DON’T LET AGE SPOTS SHOW YOUR AGE: Leading dermatologist Joshua Fox on removing dark spots, making skin look younger. 

Roslyn, NY, April 2010 - Everyone knows it. Age spots on our skin make us appear many years older than our true ages. Today, dermatologist Joshua Fox, M.D., says there are many treatments available to reduce or remove these age spots, helping us to look years younger.
 
Age spots are flat, light or dark brown marks that develop on the skin as we age. They appear mainly on areas exposed most to the sun, including the face, hands, shoulders and arms. Dr. Fox says that age spots, more correctly called lentigines, are caused by overexposure to the sun, which damages skin. Often, once you start to see age spots, he says, you’ll also see other signs of sun damage including deep wrinkles, dry rough skin, fine red veins and thinner, more translucent-looking skin.
 
Typically considered to affect people over age 40, younger people who spend a great deal of time in the sun may see age spots too.  While true age spots are harmless, they may resemble cancerous growths, says Dr. Fox. For that reason, “if you start to see age spots on your skin, ask your dermatologist to look at them to make sure they are not suspicious,” adds Dr. Fox.
 
“If you notice any new mark on your skin, or if an existing mark has any changes in color or shape, your doctor will determine if it is cancerous or something to be concerned about,” Dr. Fox says. He explains that melanoma is the most dangerous of all skin cancer types, resulting in over 80,000 cases per year. The good news, he adds, is that “most brown spots are not harmful and can be removed or easily treated to improve the skin’s appearance and make you look younger.”
 
“Once your doctor has ruled out skin cancer, there are several different home remedies and in-office treatments that can help reduce or remove the age spots,” Dr. Fox says. 
 
Once age spots have developed, Dr. Fox says, they can attempt to be lightened safely with skin-bleaching lotions and creams that can be purchased in department stores, drug stores and online. However, Dr. Fox adds that this typically only results in a small improvement. Successful treatment needs to penetrate the topmost layer of skin where the extra pigment is located, so the products must be used regularly over several weeks or months before noticeable results occur. When choosing a nonprescription fade cream, choose one that contains hydroquinone, deoxyarbutin, glycolic acid or kojic acid.
 
“If these over-the-counter products don’t do enough to reduce the spots, and Dr. Fox adds that most people do not get satisfactory results from these lotions and creams, your dermatologist has an arsenal of other treatments that do a great job of reducing or removing age spots,” Dr. Fox says, listing the top six in-office treatments.
 
Prescription creams. Bleaching creams containing hydroquinone, used alone or with retinoids and a mild steroid, when used regularly, may partially fade age spots over time.
 
Q-Switched Lasers. Laser treatments performed in your dermatologist’s office can remove sun spots, brown spots and liver spots. These treatments work by being very specific for brown color and selectively removing the lesions.
 
Microdermabrasion. In this procedure, the skin is sanded with a special instrument to lessen the age spot. This procedure helps to strengthen and rejuvenate aging skin, and may even help reduce fine lines and wrinkles.
 
Cryosurgery. This procedure uses liquid nitrogen to freeze skin tissue and remove age spots.
 
Chemical Peel. Chemical peels are a powerful treatment that not only help reduce and remove age spots, but can also strengthen the skin to boost collagen production. A chemical peel involves applying an acid, which burns the outer layer of your skin. As the skin peels, new skin forms to take its place.
 
Laser Skin Rejuvenation. Fraxel and Pixel. A popular cosmetic treatment, Fraxel is a powerful resurfacing laser treatment that smoothes and rejuvenates the skin, removes age spots and reduces the appearance of fine lines. Pixel is a more powerful resurfacing laser which also treats some of the deeper lines.
 
Dr. Fox adds that “prevention, or reducing exposure to the sun, is the best way to reduce the likelihood of getting age spots. Wear sunscreen all the time on all areas of exposed skin, no matter what the weather or season. If you must be in the sun, even in winter, use a broad-spectrum sunscreen (which blocks both UVA and UVB rays) with an SPF of at least 15.”
 
“While aging does cause a host of changes to our bodies, our skin doesn’t have to make us look or feel old,” says Dr. Fox.  “A consultation with your dermatologist can help you identify the right treatment for you that will reduce or even remove age spots and leave you feeling and looking younger,” adds Dr. Fox.

Conquering Oily Skin
by Eva Chen January 04, 2010

A new study from Germany found that oily skin is both “emotionally and socially disruptive.” Well, duh! I could’ve told you that from experience with oily skin as a teen! Here, some tips from Joshua Fox, MD, a dermatologist and spokesperson for the American Academy of Dermatology.

“Oily skin can usually be managed by adding just a few simple steps to one’s daily skincare regimen. The good news is that despite popular opinion, diet has little, if anything, to do with whether or not you have oily skin. In oily skin, the sebaceous glands, located deep within the skin, produce too much oil, especially on the face, neck, chest, head and back. While some oil is needed for the health of your skin and hair, too much oil can make skin and hair look greasy and dirty; it makes pores look large, and promotes pimples, blackheads and other blemishes. Oil production can be stimulated by hormones, so anything that causes hormones to fluctuate can cause skin to become more oily. Humidity, hot weather, sun, exercise and other environmental conditions, and even some cosmetics, can make things worse. My recommendations:

Use only water-based or oil-free cosmetics

Use only products designed for oily skin.

Consider using different cleansers during the summer and winter. Hot, humid weather requires a heavier cleanser, while cool dry air calls for a moisturizing product.

Consider prescription and non prescription astringents, face washes, masks and other degreasing agents which can help.

Use a glycolic or salicylic acid product with a light oil-free moisturizer containing a sunscreen.”

Dimming the Shine on Oily Skin
Leading Dermatologist on reducing oil, helping skin feel fresh and young

Roslyn, New York, December 2009 - Most participants in a recent series of American and German focus groups said their oily facial skin was both emotionally and socially disruptive, making them feel unattractive, self conscious, embarrassed, irritated and frustrated. The results of the focus group study were reported in the October 2008 of Health and Quality of Life Outcomes.

Up to 75 percent of teenagers and many older adults say they have oily skin, a common condition affecting both men and women, typically between puberty and about 60 years of age. But despite its prevalence, says Joshua Fox, M.D., a leading dermatologist, founder of Advanced Dermatology PC, and a spokesperson for the American Academy of Dermatology, “oily skin can usually be managed by adding just a few simple steps to one’s daily skincare regimen.”
 
According to the National Institutes of Health, genetics and hormones are the key factors contributing to oily skin. “The good news,” Dr. Fox says, “is that despite popular opinion, diet has little, if anything, to do with whether or not you have oily skin.” He explains that in oily skin, the sebaceous glands, located deep within the skin, produce too much oil, especially on the face, neck, chest, head and back. “While some oil is needed for the health of your skin and hair, too much oil can make skin and hair look greasy and dirty; it makes pores look large, and promotes pimples, blackheads and other blemishes.”

“Oil production can be stimulated by hormones, so anything that causes hormones to fluctuate can cause skin to become more oily,” Dr. Fox says, adding that for women, that means that more oil tends to be produced during puberty, at the start of each menstrual cycle and during pregnancy and perimenopause.  In addition, oil production in men or women can be stimulated by any physical or emotional situation that causes hormone swings.

“Separately, humidity, hot weather, sun, exercise and other environmental conditions, and even some cosmetics, can make things worse,” he says.  Dr. Fox says there are several basic steps people with oily skin should do daily to help reduce the shine, grease and discomfort caused by oily skin.

1.     “Make sure to keep your skin clean. Dr. Fox recommends using warm water and gentle soap or a non-soap cleanser no more than twice a day.
Use only water-based or oil-free cosmetics (noncomidogenic)
3.     Use only products designed for oily skin.
4.     Consider using different cleansers during the summer and winter. Hot, humid weather requires a heavier cleanser, while cool dry air calls for a moisturizing product.
5.     Consider prescription and non prescription astringents, face washes, masks and other degreasing agents which can help.

If these simple steps don’t provide the results you seek, Dr. Fox suggests using a glycolic or salicylic acid product with a light oil-free moisturizer containing a sunscreen. “For even more dramatic results, anyone suffering from oily skin should visit his or her dermatologist, who knows their specific skin and its challenges and can create a personalized skincare plan to reduce oil and maintain healthy-looking skin,” Dr. Fox says.  “A dermatologist can also offer you topical or oral prescription treatments such as Retin A, Differin, Tazorac, Benzoyl Peroxide or Accutane that help reduce the oil or can provide laser treatments for especially stubborn oily skin which shrinks the sebaceous glands.”

Skin Science

Which Age-Defying Method Is Right for You?

By Teri Brown

June 2008

New anti-aging techniques are allowing women to look younger for far longer than ever before. Botox, Restylane, Thermage, Microdermabrasion and a host of new laser methods mean women everywhere are taking advantage of the latest in age-defying techniques.

The downside to this explosion in skin science is the confusion it can bring to those of us who need it most. Which techniques should we use? We don’t want to spend money on Thermage when a round of facials would do the trick. Why waste time on Botox if lasers would be better? The following information will lead you through the maze of anti-aging techniques and help you make informed decisions.

 Thermage

Perhaps nothing has created as much excitement in the world of skin care as Thermage. This technique uses radio waves dispensed through a pen-like instrument in a grid formation over the face. The heat from radio frequencies tightens or lifts the skin, removing or reducing wrinkles and other fine lines in the skin as well as producing new collagen. The procedure takes about half of a day, and although many patients report a pinching sensation, there is very little real pain.

Dr. Joshua Fox, director of advanced dermatology at the Center for Laser and Cosmetic Surgery in New York City, N.Y., believes Thermage can be used on almost all areas of the face. “Thermage treatment was approved for wrinkle treatment around the eyes, yet we are finding that it offers even better results in other areas such as around the jaw, nasal labia folds, neck and chin areas,” says Dr. Fox.

Thermage isn’t for everyone, though. It works best for people in their 30s, 40s or 50s, who have some areas with wrinkles or sagging skin. It does not work as well for people who have advanced wrinkling or sun-damaged skin.

The results last between one and two years, and though costs vary, you can expect to pay about $2,000 for the procedure.

Laser resurfacing is performed using a beam of laser energy that vaporizes the upper layers of damaged skin with controlled levels of penetration. As your skin heals, new cells are formed and tighter, younger looking skin is the result.

“There are two major types of lasers used in resurfacing: ablative and non-ablative,” says Dr. Fox. Ablative lasers include the Carbon Dioxide Laser and the Erbium, both of which remove the top layers of skin, tightening and remodeling the collagen. Dr. Fox says this improves the appearance of wrinkles, fine lines and to a lesser degree scars and sun damaged skin. There is approximately 70 to 80 percent improvement per treatment.

Non-ablative procedures, such as CoolTouch or Intense Pulsed Light, do not provide as much improvement, but usually there is not any down time. The non-ablative methods provide approximately 10 percent improvement per treatment.

When Monica Fedri, from Sherwood, Ore., wanted a laser treatment that would take care of her acne scarring, she chose a non-ablative method. Like many women, she needed something that would give her the results she desired, yet still allow her to return to work. “I had to wear a hat to protect my skin from the light, but the redness only lasted the day of the treatment,” says Fedri. “I was able to go right to work afterwards.”

According to Dr. Fox, some of the latest laser techniques combine both the Erbium and Carbon Dioxide lasers for better results. 

Botox successfully treats severe frown lines, because when it is injected into the muscle group surrounding the brow area, those muscles cannot scrunch up for a certain period of time. The injections last from three to eight months.

Restylane, Radiance, Cosmoderm and More

‘Dr. Cheryl S. Citron, dermatologist and former president of the New Jersey Dermatology Society, believes that fillers are perfect for women on the go. “The pervasive trend is toward the less-invasive procedures with decreased down time,” says Dr. Citron. “Working men and women can not afford the time at home hiding from the outside for days after a surgical procedure, so the less invasive options are much more appealing.”

“Since it is not made from animal products, we do not have to worry about allergic reactions,” says Dr. Citron. “It is used as a soft tissue filler, for the nasolabial lines and around the mouth.”

Fillers generally don’t take long to inject, and the results generally last from three to five months. Some of the fillers mentioned are not yet FDA approved, but are available at doctors’ offices.

Dermatologists aren’t the only ones dealing with an industry exploding with new techniques. Aestheticians are now required to be both scientists and engineers as they utilize the newest potions and gadgets. Spas, such as the exclusive Belle Visage Day Spa in Studio City, Calif., are now offering facials that use both leading edge machines and the traditional creams and lotions.

The new ultrasound machines increase blood circulation and strengthen facial muscles. They can also reduce puffiness by draining excess fluid. These machines, used in conjunction with other techniques, can bring about amazing results.

Erica Trojan, a licensed clinical aesthetician from Wilmette, Ill., employs several different techniques in her practice. She is most known for her “medical facial” that uses different peels to exfoliate dead skin. Peeling is a method of taking off the top layers of skin to produce more of the necessary proteins that characterize younger skin. “It is multi-step and involves three different methods of exfoliation: an enzyme peel, a mechanical peel and a chemical peel,” says Trojan.

Enzyme and chemical peels vary in their aggressiveness. Enzyme peels use natural enzymes and herbs for a gentle peel that causes light exfoliation. You can buy and use these at home. Chemical peels are more aggressive and should be administered by a licensed aesthetician or dermatologist.

Mechanical peels can include Dermaplaning and Microdermabrasion. Dermaplaning uses a planing tool that gently scrapes away dead and inactive layers of epidermal tissue. Microdermabrasion involves a dual suction/polishing technology using crystals and suction to mechanically exfoliate tissue. Like peeling, both Dermaplaning and Microdermabrasion reveal new skin and can remove spots and blotchy patches.

Today’s anti-aging techniques are more diverse and more effective than ever before. With so many choices, women are sure to find a variety of methods that fit their lifestyles.

Coming Soon to a Salon Near You

Skin Care in Your 40s