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So which retinoid is the best for you?

You constantly hear that vitamin A is the go-to ingredient for fighting fine lines and wrinkles, dark spots and clearing up skin.  We would certainly agree, but with all the products containing variations of vitamin A, prescription and non-prescription, it's easy to get confused about which is right for you. Retinoids, retinol, retinoic acid, Retin-A, Renova, and Tazorac (and the list goes on) are all forms of vitamin A or contain derivatives of this nutrient found naturally in the skin, but what's the difference between them all?  Read on for a crash course in retinol to clear up this common confusion.

First, let’s start with retinoids, which is the general, all-encompassing term for a class of chemical compounds related to vitamin A.  Retinoids are used in various skin and beauty related products and treatments to address issues from acne to wrinkles. Retinoic acid, which is the main active ingredient of the prescription drugs Retin-A, Renova and Tazorac, is the real star when it comes to treating acne and aging skin.

Now on to retinol, which is a type of retinoid that is usually found in non-prescription wrinkle creams. Retinol found in many over the counter skin-care products can convert retinoic acid, but the operative word is can. The conversion is not predictable, so just because a product contains retinol, it doesn't mean that it can or will do what retinoic acid can do in terms of acne or even as a wrinkle treatment.  The most important factors that determine this are: how the formula is made, the percentage used, how it’s delivered into the skin, and how stable it is.  Good brands and formulations you can trust are available which is why when it comes to this ingredient you want to purchase a product from a physician or knowledgeable skincare professional.  

So which retinoid is the best for you? That depends on your concerns and your type of skin.  The skin's reaction is determined by the chemical variations and molecular structure of the retinoid product.  Generally prescription formulas are best for treating acne and suited for oily, tolerant skin.  Skin sensitivity is a major factor.  If you ARE sensitive the prescription is not best for you. Most people do have a certain degree of skin sensitivity which is why its can be a good idea to start with a non-prescription retinol first, eventually transitioning to using a prescription.  With that said, if you have any of the following conditions: 

  • Comedonal acne – This is the type of acne that appears as whiteheads, blackheads, closed comedones and clogged non-inflamed bumps.  Retinoids restore the organization of cells through cell turnover, in turn, preventing cells from getting trapped and blocked in the pore lining which is what causes those little non-infected bumps. 
  • Premature aging -  Someone over age 35 with a long history of sun damage (hello Florida sun!).  You may feel like your skin shows more visible signs of aging than other people your age.
  • Scarring – Someone who, regardless of age, has pitted, indented facial scarring from acne in your younger years
  • Melasma – Dark brown spots or patches from the sun, heat, pregnancy or hormones will benefit from something stronger to work deeper and faster.  However keep in mind that retinoids will make your skin more sensitive to the sun so daily sunscreen with diligent reapplication if very important.  Also, expectant mothers should avoid any Vitamin A products during pregnancy. 

Skip a prescription and go straight to a retinol if you’re:

  • Some one who, regardless of age, has thin, dry and or sensitive skin.  This includes rosacea, a history of eczema or simply easily irritated skin types.  While most skin’s will develop a tolerance to retinoids with continued use, these skin types may never adjust to a prescription due to the skins easily compromised, delicate barrier.
  • Someone under age 35 with no major acne issues who would like to prevent wrinkles, lighten discoloration, reduce pore size and smooth texture.  Sticking with retinol and occasional peels is perfect because you’re getting ahead of the aging process. There’s not as much repair work to do in those younger than 35.
  • Someone over the age of 35 who is interested in trying retinol for the first time and wants to start slowly. 

We have addressed the what and who, but when and how should retinol be used?  While the exact age can vary depending on skin type, typically between the ages of 26-30 is a good time to start using retinol to prevent the appearance of lines and wrinkles.   Vitamin A can speed up the skin’s turnover which begins to slow in your early 30’s.  When you’re younger your skin is already very metabolically active.  Using retinol too early might actually stir up breakouts, rashes and more by disrupting the skin’s natural balance.  As for how to use it, I typically recommend starting by using a thin layer on clean, dry skin, 2-3 times per week gauging your sensitivity and working up to 5 nights a week. If you’re experiencing dryness or irritation you may be using too much or using it too often, remember, using retinol successfully is a marathon, not a sprint. Avoid applying moisturizer immediately after application of your retinol, which could dilute it slightly.  While that can sometimes aid in tolerability, it’s generally best to let it absorb for 20 minutes before continuing with your regimen.   Retinol in and of itself is photosensitive, breaking down when exposed to sunlight in addition to increasing your skin's sensitivity to harmful UV rays, so the general rule with retinoids is to use them at night.

At Paradise Dermatology we offer a formula called Retinol Complete which is encapsulated and time-released and formulated with antioxidants, so it not only boosts skin’s radiance but also enhances it overall condition! Whether you are a newbie or a veteran, it’s a good idea to examine your retinol options and make sure you are using the best formula for you in the correct way for optimal results!  Please visit us for a 15-minute complementary consultation so we can assess your specific concerns and needs and set you on the right retinol path. 

Could Microneedling be your favorite cosmetic treatment?

Microneedling is a minimally invasive treatment in which tiny punctures are created in the skin using micro-fine needles (from 0.5 to 2 millimeters in diameter). This treatment triggers the body’s natural wound healing process, resulting in cell turnover and stimulating collagen and elastin production, reversing as well as preventing signs of aging. Though the treatment is appropriate for many different skin types, it is important to let a professional decide whether or not it’s right for you. Some skin conditions such as active acne and pustular rosacea as well as illnesses that involve issues with wound healing are contraindicated. With that said, whether your skin has texture to it due to large pores, acne scars or fine lines or you’re looking for a rejuvenating anti-aging boost, this treatment is ideal. We’ve seen some great results with melasma, a type of hyperpigmentation commonly seen in women that can be due to hormonal influences when microneedling treatments were used in conjunction with topical medications at home.

We have received great feedback regarding the results of this treatment! Here’s what one of our patients said about microneedling and melasma…”Microneedling has been my favorite cosmetic treatment. I have struggled with melasma for years. After only 2 treatments, I saw results. Not only did it help with the melasma, but it has also made my skin tone and texture amazing.” Microneedling is a great alternative to laser for patients who aren’t candidates for laser treatments or a great adjunct therapy as maintenance. Here’s what another Paradise patient had to say…”This is the only treatment that has given my skin immediate, visible results. Now after three treatments, I have improvement in the fine lines around my eyes and in the brown sun damaged spots on my cheeks. The biggest change was to the overall texture of my skin- it looks and feels significantly smoother. And my skin continues to improve. I am hooked!”

While results vary from person to person, improvement can be seen as soon as 2 weeks after the procedure with results continuing up to 8 months post-procedure as collagen is produced cyclically and builds up over time. We generally see marked improvement around 4-6 weeks after the second treatment and recommend at least 2 and up to 6 sessions. At Paradise Dermatology we offer individual microneedling sessions starting at 250.00 but also have a package of 3 available, which offers a per treatment savings. Human growth hormone and topical post procedure serums are available to maximize your results. You may have heard of microneedling referred to as the “vampire facial”. While we do bring the skin to pinpoint bleed, the procedure itself is very comfortable, as your skin will be numbed topically. You might experience a bit of redness immediately following the treatment and some dryness and tightness for a few days following, but once it subsides, you’ll notice a dewy, glowy complexion and a new plumpness to your skin! Check out our spring microneedling special and try this amazing treatment today.

What Happens to Your Skin During Pregnancy

A GUIDE TO SKINCARE DURING PREGNANCY

Pregnancy can be a time of excitement and happiness but also uncertainty, especially when it comes to skincare. Nowadays there are a multitude of sources for information on how to keep mom healthy and baby safe from books to magazine articles and of course the internet. While useful, after all knowledge is power, sometimes it can be overwhelming, confusing and even misleading. So you’ve heard of that pregnancy glow but skin conditions such as acne, heightened sensitivity and pigment issues are concerns that plague many. The struggle is real, mamas! To help you navigate the beauty minefield that pregnancy presents, here's an overview of what happens to your skin and how best to treat it.

The problem: The mask of pregnancy

Coupled with increased photosensitivity, you can experience a surge in pigment-stimulating hormones while pregnant and these can contribute to melasma – large patches of discoloration appearing on the face. While some of the tried and true solutions for pigment issues such as laser and chemical peels should be avoided as well as the skin lightening ingredient hydroquinone, topical vitamin C is an excellent alternative. Vitamin C delivers more than just brightening benefits. It plays crucial role in collagen production and acts as an antioxidant, protecting cells from free radical damage. Our Revision Vitamin C 30% lotion will give your skin a glow pregnant or not! It's also extra important to be sun-safe during pregnancy. Broad spectrum physical sunscreens that block both UVA and UVB rays are great to protect without chemicals that absorb into the skin and cause irritation. One of my favorites is EltaMD’s UV Pure is good for both face and body, offers SPF 47 and is water resistant. We also carry Elta’s UV Physical, a tinted version for the face.

The problem: Hormonal Acne

With fluctuating hormone levels, an increase in oil production and anxiety added into the mix, many women break out during pregnancy, especially around the chin, jawline and cheeks. While you may want to stay away from traditional acne remedies containing benzoyl peroxide, retinol and salicylic acid, alpha hydroxy acids such as glycolic and lactic acids as well as natural enzymes can be well tolerated and have been shown to be safe. Facial treatments at Paradise Dermatology are personalized to treat your skin safely and effectively while providing relaxation and rest. Products like EltaMD Foaming Facial Cleanser, a gentle cleanser that foams to loosen makeup, oil, and other impurities on the skin and in the pores, and Avene Skincare’s Clean-AC cream work to clean, soothe and hydrate the skin without causing additional breakouts.

The Problem: Heightened sensitivity

Hormonal Changes in pregnancy can also increase skin sensitivities, making you more sun sensitive and exacerbating skin conditions such as eczema and rosacea. Additionally, when pregnant the volume of blood in the body increases often tipping that healthy glow into redness. Using a product such as Colorescience All Calm, a chemical free mineral SPF 50 with soothing agents to calm skim and a tinted redness-neutralizing base gives you several solutions in one easy step. Simplicity and efficiency is essential for busy moms! In the office, calming treatments that include LED light therapy and facial lymphatic massage work wonders to relax your skin and you too!

The Problem: Drier Skin

While hormonal changes cause some women’s skin to become oiler, for others dryness can occur. Also, credit a loss of bodily fluids which are traveling from you to baby and your skin can become more reptilian than radiant. Besides drinking plenty of water, using a hyaluronic acid serum such as Revision’s Hydrating Serum can help your skin retain moisture. HydraFacial treatments can be customized for expectant and nursing moms to give skin a major hydrating boost.

INGREDIENTS TO AVOID

While you might find many ingredients that can be used safely during pregnancy, there are various ingredients – both natural and synthetic- that are completely advised against during pregnancy and nursing. Below is a list and where you might find them.

  • Prescription Medication – Most prescription topicals are not safe during pregnancy and possibly nursing. Check with your medical provider.
  • Vitamin A/Retinol – All retinod products should be avoided during pregnancy as some studies have linked them to birth and child defects.
  • Phthalates/formaldehyde/toluene – Look out for these chemicals in perfume and nail polishes as they have been linked to hormonal disruption in some studies. With limited data, adverse effects on the fetus cannot be ruled out.
  • Ammonia – Found in some hair dyes. Your colorist should be able to advise you on ammonia-free options and at what point it is safe to color your hair.
  • Dihydroxyacetone (DHA) – DHA is the active ingredient in self tanning products. While it is considered safe by some to use self tanning creams or lotions, scientists are still unclear as to how much absorption of this ingredient is possible through the skin. It is best to avoid spray tanning as inhalation is a concern. Since the effects of DHA on the pregnancy are not known and it has not been proven safe during pregnancy, it’s a good idea to steer clear.
  • Certain Essential Oils – There are many natural and organic products that are gentle and have wonderful benefits for you skin during pregnancy, however certain essential oils should be avoided as they can encourage uterine contractions, adversely affect your baby in its early developmental stages and decrease milk production. Diffusing oils aromatically is a safe way to enjoy their therapeutic benefits during pregnancy.

If you are expecting a new little bundle in your life, congratulations and good luck! My best advice is to relax and enjoy the ride. As a mother of 2, I can vouch for the old saying that in parenthood…the days are long, but the years are short.

 

 

GLYCOLIC VS. SALICYLIC ACIDS - WHICH ONE IS RIGHT FOR YOU?

Any time we start discussing the best ways to exfoliate the skin, it’s not long before the ingredients glycolic acid and salicylic acid come up. Glycolic acid is an AHA, or alpha-hydroxy acid, and salicylic acid is a BHA, or beta-hydroxy acid. Both of them work extremely well at making skin look more even, brighter and refreshed.

But which one is right for your skin?

Both ingredients work as chemical exfoliators that loosen the “glue-like” substance that holds our skin cells together.  This allows dead skin cells to slough off more easily revealing smoother, healthier skin and keeping pores from becoming blocked.

How they work varies a bit though, that’s why the decision to use glycolic acid versus salicylic acid really depends on what type of skin you have…

Because glycolic acid is the AHA with the smallest molecule, it penetrates the skin more deeply and easily than other acids. That means it is more effective at the things we need it to do like exfoliate, improve fine lines and stimulate the production of collagen and elastin. Glycolic acid is best for sun-damaged, mature, and dry skin…helping to reduce the signs of premature aging and rejuvenating the skin but it can also be an effective acne treatment. Because it releases and dissolves blackheads and minimizing the appearance of pores, it can also be an effective acne treatment, It works particularly well on cystic acne, which is caused by deep blockages of dead skin and sebum.

On the other end of the spectrum, salicylic acid is better for those with oily, acne-prone skin or those with sensitive skin.

The reason is, salicylic acid gets through oil that clogs pores. It is the only acid that can penetrate oil, because it is fat-soluble. All other acids are water-soluble. Thanks to this property, it can reach *inside* a pore and exfoliate the lining of the pore wall. This loosens and allows the contents of the pore to flow out more freely. It not only clears existing blackheads but also prevents new ones from forming, improving the lining of larger pores that can be more prone to acne.  Another plus, this acid has anti-inflammatory and mildly anti-bacterial action – both of which are great for oily, acneic skin. All-in-all, salicylic acid is a great exfoliator that can improve skin thickness, improve barrier function and stimulate collagen production.

There are a range of over the counter products available. Cleansers can be left on for a few minutes and washed off so they are great for sensitive skins while wipes, toners and lotions that can be left on all day or night yield excellent results with consistent use. The newest additions to our product selection are Paradise Dermatology Acne Wash and Acne Pads. Formulated with 5% glycolic and 2% salicyclic acid, these products are an effective and affordable solution for tween, adolescent and adult patients. We’ve already gotten some great feedback from patients!

Hopefully now you have a better idea of which of these acids is right for your skin. Whichever you choose to use, the key to optimizing skin health is seeing a skin care professional. By combining a customized at-home regimen with powerful in office treatments and targeted solutions, the result is healthier, skin with visible improvement in acne, congestion, fine lines, wrinkles and other signs of aging.

Lilys Shelfie with logo

My current am routine is Revision Vitamin C 30% lotion with intellishade original over it. That gives me sun protection, a little bit of coverage and a healthy glow. I use the colorescience corrector kit ( I use the brush provided in the kit and a larger fluffier one to conceal and contour). My last step is a spray toner to set it and lip balm. I love the Colorescience SPF 50 powder for my neck and chest which gives me coverage and doesn't get all over my necklace or my clothes.

I love to dermaplane my skin monthly and apply an oil like NIA 24 Treatment Catalyst. Also love doing weekly treatment masks like Revision's Black Mask to purify my skin or Eminence Organics HOT Blueberry Detox mask which exfoliates and stimulates major circulation.

I try to massage coconut oil with essential oils (typically rosemary) on my scalp monthly to condition it and promote hair growth. It smells so good!

Eye creams from NeoCutis, NIA24 help soften fine lines and wrinkles and brighten my eye area.

Ice is a quick and totally cheap way to reduce puffiness and wake up your face. I ice my face all the time! When you have a headache applying it to your neck at the base of your skull relieves pain so miraculously!!

Preventing Hyperpigmentation

While living in paradise has its advantages, most of us struggle with the effects of the hot, sunny climate and the Florida lifestyle on our skin. A common issue facing most people is hyperpigmentation. This is because hyperpigmentation is most often caused by UV exposure.

Hyperpigmentation is a usually harmless condition in which patches of skin become darker in color than the normal surrounding skin. This darkening occurs when an excess of melanin, the brown pigment that produces normal skin color, forms deposits in the skin. UV stimulates the pigment cells (melanocytes) in our epidermis to start making melanin. Sadly, most of the hyperpigmentation you have now you probably actually earned 20 years ago. It takes an average of 10 years for sun damage to translate into brown spots and it’s just being encouraged and worsened by current UV exposure.

There are other causes worth mentioning, including heat, hormones and injury or trauma to the skin known as post inflammatory hyperpigmentation (PIH). While these can and usually do have other contributing factors all types of hyperpigmentation will benefit from following the steps below to manage and improve the condition.

  1. PROTECTION: It’s absolutely imperative to protect your skin from UV rays. When staying out of peak sun is not an option, wear hats and sun protective clothing and wear a broad-spectrum sunscreen that protects from UVA and UVB. Today there are a wide variety of formulations from clear to tinted lotions, powders, water resistant formulas, natural sun blocks and sprays. One of my favorite products is Colorescience Sunforgettable SPF 50, a brush on mineral powder that makes reapplication super easy. Remember sunscreens only last a couple of hours!
  2. ACTIVE TOPICALS WITH NATURAL LIGHTENERS: Skin-brightening products use antioxidant vitamins and plant based extracts that not only improve hyperpigmentation but also deliver anti-aging benefits and boost skin function and health. Look for ingredients such as Vitamin C, licorice root, kojic acid, bearberry extract (alpha arbutin) and Niacinimide that work by inhibiting tyrosinase, the enzyme responsible for the formation of skin darkening melanin and/or lightening skin. Nia 24 Sun Damage Repair for Décolletage and Hands contains Pro-Niacin (Vitamin B3) and a plant based brightening complex to visibly improve the appearance of sun damage on the chest, shoulders, hands and arms. As for Vitamin C, don’t miss Revision’s 30% Vitamin C lotion! It’s one of our most popular products.
  3. VISIT AN AESTHETICIAN: In office treatments such as HydraFacial, Dermaplane and Microneedling are excellent for lightening, brightening and tightening your skin as well as improving the penetration of your products. Come in for a complementary cosmetic consultation to talk about the best options available for your skin or take advantage of our 95.00 SUMMER HydraFacial Special and enjoy an amazing treatment while we analyze and get to know your skin.
  4. SEE A MEDICAL PROFESSIONAL REGULARLY: Your using a high quality Vitamin C, skin brightening and hydrating ingredients, and enjoying regular skin treatments and your skin’s appearance has really improved but you’re still dealing with stubborn discoloration. High potency lighteners such as Hydroquinone can be prescribed for maximum benefit. Paradise Dermatology Rebritaylize Pads are compounded in the office in 2%, 4% and 6% formulations. Advanced treatment such as laser is non-invasive and over the course of several sessions gives excellent results! Annual skin checks are a good idea for everyone and if in doubt it’s always best to check it out with a medical professional.
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