol. These are used at night.

Effective ascorbic acid (Vitamin C) products for firming are the serums made by Citrix, Skinceuticals, IS Clinical, Cellex-C and Obagi. Obagi is the most potent. These are used during the day underneath a anti-aging sunscreen such as Anthelios.

Good centella asiatica products are harder to find — I recommend Skinceuticals Skin Firming Cream and La Roche-Posay Redermic. These can be used as moisturizers.

La Roche-Posay Redermic UV combines sunscreen with Vitamin C and an extract of centella asiatica.

There is a comparable amount of ferulic acid in Revaleskin products, which are generally more suitable for sensitive skin than Skinceuticals.

This range is not suited to predominantly oily skin. If you would like to use an antioxidant product for oily skin, I suggest trying Citrix CRS, IS Clinical or Skinceuticals Phloretin CF.

This highly protective formulation blocks both UVA and UVB rays with Zinc Oxide 10.5% and Octinoxate 7.5% while antioxidants (Tetrahexyldecyl Ascorbate and Ubiquinone) neutralize age-accelerating free radicals.

Super Sheer Sunscreen SPF 50+'s silky, lightweight texture sets to a sheer, matte finish that never appears greasy or chalky (formulated with the latest microfine zinc).

Super Sheer Sunscreen is free of PABA and fragrances, making it suitable for all skin types.

DCL Super Sheer Sunscreen SPF 50+ is SPF 50+ and PA+++ (refers to a score of 16 in the PPD (Persistent Pigment Darkening Test) currently used in Japan to help better assess a sunscreen's level of protection against both UVA and UVB rays.

The Heliocare Supplement is an optional photoprotective antioxidant. The recommended dose is one capsule daily or two capsules for protection against prolonged direct sun exposure (in which case, take one in the morning and another by noon). It is not a replacement for sunscreen, it is an additional measure.

If the problem is ongoing and limited to the forehead, you are most likely using a facial cleanser, moisturizer or sunscreen which is too rich (too emollient) for your skin.

Kinerase Clear Skin is a complete solution tailored to dry, mature skin with breakouts (adult acne) which works by both intensely hydrating, purifying and protecting skin.

You can also spot-treat the acne with a product like Skinceuticals Blemish Control Gel or use a deep-purifying mask with alpha-hydroxy acids such as Cellex-C Betaplex Clear Complexion Mask, 2-3 times a week.

Products containing lipohydroxy acid are also great at purifying (and rejuvenating) mature skin with breakouts because they are non-drying.

Keep in mind that if you continue to use skin care which is too rich for you, the breakouts will inevitably recur.

Yes, Skinceuticals Active UV Defense and La Roche-Posay Anthelios 15 are actually the same formula, and are priced identically. Pro-Xylane is also found in formulas from both these brands. As far as I am aware, that is the extent of the duplication.

You can try generous applications of a high-concentration and emollient retinol product each evening, however make sure you start with only a small application every other night and build up your use slowly. Biomedic Retinol 60 is a good option. Make sure you use a sunscreen during the day. La Roche-Posay Redermic UV is a good sunscreen product for neck use and contains some worthwhile skin-firming and smoothing ingredients which will help protect and build on what you gain from the retinol.

For a faster but more temporary reduction in their appearance try an at-home peel such as Biomedic Pure Enzyme or Kinerase Instant Radiance Peel in the evening, and follow up with one of the more substantial moisturizers.

Moisturizers containing Pro-Xylane such as La Roche-Posay Substiane, Niacin such as Nia24 Skin Strengthening Complex and the Kinerase Pro+ products designated "ultra rich" all work well.

The Obagi Professional C Serums appear to deliver more Vitamin C to the skin and are more firming.

Obagi holds that their products provide greater antioxidant protection, however this has not been established as fact.

If you use the Obagi Professional C Serums, combine them with an additional antioxidant product such as RevaleSkin, Replenix or Glytone Vitaceutical Serum, to help broaden their antioxidant protection — antioxidant combinations are thought to work best and the Obagi Professional C Serums contain Vitamin C alone.

All the advice for aging skin applies.

At minimum, apply a retinoid product at night. As hands tend to be dry, an emollient product like Biomedic Retinol 60 applied nightly is best. You can jump straight to the highest strength because the hands are not prone to great sensitivity from retinol.

During the day, use a long-lasting sunscreen which protects optimally against UVA (Anthelios SX).

For enhanced protection, you can apply an antioxidant to the hands during the day, underneath sunscreen.

Citrix CRS and Alyria Antioxidant Capsules are good options which will not discolor your nails.

All these steps help even out skin tone and texture and reduce any hyperpigmentation (age spots) with time.

Keep hands super-moisturized by applying hand cream, even if only a small amount, or sunscreen, after hand-washing.

Nia24 Sun-Damage Repair for Decolletage and Hands and Cellex-C Hydra Hand Cream are good hand creams which helps fade age spots and prevent further photodamage.

To help "plump" the skin, you can optionally spray them with SkinMedica TNS Body Mist before sunscreen or retinol use.

The mist may also be used in place of applying hand cream if you find it a hassle.

The main ingredients in Skinceuticals A.G.E. Interrupter are Pro-Xylane, Phytosphingosine and Blueberry Extract, which is an antioxidant claimed to be especially effective against glycation. This product also contains bismuth oxychloride which lends the skin a diffuse, radiant look.

The closest product would be La Roche-Posay Substiane, which also contains Pro-Xylane, albeit less, however this product has an emollient texture whereas Skinceuticals A.G.E. Interrupter has a unique "powdery" texture.

Worthwhile concentrations of Blueberry Extract can be found in all Obagi Elastiderm products and several IS Clinical formulas (such as IS Clinical Youth Complex, IS Clinical Active Serum and IS Clinical Poly-Vitamin Serum).

You don't want an antioxidant to irritate your skin as beneficial antioxidants work against inflammation therefore "aggressive" is undesirable if it equates with prolonged irritation.

If your skin is not sensitive, Prevage MD (containing 1% idebenone) has published data showing deep penetration into skin. For information on usage and adjustment to sensitive skin, see the Prevage MD Instructions for Use.

La Roche-Posay Redermic Eyes is similar — it also contains an extract of centella asiatica called madecassoside, and also contains Vitamin C, so if you have been using Skinceuticals Eye Gel AOX+ underneath the Skinceuticals Eye Cream, you may also trial discontinuing it, although in this case less firming and protection of the under-eye area will occur. La Roche-Posay Redermic Eyes is compatible with Skinceuticals Eye Gel AOX+.

There is no longer any question that Tetrahexyldecyl Ascorbate is superior to Ascorbyl Palmitate.

Moreover ascorbyl palmitate does not appear to be significantly effective against photodamage and some research dermatologists have questioned its safety.

Tetrahexyldecyl Ascorbate has replaced Ascorbyl Palmitate in N.V. Perricone "Ester-C" products.

Ascorbyl palmitate is only found in considerable concentrations in Jan Marini C-ESTA.

Higher concentrations of Tetrahexyldecyl Ascorbate are found primarily in SkinMedica skin care products.

SkinMedica Dermal Repair Cream contains 10% Tetrahexyldecyl Ascorbate.

The most potent form of Vitamin C is ascorbic acid, however it has a tendency to be irritating.

There are several which help — Biomedic LHA Cleansing Gel, Biomedic Purifying Cleanser and Biomedic Anti-Bac Acne Wash.

Biomedic Anti-Bac Acne Wash is the one most useful if you have very active acne.

If your acne is only very mild, Biomedic LHA Cleansing Gel is a better option.

Ti-Silc GT Sunblock SPF 60 contains a substantial concentration of green tea (what the "GT" stands for) [ingredients] which has been shown to be photoprotective (helps prevent photoaging).

Replenix Anti-Photoaging Sunscreen is similar.

The green tea in both these sunscreens confers a light beige tint which largely vanishes on the skin.

If you have very dark skin the tint may be obvious, otherwise they will be fine.

Obagi's Blue Peel TCA (tri-chloro-acetic acid) method gives physicians greater control over the chemical peeling process, however all TCA peels carry risks.

Your practitioner can advise you as to your individual risk of adverse effects.

La Roche-Posay Anthelios Ultra-Light Sunscreen Fluid has been a revelation for patients with oily skin.

Finally they have not just an optimal sunscreen solution, but one which includes antioxidants (Cell-Ox Shield), is reasonably priced and a pleasure to use.

Despite providing the highest UVA (PFA 26) and UVB (SPF 60) protection, La Roche-Posay Anthelios Ultra-Light Sunscreen Fluid has a fresh, tonic and "airy" after-finish.

It leaves the skin both matte and radiant.

The Senna Alata extract in this product may contribute to the sunscreen's skin-brightening effect.

According to La Roche-Posay, one Anthelios Ultra-Light Sunscreen Fluid is sold every 15 seconds.

If you can make this alteration, you'll see enhanced results from Skinceuticals A.G.E. Eye Complex.

There is merit in using these two Skinceuticals antioxidant serums together or in alternation, particularly if you have combination skin or a tendency toward uneven skin texture.

Skinceuticals C+AHA contains zinc sulfate and bioflavonoids which are useful antioxidants absent from Skinceuticals CE Ferulic.

The glycolic and lactic acid in Skinceuticals C+AHA are skin-resurfacing agents which also increase the penetration of the Vitamin C for greater antioxidant protection.

Therefore I do not believe Skinceuticals CE Ferulic can be presumed more beneficial than Skinceuticals C+AHA.

If you would like to use both, apply the Skinceuticals C+AHA underneath the Skinceuticals CE Ferulic and reduce your use of Skinceuticals CE Ferulic by half.

To judge the difference in performance accurately, make sure you persist with any skin care changes you make for at least 4 months.

Cellex-C and Skinceuticals were created by some of the same co-operative research dermatologists and chemists (Drs. Sheldon Pinnell, Omar Mostafa, Steven S. Traikovich, Jan Zielinski), with Cellex-C being the original creation.

In the past, the Cellex-C formulations may have provided superior antioxidant protection compared with those of Skinceuticals because they contained more diverse antioxidant combinations, however both manufacturers now feature "broad-spectrum" antioxidants.

Skinceuticals claim their most photoprotective antioxidants are Skinceuticals CE Ferulic and Phloretin CF.

Cellex-C claim their superior antioxidant is Advanced-C Serum.

Further complicating matters, IS Clinical holds that IS Super Serum Advance+ is superior, and Obagi that even one of their 10% Vitamin C serums readily outperforms Skinceuticals' 20% serum.

Cellex-C use tyrosine, zinc and bioflavonoids in all their Vitamin C Serums whereas no Skinceuticals Serums contain tyrosine and only some contain zinc.

The use of tyrosine is protected by a Cellex-C patent.

Medical literature states that when tyrosine is combined with ascorbic acid (Vitamin C) it helps to promote regeneration of new connective tissue through the stimulation of fibroblasts enabling them to make more collagen.

A study co-authored by Skinceuticals' Dr. Sheldon Pinnell holds that zinc is an important and neglected antioxidant for skin.

Interestingly, zinc sulphate was a part of the original Skinceuticals C+E formula but was removed from the "new and improved" Skinceuticals CE Ferulic.

Zinc has been shown to help support increased collagen turnover stimulated by ascorbic acid — it is an essential component of collagenase, which is required to dismantle old, defective and stiffened collagen in order for new collagen to be constructed.

If more types of antioxidants are better than less, it could be that Cellex-C Advanced C Serum is the most optimal antioxidant — it contains five diverse antioxidants (l-ascorbic acid, zinc, resveratrol, pycnogenol and L-ergothioneine) and contains tyrosine, as opposed to Skinceuticals CE Ferulic's three (ascorbic acid, ferulic acid and Vitamin E) without tyrosine or zinc.

My general impression is that Skinceuticals CE Ferulic is less firming and gentler than the original Skinceuticals C+E formula, and also less firming than the current Cellex-C High-Potency Serum or Cellex-C Advanced-C Serum.

However it is not possible to know without comparative studies which is the superior antioxidant.

Skinceuticals CE Ferulic has been shown to provide a remarkable 8x endogenous photoprotection — no studies into the photoprotection offered by Cellex-C Vitamin C Serums have been published.

There are many grounds on which to consider the many skin care brands available.

I do not believe you will ever find a brand which is "best" — I suggest you use more than one brand for greater benefit and reduced cost.

You can also do your own comparative study by using Cellex-C Advanced-C Serum for at least 4 months and then switching to Skinceuticals CE Ferulic for another 4 months.

At minimum, use a good sunscreen during the day and an effective retinoid in the evening, and forego the brand concern.

If you do try either or both, please let us know at Derm Net Discussions — reviews from genuine and informed users would be helpful to all concerned and are lacking despite the heavy use of these products.

Octyl Salicylate is a chemical sunscreen bearing semblance to aspirin (acetylsalicylic acid).

You will need to consult with a dermatologist — the condition you describe gives the impression of being dyshidrotic eczema, a recurrent dermatitis.

Skinceuticals provides superior photoprotective antioxidants and sunscreens, however these have been problematic among patients with extremely sensitive skin.

There are many grounds on which to consider the many skin care brands available.

I do not believe you will ever find a product range which is "best" — I suggest you use more than one brand for greater benefit and reduced cost.

At minimum, use a good sunscreen during the day and an effective retinoid in the evening, and forego the brand concern.

Kinerase is gentler than any prescription retinoid yet still has a considerable beneficial effect on the appearance of wrinkles (also see the Kinerase Results Chart) however it is not a replacement for prescription retinoids if you are able to use them.

Kinerase and Retin-A are compatible whereas some skin care products cannot be used at the same time as retinoids like Renova, therefore you can consider using both to greater effect than either alone.

Kinerase assists healthy barrier function and skin barrier repair, which is compromised by retinoid use.

A vascular laser is the only reliable means by which to treat broken capillaries on the nose.

You can use products containing a combination of ascorbic acid and bioflavonoids such as IS Clinical Pro-Heal Serum and/or products containing caffeine such as RevaleSkin with Coffeeberry, Replenix Serum Caffeine Fortified or La Roche Posay Rosaliac to help reduce redness and, together with sunscreen, to reduce the likelihood of continued breakage.

The visibility of facial "open pores" can be attributed to genetics, unsuitable skin care, environmental factors and stress.

Visibly large open pores are one of the most recalcitrant aesthetic concerns to treat, often requiring a combination of modalities.

I recommend using a facial cleanser or toner containing salicylic acid or lipohydroxy acid once or twice daily, such as Glycolix Gly/Sal 5-2 Cleanser or La Roche-Posay Effaclar Toner Astringent Lotion and a retinoid such as Biomedic Retinol or Skinceuticals Retinol in the evening.

Always use an oil-control sunscreen such as La Roche-Posay Anthelios 60 Ultra-Light Sunscreen Fluid during the day when using products containing salicylic acid, lipohydroxy acid or retinol as part of a solution to reduce the increasing appearance of large pores.

Pleasingly, all these options also reduce and prevent photodamage symptoms.

You may have allergic skin or rosacea.

If the underlying condition(s) causing your redness have been addressed, you can use a moisturizer containing green tint and caffeine to optically counteract redness and reduce irritation.

Two good options include La Roche Posay Rosaliac (which contains added green tint) or Replenix Caffeine-Fortified Serum or Cream (which are naturally green due to their high — c. 90% — concentration of Green Tea).

Apply a mineral make up such as Colorescience or Jane Iredale and set with a soothing/protective thermal spring water spray such as Avene Thermal Spring Water Spray or La Roche Posay Thermal Spring Water.

This combination will allow you to both mask redness and reduce irritation without thick makeup.

Avoid products which aren't intended especially for oily skin — products for combination skin are going to be generally unsuitable.

There are an increasing number of products available for extremely oily skin.

If your skin isn't sensitive, use skin care products containing glycolic acid, salicylic acid and retinol to help reduce excess oiliness.

Obviously you don't want to use a moisturizer.

Add OC Eight Professional Mattifying Gel to your daily skin care.

You can also dust the skin with a sunscreen brush such as Colorescience Sunforgettable or Colorescience Invisibly Matte Finishing Powder to mattify your skin and refresh its sun protection.

He has minimal breakouts and some white heads on his nose.

Biomedic Antibac Acne Wash contains salicylic and lactic acids which work to clear pores of debris, helping prevent and treat whiteheads.

There was once an old sailor my grandfather knew
Who had so many things which he wanted to do
That, whenever he thought it was time to begin,
He couldn't because of the state he was in.

And so in the end he did nothing at all,
But basked on the shingle wrapped up in a shawl.
And I think it was dreadful the way he behaved -
He did nothing but bask until he was saved!

6/10/08 — Skin Care Failure: Do Everything At Once / Never Complete A Single Treatment.

Despite the huge number of products on the market, for most people the potential for effective skin therapy is as limited as ever.

Consumers need to choose products carefully, or not at all, if they want to avoid being duped.

If you're interested in seeing measurable improvements in your skin and "anti-aging" that goes beyond the words on a jar, its worth taking some time to understand some of the reasons why so many products and brands can exist in the face of such poor results and such high prices:

• Large skin care companies, particularly those tied to luxury brands, have more influence over the marketplace than consumers or dermatologists. How do you know the latest cream at the department store/beauty salon is currently the most effective at achieving a particular outcome?
  
  The bottom line: you don't. There's too many products, too much double-talk, and too much pressure to purchase.
  
  
• Countless old, overpriced or otherwise inferior products remain on the market because they're already ubiquitous. Interest in these products is primarily driven by mass media advertisement. They've never been trialled in medical journals or integrated in professional dermatological practice for good reasons, nor will they ever be.
  
  The bottom line: most people never get to experience skin treatment with measurable effects. They're left in the dark.
  

The solution, not surprisingly, is to arm yourself with knowledge and to go the route of accountable channels.

Above all else, avoid any retailer that sells anything and everything they can get their hands on, particularly if they're selling products with very different "brand philosophies."

Pleasantly, there's an upside to the cosmetics manufacturer/cosmetics buyer power imbalance: cost.

Superior products are generally cheaper due to their comparatively miniscule marketing costs.

The downside: a lot of people have already been defrauded by dishonest manufacturers and retailers.

Once bitten, twice shy, they're either unlikely to risk any further experimentation, or continue to willfully waste their skin's future by indulging in gimmicks like oxygen skin care, Paula Begoun, face bras and chirality.

Melbourne Dermatology aims to assist people in avoiding the dreck of skin care.

Putting it another way, regimens of skin care which do not pass these basic standards offer only limited and temporary, cosmetic changes in skin's appearance, and over time encourage and secure the overall permanent deterioration commonly referred to as premature skin aging.

Managed proactively and with a preference for sound formulas grounded in reality, the skin need not age considerably beyond the age of 25.

Effective Skin Care Criteria

Any skin care management and treatment protocol must provide:

1. A means of regularly and non-abrasively removing the useless dead skin cells and wastes which are at the root of many everyday skin complaints. Get rid of compacted dead cells the right way and watch your skin start to thrive. Just as regularly mowing a lawn helps prevent irregular grass growth (coarse texture, wrinkles), colour (hyperpigmentation, freckles, age spots), uneven wetting (dry skin, oily skin) and weeds (open pores, blackheads, acne), appropriate, effective exfoliation and cleansing are the opening tenets of all meaningful skin maintenance, treatment or rejuvenation protocols.
   
   
2. A means of enhancing the skin's declined functions, if any. By the time most people seek treatment, they will require skin firming, immunity re-building or otherwise stimulating topicals to help revert their skin to more youthful behaviour. Women now also have the option of topical skin care which replaces declining levels of female hormones.
   
   
3. A means of protecting the skin's functions which are presently trouble-free, and protecting the progress and health of those which are being rebuilt. This refers in the first instance to antioxidant and true broad spectrum sunscreen usage at all times of the year during the day, but also to the avoidance of skin care products not derived from an understanding of cellular functioning. The body seeks to eliminate non-native ingredients because they are at odds with its chemisty and this process is associated with aging and allergic reactions, be they outwardly visible or not.
   
   
4. Twice daily maintenance. Just like brushing teeth only once a day still leads to cavities, skin care and treatment protocols which are haphazardly followed produce extremely limited results. In fact, some anti-aging and skin resurfacing programs will produce adverse results if not followed correctly.

All four elements must be used in concert.